PCOS - Lifestyle, Conception and Pregnancy

October 30, 2007 - Tuesday
1:17 PM to (EST)
Guest Speakers: Scott Roseff, M.D.

Categories
Acupuncture • Fertility Drugs • Infertility • IVF • PCOS • Pregnancy • Pregnancy Loss

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Corey_Whelan	Hi earlybirds!
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Corey_Whelan	I'm Corey Whelan, The AFA's Director of Development and your chat moderator this evening. Tonight's chat is on PCOS. We are very fortunate to have Dr. Scott Roseff, the Director of the Palm Beach Center for Reproductive Medicine joining us. Dr. Roseff will be here in around five minutes.
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Corey_Whelan	Welcome Dr. Roseff! We have a lot of eager early birds lined up in the chat room. Thank you so much for joining us!
Scott_Roseff_MD	It's great to be here - Thanks for inviting me!
Corey_Whelan	Our chat officially begins in five minutes, but please feel free to post your questions for Dr. Roseff. We are VERY lucky to have him on board tonight.
lisagban	Dr. Roseff, what are your recommendations regarding weight gain for women who are currently pregnant and have PCOS.
Scott_Roseff_MD	Lisagban - It's critical to meet with a qualified nutritionist/dietician. A well-informed nutritionist who is savvy in PCOS can help someone who is pregnant with proper eating during pregnancy.
casper19	With PCOS, why is it so difficult to lose weight even while dieting and exercising?
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Scott_Roseff_MD	Some women don't have to gain much weight during pregnancy, lisagban, while others need to. Very obese women may actually be able to lose weight during pregnancy, but must do so under proper supervision and guidance.
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lisagban	How should I help guide my OB regarding my concerns of weight gain?
Scott_Roseff_MD	casper19 - it's difficult to lose weight for several reasons. One is that many women with PCOS THINK they are eating right and exercising properly, but they are not eating right for PCOS. Sometimes OVER-exercising can cause metabolism to go down, effectively preventing weight loss. Also, high insulin levels can work against weight loss.
danac262	I Have PCOS and I'm trying to conceive using Clomid 100mg, HCG trigger shot and IUI....what are my chances of conceiving? This will be my 3rd IUI....when should I move onto something else like IVF?
Scott_Roseff_MD	lisagban - Ask your OB for a referral to a nutritionist who treats many women with PCOS.
lisagban	Thank you!
Corey_Whelan	And as a pcoser myself, I must say that I feel strongly about the low carb connection. I did lose 80 lbs around 8 years ago and never put it back on.
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Scott_Roseff_MD	danac262 - Your odds of conceiving with that treatment depend on LOTS of different factors, including (and not limited to) sperm numbers the day of IUI, your peak E2 level, the timing of your IUI, the expertise of the person doing the IUI, your body mass index, etc. etc.
hmzaiter	I have PCOS but I also have a factor V lieden abnormality. If I am not ovulating due to PCOS, can I use drugs such as Clomid with my clotting disorder?
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casper19	What would you consider over exercising? I need to lose about 100lbs, I work out at a gym 3 days a week doing a combo of cardio and weights.
jenwatt79	i have pcos and been trying infertility tratment for about 4 years and actually trying to have a baby for 8 years i just found out last monday i pregnant for the first time ever in my life
Scott_Roseff_MD	Corey - GREAT work with losing such a huge amount of weight - You must be SOoooooo proud!
danac262	thank u
Corey_Whelan	guys, let's let DR. Roseff catch up, please.
jleighcr	I have PCOS but do not have the weight problem that seems to be common. I was diagnosed by ultrasound. I am wondering if there is anything I can do to begin having normal periods or a diet I should be following?
danac262	Congratualations!
jenwatt79	thanks
Scott_Roseff_MD	Corey - who's next?
Corey_Whelan	hmzaiter
hmzaiter	yes?
hmzaiter	oh, thanks
Corey_Whelan	your question is next
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tony67	goodevening everyone
Scott_Roseff_MD	hmzaiter - I don't see Clomid as being a contraindication in patients with FVL mutation. Make sure, though, that proper precautions are taken before getting pregnant. For example, some women need baby aspirin and/or heparin.
tony67	what is heparin
Corey_Whelan	casper, I can field your question. You absolutely MUST lose weight under a doctor's supervision - this is critical. You should work out with a qualified and licensed personal trainer. And three times a week is not excessive. You should build exercise into your life on a daily basis - think about walking and swimming
Corey_Whelan	Hey tony. welcome
Scott_Roseff_MD	casper - overexercising is a matter of individualization. A good RE who knows a lot about PCOS should be able to guide you. As a broad generalization, 30-45 minutes/day of cardio 5-6 days per week is OK.
Corey_Whelan	ok folks, we are ready for your questions now
danac262	what would a good E2level be?
Emma	Hi Dr. I have been trying to get pregnant and have been using LH test strips but they always seem to give me a positive several times a week is there something else I can use to tell me when I am ovulating
bkschaper	Dr. Roseff, I have been diagnosed with PCOS and trying to get pregnant for 3 1/2 years. We have had 3 miscarriages - the last one happening the end of Sept / beginning of Oct. With all 3 pregnancies the problems started happening around week 6. We have used Clomid 100 mg for 10 days along with doing IUI's. Is there hope for us to achieve a full-term pregnancy? I am overweight and have been told that in each pregnancy no fetus developed because of poor egg quality. My husbands sperm count is really good, so it is me that has the problem. Any advise would be helpful. We pray there is still a chance to conceive, but are losing hope.
