PCOS - Its Treatment and the Effect on Fertility

August 1, 2006 - Tuesday
6:41 PM to (EST)
Guest Speakers: Rachel Bennet, MD
Westchester Reproductive Medicine

Categories
Fertility • Infertility • IUI • IVF • PCOS • Pregnancy • Pregnancy Loss

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deb	Good Evening and welcome to tonight's online education session, hosted by The American Fertility Association and sponsored by Fertility Lifelines.
deb	I am your moderator tonight. If you need help during the session all you have to do is double click on my name on the left.
deb	Our guest this evening is Dr. Rachel Bennett from Westchester Reproductive Medicine.
deb	Tonight we will be discussing PCOS-its treatment and the effect on fertility
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dr._rachel_bennett	hi deb. it's a pleasure to be here tonight. i hope i can be of some help in answering some questions on the effect of pcos on fertility.
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corgimommy	Hello
deb	PCOS is extremely common topic, yet is often misdiagnosed as the symptoms may be unclear and even muddled. Possibly because there is no one test for PCOS and the symptoms can be present in other disorders. Whatever the reason, tonight we are here to shed some light on this disorder and discuss its role in fertility
deb	I want to thank Dr. Bennett for joining us...out of the heat of the East Coast! Dr. Bennett, why don't you make some opening comments to get the ball rolling.
dr._rachel_bennett	sure deb. people can present with pcos in a variety of ways. for some women, the cardinal feature is irregular or no periods. for others, it's abnormal hair growth, usually on the face (male pattern.) for others yet, it is polycystic ovaries on ultrasound.
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dr._rachel_bennett	the presentation, and the woman's complaints will determine how to treat.
dr._rachel_bennett	most women who have been diagnosed with PCOS and seek out a fertility specialist complain of irregular periods and inability to conceive. for these woman, the obvious treatment is ovulation induction.
pam	Dr. Bennett- how does insulin resistance play into it and how does insulin resistance differ from Diabetes? It is simply a precursor to Diabetes? Also, for the abnormal hair growth .......do abnormal levels of androgen have to be present or can a woman have abnormalhair growth but normal levels of androgens?
pam	I hope it is okay Ito have just jumped in.
dr._rachel_bennett	please do jump in. i'm here to answer your queestions.
deb	pam, it is absolutely ok to jump in...
dr._rachel_bennett	insulin resistance plays a large role in pcos, although it is not used to make the diagnosis (you don't need to be insulin resistant to be diagnosed with pcos, and not all women with pcos are insulin resistant (IR). IR is much more common in women with pcos than in women in the general population. IR is a precursor to diabetes, and women who have IR and pcos, are at significant risk of developing impaired glucose tolerance, and eventually diabetes.
deb	And the same is true for everyone. These session are for you.
pam	how does all this effect egg quality?
dr._rachel_bennett	as for the abnormal hair growth, abnormal levels of androgen do not have to be present. a woman can have abnormal hair growth but normal levels of androgen. in order to be diagnosed with pcos, you need to have 2 of the following 3 criteria: irregular, or no periods; abnormal hair growth, or elevated androgens; polycystic ovaries on ultrasound, and exclusion of other diagnoses that can cause a pcos picture.
corgimommy	Hello everyone! Let me give you some history on me. I'm 25 and went to OB/GYN after 3 months of no period after birth control pills. We did two cycles of clomid and progesterone testing on day 21. My blood levels were low. So, in March I was referred to a RE. So far I have done 2 cycles of Clomid 50mg days 3-7 + Metformin everyday + HCG trigger and IUI. Still no pregnancy but RE assures me I'm ovulating. So my question is why no pregnancy? What are my options after this 3rd round of Clomid (still at 50mg). Going for a day 14 u/s tomorrow (went monday but largest follicle was 15). Planning to trigger tomorrow night and IUI on Friday. Basically, I am confused because I'm responding to Clomid but no pregnancy....
corgimommy	Oh I forgot just did an HSG in July. Dye only went into 1 tube. My RE doesn't think it is blocked. This is also confusing to me.
