PCOS- Shady Grove Push for IVF

[Anonymous]

I was diagnosed with PCOS when trying for my first at 26. We did all the testing with a RE, and ended up naturally pregnant that same cycle. We’ve been trying for two years for a second (we are now 30) and with my new insurance shady grove is in network. We had our consultation and she said I must be ovulating since I get a regular cycle and positive opk, my 9 day luteal phase is an afterthought, and I’m unexplained with a 2-3% chance of conceiving naturally. I’ll have a 10% chance with an IUI(we did two clomid/TI cycles last summer unsuccessfully) and 50% chance with IVF. She pushed for IVF. Doesn’t that seem odd for PCOS in a 30 year old? My last re (who since moved to Richmond) felt PCOS gave false positives. This lady damn near guaranteed I’m ovulating and unexplained.

Has anyone gotten pregnant naturally with PCOS (I did with dd) and what did you do or change? I’ve tried metformin er but it makes me sick as hell as in I cannot function sick.

[Anonymous]

I don’t think it’s odd. Honestly I wouldn’t waste time with an IUI. You already tried once. IUI still involves drugs, money and time. Go for IVF and hopefully you’ll get your baby. I skipped IUI all together and glad I did as the first IVF attempt worked.

[Anonymous]

Anonymous wrote:I don’t think it’s odd. Honestly I wouldn’t waste time with an IUI. You already tried once. IUI still involves drugs, money and time. Go for IVF and hopefully you’ll get your baby. I skipped IUI all together and glad I did as the first IVF attempt worked.

Op here, I’ve never had an iui. I did two cycles of clomid and timed intercouse.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don’t think it’s odd. Honestly I wouldn’t waste time with an IUI. You already tried once. IUI still involves drugs, money and time. Go for IVF and hopefully you’ll get your baby. I skipped IUI all together and glad I did as the first IVF attempt worked.

Op here, I’ve never had an iui. I did two cycles of clomid and timed intercouse.

Okay. Well personally I’d choose the option with the highest chance of success. It’s not IUI.

[Anonymous]

After 2 years of trying, IVF does seem like the way to go. For the record, we tried for 4 years (including 4 iui)before going to IVF. Pregnant first cycle. Only issue was Pcos and I wish we hadn’t waited. I was 26 when we started. 30 when pregnant.

[Anonymous]

Anonymous wrote:After 2 years of trying, IVF does seem like the way to go. For the record, we tried for 4 years (including 4 iui)before going to IVF. Pregnant first cycle. Only issue was Pcos and I wish we hadn’t waited. I was 26 when we started. 30 when pregnant.

This +1. Just go straight for what has the best chance of working. You’re most likely to only spend more money and time on IUI. After pregnancy, IVF won’t seem like that much of a deal anyway.

[Anonymous]

There's a lot of speculation that there is an egg quality issue with PCOS. So even if you are ovulating regularly, you still may not have the best odds of conception (which if you've been trying for 2 years, seems likely.) IVF helps to separate the higher quality eggs from the lower quality because the lower may not fertilize or make it to day 5.

I ovulated regularly with PCOS and couldn't get pregnant. I decided IUI was a complete waste of time.

[Anonymous]

Whoa, kind of surprised to see all this advice. I feel like it would make sense to try a few letrozole (which should help with egg quality / strength of ovulation) + IUI cycles first, no? I mean, unless you're just DONE with trying and want the fastest possible route towards the highest chance of success - then, yes, IVF. But you're only 30 and you've had a kid before...

Are you overweight? Are you watching your blood sugar? If you want to try a few more rounds before jumping to IVF, I think that makes sense...but would add letrozole (followed by injectables). I would also, based on things I've read, give metformin another go

[Anonymous]

If you want to try IUI with letrozole, go ahead. But, no, I don't think the recommendation to go to IVF is that odd. I have PCOS. We did 6 IUI cycles with either letrozole or clomid. We had another 7 or 8 cycles (unmonitored) of TI where ovulation was seemingly confirmed by BBT. All BFN. IVF/FET worked on the first try for us. I wish we hadn't wasted 2 years of time trying other things first, especially since we had the insurance coverage.
I don't have any proof myself, but I do think that there's something to the egg quality - PCOS connection, based on my own experiences and the outcomes of our IVF cycle (# retrieved vs # fertilized vs # of PGS normal embryos).

