Thanks BW!
My FS told me to use the Calorie King website. Actually I did make a suggestion in the clinics survey that Dietician support should come as part of the deal if this impact so significantly on the outcomes.
It was my FS that made me do calorie king as well. He actually got my username and password and checked everything I'd done in the 4 weeks between appointments at one stage. He used slightly different dietary guidelines to what calorie king suggested for me, though.
I had a long list of "do not eat" foods, but after the first week or so it wasn't too bad. I'm not a person who does well with a diet that specifies what things to eat at which meal on what day, so being able to choose my own foods to fall within certain limits actually worked well for me, but I can see how some people would prefer the other kind of diet.
Have a bit more time to post a reply at this time of night...
With that third cycle, I still ended up on daily blood tests with the puregon injections. After spending a week in hospital with OHSS, I was pretty happy to do anything to avoid another case of it. I distinctly recall one Sunday - I'd had blood taken that morning, my levels were fine, but they dropped my puregon dose again and had me come back again on the Monday for more blood. I was tired, over it and generally craving some junk food - so I ate a hamburger and chips for lunch. My first and only slip up during the entire cycle. My results the following day were not so good and I very nearly got my E2 levels up high enough to need yet another freeze all cycle. That was the point where I was convinced! I still got OHSS again - but it was mild, and only set in with a positive pregnancy test.
One question - do you take metformin to help with the PCOS/insulin resistance? It's the insulin problem that mucks up the hormones and makes OHSS more likely (less insulin spikes means less likelihood of getting OHSS from sky-rocketing E2 levels) so it could quite possibly help a bit if you're not already taking it.
Thanks heaps for sharing!
Yes a big fat green and blacks chocolate bar the night before my final blood and ultrasound had my first cycle cancelled! There I was rewarding and comforting myself for my perfect cycle when I really just sabotaged it.
Can I hazzard a guess Dr David Knight might be your guy? If not at least it means others are doing this as well. The thing that had me confused was he told me off one day right in the beginning saying you eat to many carbs but really didn't explain why. I really don't understand the PCOS thing myself or if I have a subtype or if it runs or scale or what. Contrary to the usual type, I am very slim 168.5cm and 49kg, and not somebody who needs to lose weight - for the life of me i eat the same as my husband if not more and it won't budge. I understand it has something to do with insulin resistance and the impacting the hormones. And I do overstimulate easily and produce the immature eggs.
This is my final question as I am already trying to find a dietician to give me some ideas (I want a pick from list as well and to understand it a bit bettter).
I have been following the "eating plan" through my cycles, I don't religiously every day enter my into C/King - maybe a week at a time then a few day off and on again. I am trying not to get myself stressed if my % don't add up perfectly as it is hard to reverse it. Obviously I try to eat all the right things during cycle. The thing that confused me is you are told a % of protein, carbs, and fats you can have. Does every meal in the day need to be balanced this way? I have found myself cramming down cheese, silverside or say fruit in the night just to try and bring my % in to line. To me this seems like I am getting it wrong already even if I am going low GI .. and finally yes I know it is question number two..did you stick to the plan after transfer, how important is this?
BTW, I am not taking metformin. I'll ask about that at the next appt then.
Thanks again!
Last edited by Sophie Baby Makes 3; March 9th, 2010 at 09:18 PM.
: forgot something
Got it in one! But I seriously doubt I'd go back to him if we decide to try for number two (don't really like some of the things about the way the new clinic does things).
I'm a bit like you - not overweight and really don't have any of the usual physical signs of PCOS, but when I was sent to do a glucose tolerance test David just about fell out of his chair at my results. He usually only does the eating plan thing with people who are overweight but my insulin levels were so high that he made me do it as well. After transfer and through the early stages of pregnancy I still stuck to the plan as much as I could. It made sense to do so - PCOS can increase the chance of miscarriage and I'd already had three, so I still did what I could to keep the PCOS and my insulin levels under control.
I would balance what I ate over the whole day. Sometimes I would try to eat eggs for breakfast to lift my protein levels, but I'm very much a cereal girl so I would often have my usual cereal for breakfast and then have virtually no carbs for the rest of the day (apart from what you find in fruits and vegies - I would avoid bread, pasta, rice, potato, etc) and stick to things like meat and salads or stir fries with lots of vegies. I even managed to have pizza once without killing the entire day, and I wouldn't stress if one day was a bit high in carbs, as I'd often have others which were low so it would tend to balance out over a week. Except for during that last stim cycle - I was absolutely rigid with it and didn't allow any "carb borrowing" from one day to another. I did it from when I started lucrin right through until I was so ill with morning sickness that the constant need for a ginger nut biscuit to nibble on meant I really had no hope of keeping carbs under the limit.
