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PCOS, Conception and Pregnancy

February 5, 2008 - Tuesday
12:34 PM to (EST)
Guest Speakers: Michael Swanson, M.D., Conceptions Reproductive Associates of Colorado

Categories
IVF • PCOS • Pregnancy • Pregnancy Loss


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[Tue Feb 05 10:43:50 PST 2008] elizabethWho else is on right now?
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[Tue Feb 05 16:17:19 PST 2008] tenayagirl2hello
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[Tue Feb 05 16:56:54 PST 2008] Corey_WhelanWow! Hi everyone! I'm Corey Whelan, your chat moderator tonight. How great to see so many early birds! I'm The AFA's Director of Development and a PCO'er myself. Welcome everyone.
[Tue Feb 05 16:59:00 PST 2008] christalpGood evening Corey. Hello everyone else
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[Tue Feb 05 17:00:06 PST 2008] safiamullickhello everyone
[Tue Feb 05 17:00:37 PST 2008] trble81Good evening everyone. Happy Fat Tuesday.
[Tue Feb 05 17:01:36 PST 2008] janHello everyone
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[Tue Feb 05 17:02:53 PST 2008] Corey_WhelanHi everyone, we're back and Dr. Swanson has joined us. Welcome Dr. Swanson. Folks, feel free to ask your questions now
[Tue Feb 05 17:02:58 PST 2008] janHello, I have PCOS (not overweight but can't ovulate on my own). I have gone through two rounds of fertility meds and IUIs - the second one was successful. However, I miscarried at 8.5 weeks (fetal demise - no abnormalities in the fetal tissue analysis). I am now trying again - was inseminated this past week and am VERY nervous about miscarrying again. I take vitamins and exercise regularly and have cut out caffeine and alcohol from my diet. My fertility doctor has me on progesterone suppositories as well. Are women with PCOS more likely to miscarry? Is there anything I can do to reduce the chance of it happening again? Thanks for your help!
[Tue Feb 05 17:03:34 PST 2008] Ellen_Hi I was wondering what you think is the best at home method of detecting ovulation when having PCOS such as opk, temps, OV-Watch or CBFM?
[Tue Feb 05 17:03:54 PST 2008] Corey_WhelanHi guys. Jan first, then Ellen
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[Tue Feb 05 17:04:19 PST 2008] Dr._SwansonHello and thank you for inviting me to participate in tonights OnLine Chat.
[Tue Feb 05 17:04:31 PST 2008] Corey_WhelanHi dree, we're just starting.
[Tue Feb 05 17:06:18 PST 2008] kk31393Jan, great question. I have gone through the same thing, with 2 miscarriages. Your situation sounds very similar to my own. Thanks for asking.
[Tue Feb 05 17:06:43 PST 2008] christalpGood evening Dr. Swanson. I am a 31 yo with PCOS. I have just completed my 2nd fresh IVF cycle that ended in BFN. My 1st cycle I got pregnant but it ended in a miscarriage resulting from a blighted ovum. I have also had a FET that was a BFN. How can I improve my egg quality?
[Tue Feb 05 17:07:19 PST 2008] Corey_Whelanhang in chris kiddo. you're number 3.
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[Tue Feb 05 17:08:40 PST 2008] Corey_WhelanHi Fari, welcome. Ditto soon2b, absolutely!
[Tue Feb 05 17:09:09 PST 2008] Dr._SwansonJan, I certainly like you idea of lifestyle modifications. Pt.s with PCOS are at increased risk to miscarry. At this point I would continue on your progesterone support as prescribed by you physician. You should know that 50 to 60% of first trimester loss is in the setting of fetal aneuploidy, ( chromosomal abnormalites ). There is some observational data that patients with insulin resisitance might benefit from metformin, but this concept has recently been challenged.
[Tue Feb 05 17:09:12 PST 2008] Corey_Whelanguys, hang back, let Dr. Swanson catch up with the questions that are up.
[Tue Feb 05 17:09:46 PST 2008] Corey_WhelanEllen next Dr. Swanson
[Tue Feb 05 17:10:03 PST 2008] janMy fertility doctor also has me on metformin as well.
