What would you do? PCOS edition

[Anonymous]

My menstrual cycles can be quite irregular and I don't think I ovulate regularly. I am 34. I am currently on day 39 of my cycle :/ Very frustrating. I am doing what I can to regulate my cycles with exercise diet and distressing (really important for me).

In the meantime, I have 7 frozen embryos from last Nov when I was 33 during which time my insurance covered it. Wasn't ready to be pregnant at that time so we didn't transfer any. 5 are day 6 and 2 are day 5.

What would you do in my shoes? Keep trying naturally or just go for the FET? Any pros and cons and personal experience would be so appreciated. P.S. Money is somewhat of an issue for us.

[Anonymous]

Anonymous wrote:My menstrual cycles can be quite irregular and I don't think I ovulate regularly. I am 34. I am currently on day 39 of my cycle :/ Very frustrating. I am doing what I can to regulate my cycles with exercise diet and distressing (really important for me).

In the meantime, I have 7 frozen embryos from last Nov when I was 33 during which time my insurance covered it. Wasn't ready to be pregnant at that time so we didn't transfer any. 5 are day 6 and 2 are day 5.

What would you do in my shoes? Keep trying naturally or just go for the FET? Any pros and cons and personal experience would be so appreciated. P.S. Money is somewhat of an issue for us.

Oh, we moved and changed jobs, so we would have to pay out of pocket for any infertility treatment now.

[Anonymous]

Are they PGS normal?

[Anonymous]

I mean, what about in between (and much less expensive steps)? I have pcos and am pregnant with my second letrozole baby. It was a pretty easy process both times - the meds are SUPER cheap; you do have to go to multiple monitoring appointments but a lot of insurance plans cover a decent chunk of it. And even if not, it's cheaper than IVF by a landslide. If it were me I'd try a few cycles and see how you respond - often with PCOS you're dealing with an egg quality issue (even if you are ovulating on your own). Is there a reason you wouldn't try letrozole (or clomid, or even injectables) first? I know a lot of people who had pretty quick success with letrozole, and it's not like you're 37.

[Anonymous]

Anonymous wrote:I mean, what about in between (and much less expensive steps)? I have pcos and am pregnant with my second letrozole baby. It was a pretty easy process both times - the meds are SUPER cheap; you do have to go to multiple monitoring appointments but a lot of insurance plans cover a decent chunk of it. And even if not, it's cheaper than IVF by a landslide. If it were me I'd try a few cycles and see how you respond - often with PCOS you're dealing with an egg quality issue (even if you are ovulating on your own). Is there a reason you wouldn't try letrozole (or clomid, or even injectables) first? I know a lot of people who had pretty quick success with letrozole, and it's not like you're 37.

Well, the doctor told me it would put me at a risk of multiples, and I have heard that it makes you feel like death... but I am open to it...

[Anonymous]

Anonymous wrote:Are they PGS normal?

I did not have them tested for this. I don't have any reason to believe at 33 that they would have been atypically abnormal?

[Anonymous]

I don't think I'd keep trying much longer without help. The idea of doing the less expensive interventions for a few cycles sounds like a good plan. If/when you do a FET, go with the 5 days first (statistically better chances of being normal - and you can expect about half of your blasts to be abnormal).

FETs are less expensive than the retrieval. I also ended up going to an OB for the pregnancy tests and early ultrasounds, so I insurance will cover those. Sometimes those are part of a pricing package for the FET anyway, so it may not matter that much. My RE was in California, so I had to do something remote, but I thought going to another RE was silly and I was going to have to send results anyway. I went with CWC and they've been super easy to work with so far. I actually had been at Reiter Hill - they did the blood tests for hCG and the doc was amenable to doing the early ultrasounds, but the staff wasn't allowed to schedule the ultrasound outside their routine (understandable) and then rudely refused to schedule any appt for me (even a consult) before 8 or 9 weeks (I can't remember exactly).

[Anonymous]

Anonymous wrote:

Anonymous wrote:I mean, what about in between (and much less expensive steps)? I have pcos and am pregnant with my second letrozole baby. It was a pretty easy process both times - the meds are SUPER cheap; you do have to go to multiple monitoring appointments but a lot of insurance plans cover a decent chunk of it. And even if not, it's cheaper than IVF by a landslide. If it were me I'd try a few cycles and see how you respond - often with PCOS you're dealing with an egg quality issue (even if you are ovulating on your own). Is there a reason you wouldn't try letrozole (or clomid, or even injectables) first? I know a lot of people who had pretty quick success with letrozole, and it's not like you're 37.

Well, the doctor told me it would put me at a risk of multiples, and I have heard that it makes you feel like death... but I am open to it...

NP here. Also have PCOS. I got pregnant with letrozole (which has half the probability of multiples relative to clomid which is the other drug we considered) on the first cycle of IUI. It didn't make me feel like death at all. I don't think I noticed any difference.

[Anonymous]

I would probably take metformin and continue to try naturally for a few months.

Then I would do the FET.

I would also continue to use birth control when you don't want to get pregnant. I have a few friends whose doctors told them they would never get pregnant and they had kids in their 40s.

[Anonymous]

PCOS here as well and I got pregnant with a singleton with clomid on the second round. Way cheaper than more invasive procedures. Risk of multiples was 5-10%. With PCOS our eggs are often immature and don’t mature so clomid gave me what Dr. Greenhouse called “a nice juicy egg.” 23 weeks with a healthy baby boy.

[Anonymous]

Anyone had any luck with myo-inostisol?

[Anonymous]

PCOS here. We tried clomid, femara, timed intercourse (trigger shot), and IUI. Only IVF worked. I would use the frozen embryos if I were you.

[Anonymous]

Anonymous wrote:PCOS here. We tried clomid, femara, timed intercourse (trigger shot), and IUI. Only IVF worked. I would use the frozen embryos if I were you.

Forgot to add that both my DS and current pregnancy were from day 6 frozens.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I mean, what about in between (and much less expensive steps)? I have pcos and am pregnant with my second letrozole baby. It was a pretty easy process both times - the meds are SUPER cheap; you do have to go to multiple monitoring appointments but a lot of insurance plans cover a decent chunk of it. And even if not, it's cheaper than IVF by a landslide. If it were me I'd try a few cycles and see how you respond - often with PCOS you're dealing with an egg quality issue (even if you are ovulating on your own). Is there a reason you wouldn't try letrozole (or clomid, or even injectables) first? I know a lot of people who had pretty quick success with letrozole, and it's not like you're 37.

Well, the doctor told me it would put me at a risk of multiples, and I have heard that it makes you feel like death... but I am open to it...

Ah, I see. Well the risk of multiples IS higher with injectables, but with letrozole it's actually pretty low. And assuming you do a monitored cycle you'll know what's going on in there, so if somehow you have 3 dominant follicles or something (v unlikely), you can always abstain that cycle. But letrozole is designed to help you grow just one dominant follicle - that's what happened for me each time. And I actually had zero side effects on it! I've heard clomid has some side effects but people's experiences vary, and letrozole seems to be the newer / more popular go to anyways. I was honestly worried it wasn't working because I felt so un-different. Like the other PP, I had pretty quick and easy success. I had a CP my first round, then got pregnant the second round. And conceiving my second we had success our third cycle. I would certainly recommend looking into this option! Happy to answer any other questions you have

[Anonymous]

Anonymous wrote:Anyone had any luck with myo-inostisol?

It did not work for me. Neither did metformin. Clomid is what worked for us.