But it does work. And I know David likes to tell you that and he'll often tell stories about different patients who got nowhere until they followed the plan... and sometimes it helps to actually be able to talk to one of those patients and find out that it is actually true.
One thing I do want to comment on - I was told that the only chance I had of getting pregnant was to use a frozen blastocyst and that I just had to get used to the hyperstimulation because that's what my body just liked to do. Well, I did a cycle without hyperstimulating - and thought all was lost when out of my 20 eggs only 12 were mature and of those only 3 fertilised. We didn't have enough embryos to grow to blastocyst so we transferred at day 3 (and I think this is one thing that his clinic no longer does)... so after being told my only hope was a frozen blast, I got pregnant and stayed pregnant with a fresh day 3.
I do find he can be a bit confusing. You know one week he says one thing and the other his approach is different. I even asked him the other day, so what is more important gi or no. of carbs and he said something like "well... not so much gi, more no. of carbs. actually these days it is more about the protein".
From having more of a read on PCOS last night, I believe the bit I am sabotaging is implantation phase and certainly it sounds like if I didn't carry through with the diet I would probably end up having an MC.
My problems is that as soon as I have had pickup I let loose on the diet as I am absolutely craving something, then am trying to be sensible but in no way at all stict as I should following transfer.
I feel terrible about my shocking will power, however I now know what I need to do to get an outcome!
BTW he hasn't mentioned anything to be about saying I should hyperstimulate or only use frozen embryos.
I suspect that he was referring to my specific situation. At the point where he'd said that I needed a frozen blast, I'd done two stim cycles and got quite bad OHSS with both. I'd had a total of 11 blasts frozen, but had a lot fail to thaw. Only 4 of those 11 blasts had been able to be transferred and from those 4 blasts I had three miscarriages. He'd decided that my body just liked to hyperstimulate and suggested that I just get used to getting very sick with each egg pick up and having all my embryos frozen. He also suggested that we had some chromosomal issues leading to the thaw failures and the miscarriages (one at 9 weeks the others very early) but when we asked about PGD he said it couldn't check enough chromosome pairs to be confident that it would fix the problem and that we should just rely on freezing and thawing to weed out a lot of our crap embryos and hope we eventually got one that would implant and go on to give us a successful pregnancy.
But in another appointment - the miscarriages and thaw problems were down to crap eggs which were crap because of the OHSS and that we needed to avoid OHSS and improve DH's sperm as much as possible (low count, poor motility and complete crap morphology)...
Personally - I suspect he had no idea at all and was just spinning theories to keep me happy. He did keep working towards avoiding OHSS or at the least trying to minimise it as much as possible, and we did eventually get there.
But I'd also consulted with a few other specialists - and David insisted that I stop metformin with a positive pregnancy test (but stopping metformin coincided with my first miscarriage) and that I didn't need aspirin (but we only had successful implantation when aspirin was added)... and that the prednisone I was taking for the arthritis was completely irrelevant to the conception situation (but if I reduced my prednisone dosage below 10mg while pregnant I would bleed).
Happy to have others take what they can from my experience, just glad that I can help. I honestly didn't believe the diet would work - but just did it in order to be able to tell him "told you so!", but to my complete surprise, it ended up being him telling me. However, I think the other meds had a role to play as well (I've got a few other health problems which make me a unique and complicated situation) and I never was brave enough to tell him that I was following another doctor's instructions in relating to them!
I hope you don't mind me asking but I seem to be in a somewhat similar situation, I have PCO but not the syndrome and don't have a weight problem, and I have trouble producing mature eggs. At my last 2 EPU's I have only had 1 mature egg (about 5 follicles both times) which failed to make it to day 5.
BW thankyou so much for mentioning the calorie king website, I have had a look into it but was wondering if you would be able to share some more info about how much protein you were meant to be eating each day. I'm really interested in changing my diet to see if it helps things as I often eat quite erratically and I know my sugar levels go up and down quite a lot when I skip meals.
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