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[Tue Feb 05 17:11:15 PST 2008] Corey_WhelanHi geri, welcome.
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[Tue Feb 05 17:11:32 PST 2008] gerigardner hi, this is my first chat.
[Tue Feb 05 17:11:37 PST 2008] Corey_Whelanhowdy cferster, we're discussing pco with Dr. Michael Swanson.
[Tue Feb 05 17:11:41 PST 2008] Dr._SwansonChristalp improving oocyte quality is the Nobel prize question. As a physician that treats patients with ART I do think the choice of controlled ovarian stimulation and lab expertise are crucial.
[Tue Feb 05 17:11:56 PST 2008] Corey_WhelanI didn't think I recognized your name. Welcome aboard geri!
[Tue Feb 05 17:12:10 PST 2008] gerigardnerThank you
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[Tue Feb 05 17:12:24 PST 2008] Corey_WhelanHi Red.
[Tue Feb 05 17:12:32 PST 2008] redhu
[Tue Feb 05 17:12:35 PST 2008] redhi
[Tue Feb 05 17:12:38 PST 2008] SOON2BMOMMYhello everyone
[Tue Feb 05 17:12:53 PST 2008] Ellen_Cory is the dr going to answer my question?
[Tue Feb 05 17:13:00 PST 2008] zoobabyhi
[Tue Feb 05 17:13:07 PST 2008] Corey_Whelanyes, he is typing.
[Tue Feb 05 17:13:15 PST 2008] Corey_WhelanHi zoobaby, good to see you again.
[Tue Feb 05 17:13:27 PST 2008] christalpI have responded well to the stimulation drugs. 1st cycle retrived 34 and 13 fertilized. This last cycle lower dosages and 14 retrived and 10 fertalized.
[Tue Feb 05 17:13:27 PST 2008] gerigardnerWell I'm 33 and I've had PCOS my whole life.
[Tue Feb 05 17:13:29 PST 2008]  jan left.
[Tue Feb 05 17:14:07 PST 2008] kk31393I was pregnant twice very close together, each ending in miscarriage. I am on Femara. Now it has been over a year since I have been pregnant. It was so fast the first 2 times and now I'm getting very frustrated. Can the PCOS symptoms change or get worse over time?
[Tue Feb 05 17:14:10 PST 2008] zoobabyi am 36 and haqve had pcos aall too
[Tue Feb 05 17:14:27 PST 2008] Corey_WhelanGuys, while Dr. Swanson is answering, I just want to mention.....you know I don't want you pcoer's to overload on the carbohydrates, you're heard that before, yes? It's important.
[Tue Feb 05 17:14:37 PST 2008] gerigardnerPCOS symtoms for me have only gotten worse
[Tue Feb 05 17:14:43 PST 2008] frances1I finally produced three embryos after three IVFs. The embryos are two 8-cell with no fragmentation and one 7-cell with no fragmentation. I will be using a gestational carrier due to a hysterectomy. I am in my 40's and worry about the implantation rate for embryos from someone my age. Does that fact that they are 8-cell and 7-cell with no fragmentation provide more hope? The embryologist said that they look great. They are also frozen as it was too expensive to keep getting my GC prepared for each cycle.
[Tue Feb 05 17:14:44 PST 2008] Dr._SwansonEllen ovulation detection can be a problem in patients with PCOS. I would start with urinary OPK. If you do not have demonstration of a clear "LH surge" by your OPK I would move to ultrasound monitoring.
[Tue Feb 05 17:14:55 PST 2008] zoobabyjust had 1st baby in nov
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[Tue Feb 05 17:15:14 PST 2008] gerigardneryes I know about the carbs
[Tue Feb 05 17:15:14 PST 2008] Corey_WhelanKK's question next, Dr. Swanson
[Tue Feb 05 17:15:21 PST 2008] SOON2BMOMMYcongrads zoobaby
[Tue Feb 05 17:15:45 PST 2008] Corey_Whelanoh, sorry! kk was affirming Jan's question.
[Tue Feb 05 17:15:55 PST 2008] Corey_Whelanchristalp is next
[Tue Feb 05 17:15:56 PST 2008] zoobabyso it can happen - after 7 yrs of trying
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[Tue Feb 05 17:16:05 PST 2008] zoobabythks
[Tue Feb 05 17:16:19 PST 2008] Corey_WhelanHi jendem. and zoobaby, congratulations.