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deb	Good evening Smiley, welcome aboard. We are talking with Dr. Rachel Bennett about PCOS, its diagnosis, treatment and effect on fertility. Feel free to jump in.
smiley	thanks.
dr._rachel_bennett	the first line of treatment of anovulation is usually clomid, with or without metformin. you are responding to the treatment, in the sense that you are ovulating. sometimes it just takes several months before you get pregnant. remember, even in totally fertile, ovulatory women, it can take, and often does, more than 3 ovulatory cycles with good timing to conceive. in fact, the definition of "infertility" is failure to conceive after 12 attempted cycles in an ovulatory woman under 35. so don't lose heart yet, although i know it is frustrating since you're being monitored so intensely.
dree	I was dx'd a year ago (9 mos of amenorrhea after 12 yrs on OCP; polycystic ovaries on U/S; hair growth on the chin and neck; overweight and high normal insulin levels). I've been on metformin for a year now and my periods started up again in January. I seem to be averaging a 38 day cycle. I think that I have been thinking that a resumption of my periods would be a proxy for the PCOS being under control. If I'm menstruating regularly, do I have as much chance of getting pregnant as a woman in the general population? (well, let's say a woman with 38 day cycles!) I should add that becoming pregnant is not my primary concern, I am more concerned with my own health and the impact of PCOS on it.
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dr._rachel_bennett	as far as the HSG, it's hard to know without seeing the films exactly what the story is with your tubes. we know at least one is open, right? sometime the other tube spasms during the HSG, and prevents dye from getting in. perhaps that's why your doctor thinks it may still be open.
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dr._rachel_bennett	having periods doesn't necessarily mean you are ovulating. have you any documentation of ovulation? (bbt charts, progesterone levels?) assuming you are ovulating, then yes, your chances of getting pregnant do return to the same chance that another non-PCOS women would have if she had 38 day cycles also.
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viviane	does metformin alone return avulation?
dr._rachel_bennett	the fact that your periods returned is a very good sign. have you had a glucose tolerance test to check for impaired fasting glucose, or impaired glucose tolerance, or even diabetes? you should periodically have this checked. weight loss, if it can be achieved, is an excellent way to prevent progression to diabetes in a woman with insulin resistance.
dree	would changes in vaginal discharge be a sign of ovulation? I have very obvious eggwhite discharge generally a couple of weeks before my periods start.
dr._rachel_bennett	yes, metformin alone can, but does not always, cause ovulation to resume.
corgimommy	Thank you Dr. Bennett. So, how long can you do Clomid cycles if you are responding. Does the pregnancy rate increase after each IUI? What is your protocol after Clomid?
dr._rachel_bennett	depending on the woman, many doctors might start with metformin alone for ovulation induction.
beccab96	can avandia be used in place of metformin or glucophage?
dree	if that last question was for me - I have normal fasting glucose. Have lost 22 pounds in the last year thanks to wonderful metformin (I have always been very active and a healthy eater - just was always always hungry)
corgimommy	About the HSG-my RE did mention the spasm. Would you recommend another HSG or a cannulization (sp?) Is that a procedure that you need to be asleep?
beccab96	I have a question dr....If someone has PCOS and then ends upgetting pregnant someway with help or by themselves can they start ovulating buy themselves agin or no?
viviane	I'm currently on a clomid cycle with metformin and bromocriptine, They checked my follicles today and told me that I have one on each ovary one is at 16 cm and the other at 16 1/2 what are my chances I will be taking the trigger shot tomorrow night. My Rx is PCOS, anovulation
dr._rachel_bennett	in a woman who has no other fertility factors, but who is solely anovulatory is the cause of not having conceived, i will try 3-6 months of clomid, with some variations (adjunctive medicines can be added, such as metformin, dexamethasone, estrogen..) however, if there are signs of adverse effects of clomid (thin endometrial stripe, poor cervical mucous), i would probably move on to another med after just 3 cycles.
dr._rachel_bennett	i would recommend another HSG with a cannulation at the same time - that can be done by a radiologist, and you don't need to be asleep.
dr._rachel_bennett	if someone with PCOS ends up getting pregnant, they can start ovulating by themselves after the pregnancy - this happens not infrrequently
deb	Dr. Bennett, is there a link between diet and treating/controlling PCOS?
dr._rachel_bennett	usually the trigger is given when the largest follicle is 17 - 20 mm. so it might be tomorrow night, or the next night.
viviane	they told me to take it tomorrow night and my iui is friday
dr._rachel_bennett	there is definitely a link between diet (i assume you mean dieting to lose weight), and treating PCOS. it is the best way, better than any medication, to reduce the risk of progression to diabetes.
