Severe PCOS here, but not exactly a classic presentation.
First of all - I believe metformin is only going to help if you have insulin resistance as part of your PCOS. This is determined through a two hour glucose tolerance test where they also need to check insulin levels as well as glucose. My insulin resistance is severe. I need metformin even while not TTC just to help control the symptoms of insulin rising and falling. And I can assure you that metformin success stories ARE out there. Not me, but a friend of mine. Generally it seems to be of benefit in the cases of milder PCOS. But for me, I will sing the praises of metformin until the end of my days. The thing with PCOS is that it's not just difficulty getting pregnant, it's a difficulty in staying pregnant. Without metformin I miscarry. Metformin does help to reduce the chance of miscarriage in women with PCOS however its use in pregnancy is somewhat controversial. But when I miscarried the day I so much as reduced the dose of metformin, I am thoroughly convinced.
If you really can't tolerate metformin, then there is great benefit in following a low GI diet.
As for clomid... That's the drug that I believe is evil. I had such severe panic attacks on clomid and such a severe break down while using it that my doctors have basically told me to never ever take it again. There are other options out there to help you ovulate that I believe are better than clomid (in the midst of that break down, it didn't even work). There's a drug called letrozole that is used in the same way as clomid and also FSH injections.
With the progesterone pessaries - they are never going to help you ovulate. In the lead up to ovulation, FSH rises, as well as estrogen. After ovulation, progesterone begins to rise, peaking at about one week after ovulation. If you are pregnant, it will stay high, if you are not pregnant, then it will fall and it's the drop in progesterone that triggers a period to start. Progesterone pessaries will help maintain a pregnancy after ovulation if the body doesn't produce enough on its own, but it won't cause you to ovulate.
The nasty thing about PCOS is that what works for one woman with it isn't necessarily going to work for another woman with it. In my immediate circle of friends I can easily count four women apart from myself with PCOS. One needed only metformin. Another needed metformin and clomid. Another needed IVF (successful first time). All three of them conceived their second child with no intervention at all. All three had a surprise second child. Another just took a long time but didn't actually use anything to help. And then there's me who needed IVF and ICSI as well, but took something like 5 transfers and three miscarriages before I had a successful pregnancy. We also have male factor infertility to deal with as well as a few other health issues.
Losing weight is certainly a help in managing PCOS and becoming pregnant. For some it's enough. For others, even with weight loss, more intervention is still needed.
I hope there's something of use in what I've said. PCOS really is a tricky thing to get your head around - for the doctors as well as those who have it.
Hi there i'm another PCOS sufferer. I was diagnosed June 2009 after having the most horrible pains in my stomach and after blood tests and then later on confirmed with an U/S i was told i have PCOS. I found out i also have an insulin resistance which isnt uncommon. I was put onto Metformin and the Yasmin pill. The pill gave me migraines and i was only put on a 3 month trial of metformin. I was told that it is used as a fertility drug as it makes women very fertile and was told to be careful not to fall pregnant but i ignored that advice and in November 2009 i fell pregnant after one accident. I too have a very irregular cycle i can go 3-5 months between periods and i don't ovulate as often as other women so to pin point when i do i was told would make concieving very difficult. I lost all hope in believing id be a mother but the most important thing i have learnt is to be positive.
Well done on losing weight. I lost 9kgs which i believe increased my chances of concieving.
Hey PB&J - another person with PCOS (I don't like being a sufferer )
I knew I had PCOs but as I was on the pill it masked the PCOS symptoms until we decided to TTC. After months of nothing (no periods), I went to a FS who triggered AF and did 4 clomid cycles (I didn't have any reaction to the clomid). After that I had an ovarian cyst so had to have a cycle off before trying IUI, then it was Christmas, so I decided to take myself off to a naturopath to get my body right. Suffice to say with herbs we were pregnant on cycle #1! Went back to her to trigger AF when DS was 13 months old and again - first cycle! Unfortunately that was our angel baby and we're now back trying with her in the first proper cycle post m/c.
I still have long cycles 40+days but a good luteal phase. Working on losing weight and taking some herbs to try to shorten my cycle.
So basically I'm saying it's worth trying naturopathy. There are herbs that help with insulin resistance if you have an issue with that - certainly helped me lose weight! Weight loss is awesome - good on you for doing so much of that already!! My naturopath is also a nurse who used to work in IVF so she's happy to work along side the medical people if you want to do both, I'm sure you can find someone like her.
Good luck! As my FS said to me on the first visit "you will get pregnant, don't worry, it'll happen".
Wow... I never heard any negative stories about Clomid. I didn't have any issues with it - I got pregnant on our 2nd cycle with Clomid. For me, it was a god send!
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