[Tue Feb 05 17:16:32 PST 2008] Ellen_I dont have insurance to cover infertility so I wanted to know an easier way to detect ovulation without paying out of pcoket
[Tue Feb 05 17:16:45 PST 2008] gerigardnerI have been blessed once, I have a 6 year old son and have been trying for my second ever since.
[Tue Feb 05 17:16:49 PST 2008] jendemhi, sorry new to this chat room stuff.
[Tue Feb 05 17:16:57 PST 2008] SOON2BMOMMYyes i agree.......i have had pcos for 10 yrs was always trying"hoping"....then got a divorce and my new fiancee and i just found out we are preg 6 months later
[Tue Feb 05 17:17:08 PST 2008] Corey_Whelanjendem, no worries
[Tue Feb 05 17:17:24 PST 2008] zoobabymy question has to do with what to expect for 2nd
[Tue Feb 05 17:17:34 PST 2008] gerigardnerI also don't have insurance to cover fertility.
[Tue Feb 05 17:17:44 PST 2008] Corey_Whelancongratulations to you as well, soon. The good news is that pco'ers do get pregnant.
[Tue Feb 05 17:17:49 PST 2008] zoobabycongrats soon2bmommy
[Tue Feb 05 17:18:00 PST 2008] SOON2BMOMMYyes
[Tue Feb 05 17:18:03 PST 2008] SOON2BMOMMYthank you
[Tue Feb 05 17:18:07 PST 2008] SOON2BMOMMYhuge blessing
[Tue Feb 05 17:18:15 PST 2008] SOON2BMOMMYbut i am sooo confused shocked
[Tue Feb 05 17:18:16 PST 2008] Dr._Swansonkk31393 I would recommend a re-evaluation of your ovarian reserve with a day 3 FSH, LH, Estradiol and screening US. In addition make sure that you are still responding to the femara either by OPK, US or progesterone assays. Finally make sure that other reproductive factors such as semen analysis and pelvic factor with HSG have been performed.
[Tue Feb 05 17:18:18 PST 2008] zoobabyamen!!!!
[Tue Feb 05 17:18:33 PST 2008] Corey_WhelanDr. Swanson, I believe frances has a question up
[Tue Feb 05 17:19:13 PST 2008] kk31393We've had all the tests done, and I am still getting a positive OPK. We are trying another few cycles of IUI's. Thanks.
[Tue Feb 05 17:19:27 PST 2008] mindy327Hello Dr Swanson
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[Tue Feb 05 17:19:57 PST 2008] safiamullickjust a year ago(thru blood tests) i found out that i have PCOS - sometimes i feel like that i dont have it bc i dont think i fit the typical profile since i am not overweight etc...i took metaformin for about a month then the doctor took me off it since i lost alot of weight with it (111 to 101) Now i am on it again with folic acid ..i am just wondering if there is anything else i can do for myself to get pregnant (lifestyle change etc...) is it ok to take tylenol at this time also ? should i still go to a fertily doctor or stay with this one. my doc who gave me metformin said around summer time when my doze will be 2 gram i have 60% chance of become pregnant ..is that likely? if that does not work then he will put me on clomid...im 29 yrs old thank you for your time GREATLY APPRECIATED corey u can let dr swanson look at my question when he is done with others smile
[Tue Feb 05 17:20:16 PST 2008] Corey_Whelanhi tchrchelow, welcome
[Tue Feb 05 17:20:39 PST 2008] Corey_Whelanof course. safiamullick is up too, can't forget this girl!
[Tue Feb 05 17:20:51 PST 2008] Dr._Swansonfrances 1 At this point I am encouraged by the good embyo morphology. What was your age when the embryos were generated?
[Tue Feb 05 17:20:53 PST 2008] sjAre there any preventive measures PCOSers can take to avoid miscarriage once pregnant?
[Tue Feb 05 17:22:21 PST 2008] Corey_Whelansj, great question
[Tue Feb 05 17:22:22 PST 2008] red left.