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dr._rachel_bennett	that sounds perfect, as your follicles today were 16, they'll be ready by tomorrow.
beccab96	so dr does that mean that i will never ovulate by myself my cycle normally when i was between ages of 15 and 18 i got a period 2 times a year and i was on the pill for 6 yrs from 18 to 23 and then stopped and got my period 2 times a year agin... So it will never be a regular cycle... If i have children will they suffer from this?
corgimommy	I have no other fertility factors (no male issues, etc). But I am overweight on weight watchers and have lost about 25 lbs since March. On my day 12 u/s my endometrium lining was 6. Is this normal for clomid? Should it be higher? I did have some hostile cervical mucous--but chose to do the IUI. How does estrogen help? What is dexamethasone?
viviane	this is my 4th iui, 3rd round with clomid 1st one was with follistim and failed, what are my chances with two follicles, previous cycles only had one follie
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dr._rachel_bennett	it does not mean that you will never ovulate by yourself. if you are overweight, and you lose weight, that might make your cycles regular. or, if you go on metformin, that could make your cycles regular also. as far as your children - there is probably some genetic link for pcos, but it hasn't been clearly identified. this might mean that your female children might be at higher risk for this, but not that they will necessarily have it.
pam	Dr.Bennet so if one were to lose weight and have healthy cholesterol would the polycisticness correct itself/reverse? Also can you please describe what polycistic ovaries are and how this contributes to infertility? Thanks
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dr._rachel_bennett	a lining of 6 is borderline. it depends on how large your follicles were on that day. the iui should treat the hostile cervical mucous. estrogen can help counteract the negative effect of clomid on the endometrium and cervix. dexamethasone is a steroid that can be given to enhance a clomid cycle if your DHEAS level is slightly elevated.
beccab96	Dr I did a ivf cycle # 1 in 04 and got a bad form of OHSS and i called thedr the next day i was in pain and throwing up and was just horriable they told me it was the flu i admitted myself to the hospital on that sunday i had 2.5 liters of fluid removed from my stomach and kidneys and liver shut down what are my chances if i do IVF again that this would happen to me again?
dr._rachel_bennett	polycystic ovaries are a typical appearance on ultrasound - it is an ultrasound diagnosis. the ovaries appear as a "string of pearls" around the periphery of the ovary. usually there are at least 10 small follicles of 4-10 mm on each ovary.
dr._rachel_bennett	it is not the polycystic ovaries perse that contribute to infertility. rather, it is a sign, and a diagnostic criteria of pcos.
beccab96	what causes one to get PCOS?
dree	what other situations can cause polycystic ovaries?
viviane	i believe too much testosterone contribute to producing the cysts right?
pam	i had a failed IVF and then a couple of months later got pg naturally (and miscarried). My RE suggested that having the aspiration of my ovairies during the IVF may have effected the function of my ovaries thus I got pg. IS there any other way to acheive that effect other than IVF?
dr._rachel_bennett	becca, that sounds like you had a very severe case of OHSS. you are at risk for this happening again to be sure. whoever treats you should carefully review your records and come way down on your medication doses. maybe they can also do some creative ovulation induction with you (clomid combined with gonadotropins, for example, reduces the total amount of gonadotropins you need to take .)
dr._rachel_bennett	there is no one factor that causes women to get pcos. it can be arrived at by multiple avenues. in one woman, it might be insulin resistance that is the inciting factor. in another, it might be excess weight. in another, it might be abnormal release of FSH and LH from the pituitary.
deb	Is PCOS hereditary?
corgimommy	On Clomid Day 12 I had 2 follicles measuring 15 w/ a lining of 6. When can you take estrogen? What about progesterone supplemenation--how do that help PCOS women?