[Anonymous]

Anonymous wrote:If you want to try IUI with letrozole, go ahead. But, no, I don't think the recommendation to go to IVF is that odd. I have PCOS. We did 6 IUI cycles with either letrozole or clomid. We had another 7 or 8 cycles (unmonitored) of TI where ovulation was seemingly confirmed by BBT. All BFN. IVF/FET worked on the first try for us. I wish we hadn't wasted 2 years of time trying other things first, especially since we had the insurance coverage.
I don't have any proof myself, but I do think that there's something to the egg quality - PCOS connection, based on my own experiences and the outcomes of our IVF cycle (# retrieved vs # fertilized vs # of PGS normal embryos).

But had you previously had a child?

[Anonymous]

Anonymous wrote:If you want to try IUI with letrozole, go ahead. But, no, I don't think the recommendation to go to IVF is that odd. I have PCOS. We did 6 IUI cycles with either letrozole or clomid. We had another 7 or 8 cycles (unmonitored) of TI where ovulation was seemingly confirmed by BBT. All BFN. IVF/FET worked on the first try for us. I wish we hadn't wasted 2 years of time trying other things first, especially since we had the insurance coverage.
I don't have any proof myself, but I do think that there's something to the egg quality - PCOS connection, based on my own experiences and the outcomes of our IVF cycle (# retrieved vs # fertilized vs # of PGS normal embryos).

Were you having normal (as in regular) periods on your own?

[Anonymous]

Anonymous wrote:

Anonymous wrote:If you want to try IUI with letrozole, go ahead. But, no, I don't think the recommendation to go to IVF is that odd. I have PCOS. We did 6 IUI cycles with either letrozole or clomid. We had another 7 or 8 cycles (unmonitored) of TI where ovulation was seemingly confirmed by BBT. All BFN. IVF/FET worked on the first try for us. I wish we hadn't wasted 2 years of time trying other things first, especially since we had the insurance coverage.
I don't have any proof myself, but I do think that there's something to the egg quality - PCOS connection, based on my own experiences and the outcomes of our IVF cycle (# retrieved vs # fertilized vs # of PGS normal embryos).

Were you having normal (as in regular) periods on your own?

No, I had not previously had a child. I'd had irregular cycles for a year before doing the IUIs. We took a long break in between the IUIs and IVF, and during that time, I was ovulating on my own with regular cycles (confirming ovulation via BBT rise, not just with OPK). I kept putting off the IVF because I was ovulating on my own and I was convinced that if I gave it just a little bit longer, I'd get pregnant.
I was 35 at the time.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you want to try IUI with letrozole, go ahead. But, no, I don't think the recommendation to go to IVF is that odd. I have PCOS. We did 6 IUI cycles with either letrozole or clomid. We had another 7 or 8 cycles (unmonitored) of TI where ovulation was seemingly confirmed by BBT. All BFN. IVF/FET worked on the first try for us. I wish we hadn't wasted 2 years of time trying other things first, especially since we had the insurance coverage.
I don't have any proof myself, but I do think that there's something to the egg quality - PCOS connection, based on my own experiences and the outcomes of our IVF cycle (# retrieved vs # fertilized vs # of PGS normal embryos).

Were you having normal (as in regular) periods on your own?

No, I had not previously had a child. I'd had irregular cycles for a year before doing the IUIs. We took a long break in between the IUIs and IVF, and during that time, I was ovulating on my own with regular cycles (confirming ovulation via BBT rise, not just with OPK). I kept putting off the IVF because I was ovulating on my own and I was convinced that if I gave it just a little bit longer, I'd get pregnant.
I was 35 at the time.

PP here. I've had regular, ovulatory cycles since my period returned after DD was born. 14 cycles with confirmed ovulation. No pregnancies there, either. Like I said before, I don't have any scientific evidence, but I really do feel that there's an egg quality issue at play.

[Anonymous]

PCOS is crap for IUIs. They have a low rate of working in the first place, and a high miscarriage rate (especially for PCOS patients). Plus you are more likely to have to take off a cycle in between failed IUI cycles because of large cysts. Three [failed] cycles of IUI took me 7 months with the three interim months skipped (I was 32). Don't do it, or just do one cycle and move on to IVF.

[Anonymous]

Anonymous wrote:PCOS is crap for IUIs. They have a low rate of working in the first place, and a high miscarriage rate (especially for PCOS patients). Plus you are more likely to have to take off a cycle in between failed IUI cycles because of large cysts. Three [failed] cycles of IUI took me 7 months with the three interim months skipped (I was 32). Don't do it, or just do one cycle and move on to IVF.

Just to offer a counter example, IUI worked on the second go for me (I have lean PCOS and am annovulatory on my own).