[Tue Feb 05 17:22:31 PST 2008] mindy327My story is PCOS with 4 miscarriages after IUI's and IVF's. On metformin, Overweight, trying to lose, trying to eat healthy, then going to start back with ART. Is there anything besides this that I can do to not miscarry in the future?
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[Tue Feb 05 17:25:07 PST 2008] gerigardnerSince I don't have infertility insurance/coverage, what can I do to improve my chances of conceiving?
[Tue Feb 05 17:26:23 PST 2008] cfersterHello. I have been told that I MAY be borderline PCOS and insulin resistant - I seem to be ovulating but am hirsute, my LH is a bit on the low side. I have no cysts on my ovaries but I was diagnosed with PCOS when I was younger - I had cysts then. My ob/gyny doesn't think I should be put on Metformin. I am wondering whether a small does would be useful? Also, I had an ectopic pregnancy last Feb, can that be due to PCOS? Thanks, Caren
[Tue Feb 05 17:26:36 PST 2008] Corey_Whelangeri, lifestyle changes are important. Think about exercise, weight bearing exercise and cardio, and a high protein low carb diet. That may get you ovulating
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[Tue Feb 05 17:27:27 PST 2008] Corey_WhelanHi dana and sherryl
[Tue Feb 05 17:27:39 PST 2008] Dr._Swansonsafiamullick: I would recommend a re-determination of your diagnosis. There have been several concensus opinions to establish criteria to make the diagnosis of PCOS. Important criteria include; anovulation, clinical or hormone levels suggestive of androgen excess, and an ovary that appears "polycystic" on ultrasound. Of note, just because a ovary appears "polycystic" does not mean you have PCOS. The use of metformin as a "first line" medication for ovulation has recently been challenged. I would recommend that you be evaluated for insulin resisitance and consider moving to clomid. It is safe to use Tylenol.
[Tue Feb 05 17:27:45 PST 2008] danaackermanGood Evening
[Tue Feb 05 17:28:08 PST 2008]  gerigardner left.
[Tue Feb 05 17:29:45 PST 2008] cfersterI meant to say; my Androgen Index was a bit high and SHBG - low (9) but Testosterone was ok.
[Tue Feb 05 17:30:37 PST 2008] safiamullickDr other than that im pretty sure i do have it bc i havent been pregnant for three yrs now
[Tue Feb 05 17:31:00 PST 2008] safiamullickbut i guess i should see another doctor (o man to start over again:(
[Tue Feb 05 17:31:38 PST 2008] zoobabynot everyone fits all the symptoms - I am not insulin resistant or overweight but still have the polycystic ovaries and other symptoms
[Tue Feb 05 17:31:44 PST 2008] safiamullicki havent even seen my ultrasound and i got it done
[Tue Feb 05 17:31:54 PST 2008] gerigardner joined.
[Tue Feb 05 17:31:56 PST 2008] frances1Very old for pregnancy - 45. I conceived on my own before without fertility meds but had miscarriages due to a very "diseased" uterus. I decided to try this route before adoption because I have a GC and have a doctor who believes that although rare this can happen. I had seven follicles this last attempt, five grew appropriately but only three eggs retrieved. Fertilized and divided beautifully wtih no ICSI.
[Tue Feb 05 17:31:57 PST 2008] Dr._SwansonMindy: I certainly agree with the therapeutic lifestyle changes. Since you have had 4 miscarriages, I would recommend a work-up for recurrent pregnancy loss especially if they have been consecutive before persuing another ART cycle. Studies should include chromosomal evaluations of you and your partner, an evaluation of your uterine cavity, TSH, Prolactin, and an "autoimmune/thrombophilia profile.
[Tue Feb 05 17:31:58 PST 2008] safiamullickoh i c zoobaby
[Tue Feb 05 17:33:12 PST 2008] zoobabyeven though I wasn't IR I still took metformin before I got pregnant naturally
[Tue Feb 05 17:33:40 PST 2008] rdposcar joined.
[Tue Feb 05 17:34:33 PST 2008] frances1The embryologist said that they look like embryos from a 20 year old!
[Tue Feb 05 17:34:42 PST 2008] zoobabyI had made a lot of lifestyle changes - eating better, exercising, meditating helped a lot - I was very stresses, and stress is not conducive to conceiving!!