dr._rachel_bennett	polycystic ovaries can be found in women who have no disorder (normal, cycling woman.). or it can be found in women who have excess androgens from some other cause (cushing syndrome, for example).
pam	what is cushing Syndrome?
beccab96	they said that the last time they retrieved 68 eggs and then i got ohss and my mom made the decision because i wasso sick and they didnt believe me that i was ill were going to charge me 1500 to hold and then 250 a month for storage and then when she told them to dispose they asked me to sign over the eggs which in the begining i signed to have them disposed so they were trying to be tricky
corgimommy	In general what are the percentages of PCOS women getting pregnant and staying pregnant? Aren't the odds in our favor?
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viviane	I understand PCOS is classified as a complex endocrine disorder associated with hyperandrogenism (elevated testosterone and androstenedione) with chronic anovulation (long term absence of ovulation.
dr._rachel_bennett	pam, yes, there is a treatment called ovarian drilling. this is done laparoscopically. electrocautery or laser is used to actually drill holes in the ovary, thus releasing fluid that likely contains androgens. after this procedure, androgen levels around the ovary are reduced, and it is thought that this is what releases the ovary to ovulate after the procedure. this is a good second step for someone who doesn't ovulate to clomid, or is difficult to stimulate using gonadotropins.
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dr._rachel_bennett	corgimommy:estrogen is usually given days 8-15. progesterone supplementation shouldn't be needed in the treatment of pcos. assuming your ovulation is a good one, your body should produce progesterone after ovulation.
viviane	is it a positive fact that one ovulates with the trigger shot?
pam	That is interested. This is all so complicated. I have never had a problem with ovulating or irregular cycles. but i have excess hair growth, polycystic ovaries and IR. Is Ovarian drilling something tobe considered? Also , I recently, after 2 MC's and an ectopic was dx with MTHFR, is that related at all to PCOS or the insulin resistance?
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dr._rachel_bennett	the odds are definitely in your favor - it is one of the most successful things to treat in our field. usign clomid alone, 80 percent usually ovulate, and 40 percent will conceive. so if clomid doesn't work, there's still a lot of other meds to use, and the ovarian drilling procedure.
deb	Welcome, Eileen. Dr. Rachel Bennett is discussing all aspects of PCOS
dr._rachel_bennett	vivian -it is a positive fact that one ovuloates with the trigger shot. the trigger shot will almost always cause ovulation, as long as there is a good sized follicle there.
beccab96	I heard that they dont use the drilling of the ovaries unless it is absoultely necessary... i asked the nurse at the RE ofc
viviane	would a doctor feel more confident if his patient has 2 follicles instead of one for the iui to work?
pam	along the lines of ovulation and the trigger........ is it always between 36-42 hours after the shot or could it be before or a day after?
dr._rachel_bennett	pam, if you don't have a problem ovulating, then i wouldn't consider ovarian drilling. it is used to help someone ovulate who is resistant to other meds. MTHFR is not related to PCOS or insulin resistance, at least not that we currently know of.
corgimommy	Why is the conceiving rate so low for Clomid compared to the ovulation?
pam	thank you Dr. Bennett.
corgimommy	What about 2 IUI's? Does that increase your odds?
dr._rachel_bennett	ibecca - ovarian drilling is certainly not a first line treatment. you would try medications first. but =if someone is very difficult to stimulate, and/or resistant to meds, it is something to consider.
deb	As a reminder, we have about 12 minutes left with our guest, Dr. Rachel Bennett from Westchester Reproductive Medicine. If you have been waiting to ask your questions, now would be a good time to type them in!
dr._rachel_bennett	vivane - it is fine if you have only one follicle, as long as you are the person who wasn't ovulating prior to the medication. remember, we are only trying to get you to ovulate, period, not to ovulate multiple follicles. however, if after 2 or three cycles of only one follicle, and you're not pregnant, i would probably make some change in the protocol.
deb	I want to take a minute to thank Dr. Bennett, who literally has been typing constantly for nearly sixty minutes...whew! Thanks, Dr. Bennett. This is a great session.
