Metformin and RE... HELP!!

[Katie581]

I've been on Met since December 2011. I was put on it, without further b/w...it was based on the fact that, my b/w from my regular gyno (taken mid-cycle, not cd3) said PCO and the u/s I requested at RE's office proved I had cysts on my ovaries (which my RE said I didn't have pcos before u/s). I started at 500mg and went up to 2000mg. In my January/February cycle, I had a chemical pregnancy. The RE's office said it was "false positives" even though I tested with two different brands (8 tests in 4 days), I watched the line get lighter on the third day and I waited until day four to get the beta (after an even lighter hpt). Which was negative. I waited, cause I had no idea it would end so fast.

Anyways... Met didn't do anything to move my ovulation, like my RE wants. I ovulate on my own, around cd23. So he's added Clomid (50mg) to the mix. That only moved my ovulation up 4 days, to which my body has been known to do on it's own sometimes. Is it really that bad, to ovulate on my own a week after cd14?? RE's main focus is my ovulation (and like my regular gyno) is not concerned that my luteal phase varies between 11-13 days. I know better ovulation is supposed to bring me a better LP... but can't we try adding progesterone and see what happens??

Even after my last b/w, I had them check my 8dpo progesterone levels... to which I had to call them to find out the results. They didn't think it was important to call me! My progesterone was 6.4 and when I asked what it was supposed to be, the nurse said a 10. But because my RE didn't want to look at my BBT from my CP and the one after, the nurse didn't have those copies to compare to (even though she had a year's worth of my other BBT charts on file). And even if she did have them, my BBT chart from my bfp, gave me nice 98 degree temps. So that would show her nothing. I'm lucky if I get five 98 degree temps per LP.

Aside from TTC for almost two years, charting my temps, checking my cm and all that... wouldn't I know my body a little better than these doctors? In all honesty, I don't want to be on higher doses of meds, just to get me to ovulate a week earlier... people get pregnant with late ovulation all the time! Not to mention the lack of communication between the RE's office. Is it appropriate to tell your patient on the day of the appointment, that the doctor wants to do an internal exam? Does it help, that every time I've been there, he's done an internal exam? And now that I'm on Clomid, he's not monitoring my ovaries via u/s (mid-cycle)... no, he wants me to come in at the end of every cycle, so he can internally feel if they're enlarged.

I just feel like dropping everything... the Met (since I've felt better when I wasn't on it and have NO idea if it's lowered ANY of my hormone levels), the Clomid and the RE. Why can't I just go to a normal ob/gyn, who won't pressure me to come in monthly and lean towards more drugs and/or artificial insemination procedures. If I believe my 8 hpts were real and I can get pregnant on my own... is all this RE-stress really necessary?

What do you honestly think??

[defygravity]

I think you need a new RE. I don't see anything wrong with your ovulation timeframe. A 6.4 DOES indicate ovulation, though from what I understand the higher the number the stronger the O. IMO, though, an O is an O and a shot for pregnancy. Progesterone will help with the LP, and I don't know why he hasn't suggested it or listened to your request.

Metformin, well, that's a personal decision. There are studies on both sides of the fence for its benefits for PCOS women who are not IR - there are several threads here that mention studies indicating better egg quality and other benefits. For every study that says one thing there is a study that shows the opposite. Personally, if you're on it and tolerating it, I'd consider staying with it. It won't hurt.

I can tell you that I don't have RE stress at all. I had MORE stress seeing an OB/GYN because they had no idea what they were doing, and they didn't really have the time to spend with me to talk about options and needs. It's clear you're not happy with your current doctor though, so perhaps you can try switching to another RE? You can try going with an OB/GYN, just make sure you find one that has concrete experience helping with PCOS and will support a wide variety of options to suit your needs (such as your need for Progesterone). I've found that even the GYN's who claim to specialize in PCOS have a cookie-cutter approach that won't work for me.

[Katie581]

Oh that makes sense, about the ob/gyn. I showed my last one a positive opk and she said, "I don't understand those" and that her patients tell her when they've ovulated... okay, note to self, find yet another doc.

I'm definitely going to do some research... pay down my last three months of bills from insurance and go from there. Thanks!!

[defygravity]

Yikes... THAT'S a scary OB/GYN. When I first met with my RE and told him about my experience, he just shook his head and explained to me that OB/GYNs typically deal with many women each day most of whom do not have PCOS or fertility problems. They're awesome at annual exams (which you need, even with an RE), general gynecological care, standard obstetrical care, and basic fertility, but when it comes to PCOS - an endocrine disorder - an RE is best. It's not a diss on them, it's just not their specialty. It made sense to me - I wouldn't see a dermatologist for the flu. Provided you're not High Risk, you'll probably see one when you get pregnant.

That said - there are some OB/GYNs out there who do know what they are doing and have the experience. It's really all a matter of who makes you feel the most confident and comfortable. Good luck with your research, let us know how we can help!