[Tue Feb 05 17:34:55 PST 2008] frances1I know that looks doesn't mean healthy though
[Tue Feb 05 17:35:52 PST 2008]  gerigardner left.
[Tue Feb 05 17:36:16 PST 2008] Dr._Swansongerigardner: First of all I would take a prenatal vitamin with folic acid, and make sure that there are no concerning lifestyle issues such as smoking or alcohol that could be of concern. If you are overweight there is good data that exercise and weightloss could be of benefit. You can purchase a urinary ovualtion predictor kit at the drug store to see if you are ovulating.
[Tue Feb 05 17:36:23 PST 2008]  jendem left.
[Tue Feb 05 17:36:39 PST 2008] sherryltif anovulation is a defining criteria of PCOS, why is it said that recurrent miscarriages are something that PCOS women suffer from
[Tue Feb 05 17:36:56 PST 2008] SOON2BMOMMYzoobaby is there anything you did during your preg? How did your preg go any complications?
[Tue Feb 05 17:37:29 PST 2008] Corey_Whelanguys, if anyone's question was missed, please repost it to get it answered, thanks
[Tue Feb 05 17:37:42 PST 2008] sjAre there any preventive measures PCOSers can take to avoid miscarriage once pregnant? (missed question)
[Tue Feb 05 17:38:31 PST 2008] cfersterCW - cferster: Hello. I have been told that I MAY be borderline PCOS and insulin resistant - I seem to be ovulating but am hirsute, my LH is a bit on the low side. I have no cysts on my ovaries but I was diagnosed with PCOS when I was younger - I had cysts then. My ob/gyny doesn't think I should be put on Metformin. I am wondering whether a small does would be useful? Also, I had an ectopic pregnancy last Feb, can that be due to PCOS? Thanks, Caren
[Tue Feb 05 17:38:36 PST 2008] zoobabyno complications, but I was paranoid so I made sure I took prenatal vitamins with Expecta. I got my progesterone levels tested right away b/c that has affected miscarriages with pcos.
[Tue Feb 05 17:39:27 PST 2008] Dr._Swansoncferster: If you have insulin resistance and hirsutism I would recommend metformin. I would review with your physician your diagnosis PCOS. The ectopic pregnancy was not related to PCOS
[Tue Feb 05 17:40:09 PST 2008] rdposcarI've been on metformin for about 2 years...4 IUI's and 1 miscarriage. How can I be sure that I'm even ovulating?
[Tue Feb 05 17:40:26 PST 2008] zoobabyI ate very healthy, I had a little bleeding early in pregnancy so I didn't do a lot of excercising - I took it easy
[Tue Feb 05 17:41:18 PST 2008] zoobabyand prayed every day!! I knew that miscarriages were common so anytime I spotted I went to the dr so I was monitored closely
[Tue Feb 05 17:41:39 PST 2008] cfersterThanks Dr S. The best that they can say is that I MAY be borderline IR. My fasting insulin level was 15 - is that indicative?
[Tue Feb 05 17:43:05 PST 2008] msc joined.
[Tue Feb 05 17:43:12 PST 2008] cfersterSorry, also - I meant to ask; what would be a "starting dose" of Metformin?
[Tue Feb 05 17:43:15 PST 2008] zoobabymy question had to do with how to prepare body for a 2nd pregnancy - birth control has regulated ovulation in past - if that is the case what formula of b/c do you recommend?
[Tue Feb 05 17:43:20 PST 2008] rdposcarI don't think that monitoring will prevent a miscarriage. I'm close to my ideal weight, and I go to the doctor all the time....i was getting my blood tested every few days. but i still miscarried.
[Tue Feb 05 17:43:25 PST 2008] Corey_Whelan To[Private] danaackermanhi! he was on on time, no worries
[Tue Feb 05 17:43:45 PST 2008] mindy327If all tests are normal, besides eating well, lossing weight and exercise, is there anything else that I can do? Or is it in the hands of fate?