kdwolfe	I conceived using repronex and iui. Do you know what my chances of conceiving w/o assistance will be?
dr._rachel_bennett	pam - if you haven't started ovulating in the cycle yet, ovulation usulaly happens about 36 hours after the shot.
corgimommy	What is considered a good sized follicle?
viviane	I was on 50mg of clomid now I was on 100mg, and produced two follies one on each side
beccab96	So dr before you go i just did ,y 2md IVF cycle and they had me on the very min of all meds....they got 31 eggs and they just did the ET 2 weeks ago and they found out today there are twins i am giving myself PIO shots if i stop the shots when i am 10 weeks will i be ok ?
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dr._rachel_bennett	2 iuis doesn't increase the odds very much. unless you are using donor sperm.
dree	thank you dr_b
dr._rachel_bennett	kdwolfe: are you menstruating on your own now?
pam	how do they know if you have already started ovulating in the cycle?
kdwolfe	i'm still breastfeeding and haven't had a period yet
deb	As a reminder, we are here every Tuesday night from 8pm-9pm Eastern. Next week, Dr. Wright Bates, Jr. from Atlanta will be discussing Ovulation Detection and Treatment. We hope you will pencil us in.
dr._rachel_bennett	corgimommy: a good sized follicle is 17-20 mm.
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kdwolfe	i've always menstruated on my own, my cycles at a minimum were 35 days though
dr._rachel_bennett	becca - congrats, i am happy for you. continue the prog shots. you should be fine if you stop the shots at 10 weeks, by then your placenta should be producing plenty of progesterone.
dr._rachel_bennett	only by the monitoring - increasing LH levels, or increasing progesterone levels.
deb	We always look for ways to serve you better. If you have ideas for topics you would like to see covered, please let me know. You can reach me at deb@theafa.org. And don't forget www.theafa.org is a wealth of information that is at your disposal 24/7 for No Barriers members. And best of all, membership is free!
beccab96	Im kind of nervous becaue i had a m/c of twins at 8 wks in 03 and then the OHSS in 04 they say im high risk do you think i will be able to carry to full term?
dr._rachel_bennett	kdwolfe: if your breastfeeding solely, that may also be the reason why you haven't had a period yet. see what happens after your done breastfeeding.
deb	I am ringing the five minute warning bell.
pam	if you already started to ovulate would they cancel the cycle or still have you trigger?
corgimommy	How often should you have sex after trigger and IUI?
kdwolfe	thank you
dr._rachel_bennett	becca - you should remain hopeful. you have a very good chance of carrying to term, despite the history of miscarriage.
viviane	well everyone wish me luck on friday with my iui, this is my fourth and last time before I give up. Thanks for answering my ???s
deb	Dr. Bennett, would you like to give some closing comments. And would it be possible for our guests to contact you for more information?
beccab96	ok thank you
corgimommy	THANK YOU
dr._rachel_bennett	pam - they might still have you trigger, but they might plan the iui sooner than usual.
pam	thank you very much for your time and information. this was very helpful.
deb	Once again, our heartfelt thanks to Dr. Rachel Bennett. We literally could not do what we do without your support and participation.
dr._rachel_bennett	corgimommy: i would have sex the night of the trigger, and the night of the iui. but your doctor might have his/her own protocol.
dr._rachel_bennett	i am always happy to be abvailable to answer questions. if anyone would like to contact me, you can reach me at Westchester Reproductive Medicine 914-962-6300. thank you for your questions.
deb	Thanks for a great session, Dr. Bennett...and to those of you on the East Coast...keep cool!
deb	We will see you all next week. Thanks for joining us.
viviane	110 degrees here in NY
dr._rachel_bennett	you are welcome.
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viviane	if anyone would like to email me its elvt28@msn.com or chat on Yahoo "kassy1020"
beccab96	Viv at what age did they tell you that you had PCOS?