[Tue Feb 05 17:43:50 PST 2008] SOON2BMOMMYwell i am 8 weeks today.....haven't actually seen the OB yet.....not till the 28th of this month........i am beyond parinod........my dr knows my history........they did do a ultra sound last week and said that everything looked good baby's heartbeat is at 148 so i am praying there going by that...........and why there not gettin me in sooner
[Tue Feb 05 17:43:53 PST 2008] danaackerman To[Private] Corey_WhelanOh thank goodness! I feel awful! Thanks for all your help!
[Tue Feb 05 17:43:55 PST 2008] Corey_Whelan To[Private] danaackermandid you like the blast? was it ok?
[Tue Feb 05 17:44:01 PST 2008] Corey_Whelan To[Private] danaackermanoh please, let it go.
[Tue Feb 05 17:44:08 PST 2008] danaackerman To[Private] Corey_WhelanI thought it was great!
[Tue Feb 05 17:44:14 PST 2008] Corey_Whelan To[Private] danaackermangood.
[Tue Feb 05 17:44:16 PST 2008]  tacori25 joined.
[Tue Feb 05 17:44:20 PST 2008] Corey_Whelan To[Private] danaackermanwe'll do it again soon
[Tue Feb 05 17:44:39 PST 2008] Corey_Whelanhi tacori, welcome!
[Tue Feb 05 17:44:49 PST 2008]  Kbrower joined.
[Tue Feb 05 17:44:50 PST 2008] danaackerman To[Private] Corey_WhelanMy 4 month old and my 3 year old are sick. My husband just had a vasectomy and well so I have three babies to deal with!
[Tue Feb 05 17:44:51 PST 2008] Corey_Whelanmissed you msc, hi to you too
[Tue Feb 05 17:44:53 PST 2008] tacori25Hello thanks u
[Tue Feb 05 17:44:56 PST 2008] Corey_Whelanand kbrower.
[Tue Feb 05 17:44:57 PST 2008] Dr._Swansonsherrtt: Anovulation is a criteria for PCOS. In addition I look for either biochemical, (hormone levels), or clinical evidence, ( hirsutism, acne), of excess androgens. It has been proposed that patients with PCOS are at increased risk of pregnancy loss because of elevated PAI-1 levels that could impair circulation in the placenta. There is also some observational data that metformin may be of help to reduce the risk of miscarriage.
[Tue Feb 05 17:45:34 PST 2008]  hoping joined.
[Tue Feb 05 17:45:39 PST 2008] Corey_WhelanMindy, the hands of fate are yours. Making those changes are very powerful
[Tue Feb 05 17:45:44 PST 2008] frances1Thank you for your kind attention despite my age, as this is very exciting for me. Good luck to everyone. Think positive, it helps the process.
[Tue Feb 05 17:45:58 PST 2008]  dree left.
[Tue Feb 05 17:47:00 PST 2008] tacori25Do all women with PCOS suffer from Insulin Resistant.
[Tue Feb 05 17:49:09 PST 2008] Dr._Swansonsj: As previously noted a complete evaluation of RPL, ( recurrent pregnancy loss), is indicated after 3 consecutive losses. Many, myself included, will start a work-up after 2 losses in some situations. Perhaps 30-40% of patients after an exhaustive evaluation still have unexplained RPL. Tempfer has proposed empiric therapies for this group of patiens which includes; folic acid, ASA, antibiotics, prednisone, and progesterone support with some exciting success.
[Tue Feb 05 17:49:25 PST 2008] mindy327To anyone who knows, once you do become preganant, should you remain on metformin to help avoid a miscarriage?
[Tue Feb 05 17:49:48 PST 2008] Corey_Whelanguys, just a heads up that we're at the ten minute mark.
[Tue Feb 05 17:49:58 PST 2008] sherryltwhat is ASA
[Tue Feb 05 17:50:26 PST 2008] danaackermanIs ASA anti-sperm antibodies?
[Tue Feb 05 17:50:39 PST 2008] christalpASA is aspirin
[Tue Feb 05 17:51:22 PST 2008] Ellen_ left.
[Tue Feb 05 17:51:35 PST 2008] zoobabyI stayed on Metformin throughout the pregnancy per drs orders
[Tue Feb 05 17:51:50 PST 2008] rdposcarmy specialist recommends staying on metformin until 12 weeks...but i know that doctor's opinions vary on the subject
[Tue Feb 05 17:52:15 PST 2008] Dr._Swansoncferster: An insulin level of 15 is not necessarily indicative of insulin resistance. In fact there is no accurate, inexpensive, reproducible test for insulin resistance.