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viviane	I was the one that asked the doctor if I had PCOS about 2 Years ago because of a report I saw on the news which discribed the symptoms I was having, then he looked at my neck and saw skin tags very tiny though and yes I have PCOS
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viviane	but I've been having problems with my period since i was 15 years old
viviane	my period were not coming and I had missed it for three whole years and they found out I had very high prolactin levels I had 143 and the level should be from 4-30
beccab96	ohhh my mom figured something when i was 12 and my period didnt come back till i was 15 and then it came 2 times a year then when i was 19 my mom wanted to do testing but i was rebellious and wanted to do my stuff and never really wanted to find out what i had now im married aand its hard for me wich i had paticience a while ago to find the problem then then now
viviane	Yes, I found my problem really on my own when things were just not going right with my hormones and my gyn doc sent me to a RE who has been working with me for the past 2 years. Hopefully Friday with my IUI this time it will work. Have u ever been Preggo, I got married 3 years ago Im 33 and we are still trying for #1
beccab96	I have been married for 5 yrs to my younger husband who is a trouble maker ;-( yes i had a miscarriage of twins in 03 at 2 months and i did my first IVF in 04 and got really sick with OHSS and waited to just about now to see if i could get pregnant? Why dont you and you Hunny just do IVF ?
viviane	My doc said I still have a few protocols to try since I respond well to the Injection, this time I decided to go with clomid because it was less expensive, but doc said I still have a few more tries before IVF is considered.
beccab96	I got pregnant on the 2nd cycle of clomid and then i got pregnant the dr called me at work like it was an er and we saw that there were twins and then she said well we know you miscarry we at least know you can get pregnant.... After that i never went back to that dr .... where do you live?
viviane	they told me for clomid to work with iui, one should have a least two to three follies, right now I have 2 one on each ovary, I am taking the trigger shot tomorrow
viviane	I live in New York, and u?
beccab96	I live in CHGO
viviane	did u have any symptoms during the 2 week wait
viviane	cool
beccab96	I dont remember doing a trigger shot on clomid i think she said just have sex and we did and it happened to be on my husbands bday and it was so cool the babies wld have been born on our anniversary
viviane	awwww, If I were u I would give clomid a try again
beccab96	i cant remember 3 yrs ago i had some much trauma after that .....They say in the 2ww that when its working you feel like you are getting your period and you have some cramping but just very mild
viviane	on this clomid cycle they have been monitoring me like every other day for the past week and a half
viviane	I had an ultrasound yesterday and today, and finally they saw my follicles today and they are at 16mm each
viviane	my estrodoil is at 350 and progesterone at 7
beccab96	if you ever decide to do IVF they will monitor you sometimes everyday
viviane	I think I would get on a stricked diet before I do IVF, and try to correct my hormone inbalance myself, I am about 60 lbs overweight, I am affraid of the OHSS
beccab96	if you have a good dr they wont let you get OHSS
viviane	metformine seems to be helping me lose the weight though, I take 1500 mg a day and lost 17lbs so far in 3 months
viviane	they said met also helps restore ovulation, I do get my period everymonth so far for the past two years
beccab96	if you do walking around your block for about 15 minutes a day that will help too and if you eat vegtables and they say if you drink lots of milk products you will lose weight
beccab96	metformin and glucophage made me sick they put me on avandia and it worked
viviane	yeah, avandia is about the same as met, how much did u lose on avandia
beccab96	I dont know i always have weighted the same
viviane	these prenatal pills make me sick to my stomach though they are huge capsules yuk, but hey its for the baby
beccab96	are you pregnant?
viviane	not yet, hopefully my iui will work on friday. They put me on Prenatals 3 months ago
beccab96	you should ask yo change brands or take them with food or take them in the am or pm
pam	becca- where in chicago do you live. I live in Rogers Park.
viviane	its probably the combination of medications, Bromocriptine for the prolactin, Prenatals, clomid, Metformin, and my husband, lol they all make me sick to the stomach lol
beccab96	I live in the burbs i live close to schaumburg
beccab96	dont all husbands make you feel that way some times
viviane	specially in this heat!
beccab96	yep
beccab96	its hard right now my hunny works the pm from 12 till 1 am and i work 830 to 6 and i actually miss him
beccab96	when i get off work
beccab96	pam are you still there ?
pam	i am here.
viviane	yeah my hubby works 12 midnight to 8 am, and when he comes home I'm long gone I work from 7 am to 5
beccab96	what are you doing ?