[Tue Feb 05 17:52:34 PST 2008] rdposcarDr. Swanson - how can I be sure I'm ovulating even with HCG shots during IUI's?
[Tue Feb 05 17:54:45 PST 2008] Dr._Swansonrdposcar: Unfortunately the only definitive test of ovualtion is pregnancy. However, I would recommend a urinary ovulation predictor kit and luteal progesterone blood tests.
[Tue Feb 05 17:54:52 PST 2008]  frances1 left.
[Tue Feb 05 17:55:31 PST 2008] KbrowerHello everyone! Good Evening. I am needing some advice.I have PCOS and I am having trouble concieving. I have done 5 IUIs without success. I am met and actos. I found out today that I have a 30mm cyst in one ovary and 25 in the other. My fertility doctor put me on bc pills to try to shrink and I am trying to decide if IVF is the next step for me. My dr says that that is an option but it is my decision. Anyone have any suggestions? If anyone is pregnant, what methods did you use to concieve. Thanks
[Tue Feb 05 17:56:15 PST 2008] rdposcarwhat is "actos"?
[Tue Feb 05 17:56:32 PST 2008]  hoping left.
[Tue Feb 05 17:56:42 PST 2008] tacori25Dr.Swanson what is the best way to tell your ovulating without checking BB.
[Tue Feb 05 17:56:51 PST 2008]  msc left.
[Tue Feb 05 17:56:52 PST 2008] KbrowerIt is a medication for insulin resistance
[Tue Feb 05 17:57:12 PST 2008] Corey_Whelanguys, we only have a few minutes left, I request we hold back our questions now and let Dr. Swanson answer what is up. I promise I will schedule another chat with him soon.
[Tue Feb 05 17:57:22 PST 2008] rdposcarkbrower - it's a medicine you take in addition to metformin? isn't that repeatitive?
[Tue Feb 05 17:57:35 PST 2008] mindy327typical med for insulin resistance is metformin
[Tue Feb 05 17:57:49 PST 2008] Corey_WhelanI also want to make sure you all know about Family Matters this weekend? For those who love San Francisco, DO NOT MISS this conference. email me for more info corey@theafa.org
[Tue Feb 05 17:57:51 PST 2008] Dr._Swansonrdposcar: If you are insulin resistant and tolerating metformin with documented control, I would staty on the metformin during the pregnancy.
[Tue Feb 05 17:58:19 PST 2008] Corey_Whelanwere any questions missed?
[Tue Feb 05 17:58:23 PST 2008] rdposcarDr. Swanson - stay on metformin for all 40 weeks?
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[Tue Feb 05 17:59:11 PST 2008] Dr._Swansonsherrytt: Sorry, ASA is aspirin.
[Tue Feb 05 17:59:52 PST 2008] Corey_WhelanDr. Swanson, thank you so much for being here tonight! I learned a lot.
[Tue Feb 05 18:00:20 PST 2008] Corey_Whelanand thanks to everyone else for being here and asking your questions. You know I wish you all so much, so very much luck in your journey.
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[Tue Feb 05 18:00:43 PST 2008] christalpthank you Dr. Swanson and you too Corey
[Tue Feb 05 18:00:49 PST 2008] Dr._SwansonCorey: Thanks for asking me to participate.
[Tue Feb 05 18:00:51 PST 2008] Corey_Whelananytime love
[Tue Feb 05 18:00:55 PST 2008] mindy327Thank you very much Dr Swanson
[Tue Feb 05 18:00:59 PST 2008] Corey_WhelanThat was for christalp!
[Tue Feb 05 18:01:09 PST 2008] Corey_Whelanthanks to you too Dr. Swanson
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[Tue Feb 05 18:01:33 PST 2008] Corey_Whelanguys, our chat is officially over. I'll see you all next week.
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[Tue Feb 05 19:23:22 PST 2008] lunawhere will the scripts for this chat be?
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[Tue Feb 05 20:16:13 PST 2008] floi miss tonight chat where can i find the trascripts
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