viviane	hey girls, join in
beccab96	when do you have time to actually give him a kiss
viviane	when i come home he is sleeping, what great baby making protocol, we rarely see each other!
beccab96	i couldnt not have my husband nectto me sleeping at night
viviane	Tuesdays and Wednesdays when he is off, but I get home at 6pm, Weekends I see him when he gets home
beccab96	tell himt o find the same type of job but to have better hours
viviane	he's trying
beccab96	pam where are you in your process of fertility?
pam	i am going backwards. I did clomid with IUI two years ago, then did 3 IVF's, now I am back to IUI with injectibles.
beccab96	hes trying but it seems like it takes for ever when ever you want to be with him
viviane	yes
beccab96	What happened with the 3 IVF's Pam did you get any positives out of it?
viviane	he is very supportive though, and takes alot of time off to be with me, he gets about 5 weeks vacation and 20 sick days a year so he works around that and my vacation time
beccab96	ahhh he sounds like a nice guy how long has he worked for his company?
viviane	he is a cop, 12 years
beccab96	ohhhh i wouldnt want him to be in that job
viviane	yeah, he is going more into corrections, he is not doing the streets
pam	two were BFN and one was ectopic. I have been pg twice naturally and MC'ed. I was recently diagnosed with MTHFR that might be a factor in the MC's.
viviane	what is MTHFR?
pam	it is blood clotting issue. It looks obscene doesnt it?
viviane	lol, yes it does, that's what I thought it was lol
beccab96	MTHFR what does that stand for?
viviane	take baby aspirin 81mg a day, it thins the blood and hels circulation
beccab96	also i did accupunture before i did ET
pam	Metylene-Tetra-Hydro-Folate-Reductase is what it stands for.
beccab96	ill never remember that
pam	i take baby aspirin and nowlots of folic acid ,b6 and b12 becasue of the MTHFR
pam	me neither, that is why they call it MTHFR
viviane	how long have u had that MTHFRK?? lol
beccab96	can you do the PGD and have them take it out if you do ivf?
pam	it is inherited so probablty always
viviane	have ppl gotten preggo having that?
beccab96	it must be a really ugly part of IVF if they give it a long hard to remember name but once you have it you always remember it
beccab96	does any one else in your family suffer from IF?
viviane	three of my cousins have menstral issues PCOS, Endom., but they all had babies without treament
beccab96	each person is different
pam	how old are you guys?
beccab96	and it maybe easy for some and hard for others
beccab96	the ones that its hard for to me will love there children more and be more pertective and spoil them to death
beccab96	viv did you leave me
viviane	no, hubby wanted COFFEE!
viviane	lol
viviane	im 33
kdwolfe	do any of you have kids
viviane	no, just a puppy
pam	good night everyone.
beccab96	so he has 2 hands and 2 feet
	pam left.
kdwolfe	i noticed previous talk about metformin, etc. i haven't tried anything like that yet although my mom is diabetic. i'm interested in how much it might improve our future chances of conceiving
viviane	good nite Pam, like I said, you guys may e-mail me at elvt28@msn.com or Yahoo at Kassy1020, I will let you know How my iui went on Friday
beccab96	i didnt react well to metformin or glucophage but avandia did work for me
viviane	Metformine is said to be very good at resoring ovulation and weight loss
kdwolfe	well, i definitely need the weight loss
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kdwolfe	sometimes those "kids" with 4 feet are just as much work as the 2 legged ones (including husbands)
viviane	mee too
viviane	lol
kdwolfe	good luck with the iui. my 5th one was the charm. i'm just hoping that we don't have to go through all of this again to have another.
beccab96	so you DH doent know how to make coffee? i can do the kind in the pot but the kind with a water and spoon i cant
ArchAngelll	so how was the session?
viviane	hey guys, I have to run now, but it was great chatting with you, I wish you all the best of luck. It would be nice to keep in touch
viviane	session was great
beccab96	the session was ver informative
ArchAngelll	I wanted to join but had a problem getting here to log on
beccab96	sorry
viviane	you can print the session if you check the archives for the topic
kdwolfe	I need to go too. There's a storm coming with lots of lightening. Good luck to everyone.
viviane	where are u
ArchAngelll	Have any of you had problems with miscarriages
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viviane	i have no kids
ArchAngelll	Is the session available already to print?
viviane	should be let me see if I can copy and paste it to this chat room hold on
ArchAngelll	I am in Phoenix Az
ArchAngelll	I have been trying for 4 yrs and had so many things to go thru to find out what I really needed to do.
viviane	go to the top of this window, see the work action, click on that and see recent room history
ArchAngelll	Viv do u take metformin?
viviane	yes
ArchAngelll	how many a day?
viviane	3
ArchAngelll	I am supposed to be on 4 a day
ArchAngelll	ok go to the top and work action
viviane	i take 1500 mg a day
viviane	sometimes i forget to take it and I take 1, lol
viviane	the word action
viviane	then click on room history
beccab96	hey viv i have to run i havent eatten since 1 pm if i dont eat im going to be sick i have your email
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ArchAngelll	it only allows me to see the info since I came on
viviane	let me see hold on
ArchAngelll	can u copy and send to my email?
ArchAngelll	I started with a dr that did not do all the testing he really should have
viviane	yeah, that's what I'm trying to do, what is you email
ArchAngelll	I just got a new dr but my new dr said I need to lose some weight to do my first iui and I am turning 41 next month
ArchAngelll	it is angel85029@cox.net
ArchAngelll	i have been prego 4 times and keep miscarring
viviane	how much do you weight if u don't mind me asking
ArchAngelll	I weigh t 273
viviane	you need progestorone cream, u can buy that at the pharmacy
ArchAngelll	I was at 303 after my last preg loss
ArchAngelll	do i need a prescription?
viviane	no
viviane	look for it where they have preg test and condoms
viviane	lol
ArchAngelll	I usually don't show a pregnancy positive until it is too late like 3 weeks
ArchAngelll	lol
ArchAngelll	ok I will look
ArchAngelll	I need to get down to 250 before this new dr will treat me
viviane	also, do not pick up anything heavier than 12lbs while you are waiting
viviane	to see if u are preggo
ArchAngelll	he has gotten 3 woman to carry at age 35-46 with worse problems thanI have
ArchAngelll	have u had these problems?
viviane	no
viviane	i don't ovulate
ArchAngelll	I started out at age 22 gained 62 pounds in 3 months
ArchAngelll	noone at the time could figure anything out
ArchAngelll	then I stopped my cycles and 4 yrs later they found this PCOS
viviane	wow, I weight 189 but im very short like 4'10 i too need to get to 135 lbs
ArchAngelll	this is when they started running tests and I just found out 4 yrs ago
viviane	wow
ArchAngelll	If i was your weight I would be so happy lol
viviane	yeah, keep up witht he met, and tell your doc if he can send you to a dietician that can work with u
ArchAngelll	I am doing prettu good on my own so far
ArchAngelll	I am down almost 30 pounds
ArchAngelll	I just think I stayed too long with the wrong dr.
viviane	good, just skip the breads and pastas and you will see the difference in a week, I did, I was at 204 3 months ago
ArchAngelll	wow thats great
viviane	yeah, stopped the morning bagel
ArchAngelll	yeah those used to be my fav too.
viviane	lol, what is you real name
ArchAngelll	How long u been trying to get preggo
ArchAngelll	Angel
viviane	4 years
viviane	mine is Letty like betty with an L
ArchAngelll	I like Letty
viviane	viviane is my middle
ArchAngelll	ahhh
ArchAngelll	How old r u Letty
viviane	33
ArchAngelll	u still have time at least
viviane	my hubby is 40
ArchAngelll	he has a while though
viviane	yeah, they always do
ArchAngelll	they are good for a longer time
ArchAngelll	lol
viviane	hey, I have to get going, it was nice chatting with you, you can email me i will try to send you this session
ArchAngelll	ok sounds great
ArchAngelll	back at u
ArchAngelll	night
viviane	night
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viviane	::biggrin
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PCOS - Its Treatment and the Effect on Fertility

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