casper19	Thank You!
Corey_Whelan	Danac is next
Corey_Whelan	then Emma and then bk
Corey_Whelan	hang on guys
Scott_Roseff_MD	danac - A good E2 level is about 200 pg/ml per mature sized follicle on ultrasound.
jenwatt79	i have pcos and been trying to get preg for 8 years now 4 years of infertility treatment i just found out i am pregnant last week i never been prenant before am i still high risk
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danac262	ok thank you
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Scott_Roseff_MD	Emma - Women with PCOS often have abnormally high LH levels, and therefore an ovulation predictor kit that checks LH in the urine may not be accurate or helpful. In this case, blood tests and ultrasound monitoring may be needed.
Corey_Whelan To[Private] Scott_Roseff_MD	you're doing great. If you need anything let me know
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Scott_Roseff_MD To[Private] Corey_Whelan	thank
Scott_Roseff_MD To[Private] Corey_Whelan	you
Corey_Whelan	hi megan
Scott_Roseff_MD	bk - you're next.
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Corey_Whelan	then jenwatt
Emma	My girlfriend has an OV-Watch that she said I could borrow. Would that be good to use while I am waiting for my insurance to change so I am covered by an RE?
tony67	i was told by my gyn that my by being 30 and having pcos i had no chance of conceiving that my eggs were too old is this true
Scott_Roseff_MD	bk - have you had a full workup for why you are losing pregnancies? It's critical to know why. When you say poor egg quality, how do you know that?
jleighcr	I have PCOS but do not have the weight problem that seems to be common. I was diagnosed by ultrasound. Currently am pregnant, via IVF. I am wondering once I give birth if there is anything I can do to begin having normal periods?
Corey_Whelan	Tony67 - NOT TRUE
Corey_Whelan	change doctors, please. See a specialist, not a gyn
Corey_Whelan	if you need a referral, call me
danac262	Tony67 I am 30 also and Corey is right....change doctors...what state do you live in
tony67	plan on in january, thanks for the offer of the referral i might just take you up on that
Scott_Roseff_MD	jenwatt - Yes, infertility in and of itself makes you high risk.
tony67	ohio
jenwatt79	i hae pcos i been trying for 8 years now 4 years of infertinity treatment i finally got a postive test last week first time i am pregnant and i still high risk since i never been preg before ever
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danac262	oh ok sorry NJ here
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Scott_Roseff_MD	Emma - Ov-Watch is not very accurate in my experience.
bkschaper	I have had an HSG done (which was clear), multiple ultrasounds with each cycle and blood work. Other than that the PCOS diagnosis has been made from my being overweight.
Corey_Whelan	tony, contact me at corey@theafa.org, I'll give you several good names
nithasha	I have pcos and had five miscarriage.I have been on metformin and also got an ivf cycle done which ended up in miscariage
Scott_Roseff_MD	tony - Not true - see an RE or different OB.
Corey_Whelan	Emma, try the Fertell test
Scott_Roseff_MD	bkschaper - I'm not sure what your ? is here.
tony67	thanks corey i will be contacting you. what is the fertell test?
Scott_Roseff_MD	nithasha - What did your workup for recurrent pregnancy loss show???
Corey_Whelan	an over the counter ovulation/sperm test
michelle	I have been pregnant twice and miscarried both times. They did all sorts of tests and cannot find a reason to why I am miscarrying. He attributes it to the PCOS. He also says there is nothing I can do to prevent miscarriages from continuing to happen. Is there something I can do?
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Scott_Roseff_MD	michelle - Did you receive any type of progesterone support? Were you taking metformin?
michelle	I am on metformin
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Scott_Roseff_MD	Did you take metformin during pregnancy michelle?
bkschaper	Is there a definate test that I should have done that will determine if I truly have PCOS or if there is another problem? As for the poor egg quality that is what the doctors have told me with no actaul workup beside what I mentioned earlier.
lisagban	Jenwatt has been waiting...
michelle	YEs
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danac262	Is there a better chance of conceiving using metformin along with clomid?
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Corey_Whelan	guys, please let Dr. R coach Michelle. Then we will cue up again
Scott_Roseff_MD	michelle - Some studies have shown a higher LOSS rate in women taking metformin in pregnancy. Do you really NEED the metformin?
nithasha	i had an early miscarige. My doc told me due to high androgen levels
michelle	well I am on it for pre diabetes and possibly am now diabetic
jleighcr	I have PCOS but do not have the weight problem. I am currently pregnant via IVF and am wondering once I give birth if there is anything I can do to begin having normal periods?
Scott_Roseff_MD	Consider a second opinion, michelle.
casper19	My RE gave me a 5 day dose of Provera to induce a period before I start the fertility meds, it has been 11 days since my last pill and nothing. Is it suppose to take this long?
Scott_Roseff_MD	nithasha - That's possible, but has EVERYthing been looked at?
jenwatt79	they skipped my questions
michelle	ok thanks i guess i will have to do that
Scott_Roseff_MD	danac - No, no better odds with metformin than Clomid. In fact, lower odds according to the most recent data.
Corey_Whelan	ok jenwatt. please repost your question and you will be next
jleighcr	me too
danac262	ok ty
Corey_Whelan	ok, hang in there. we are going very fast.
jenwatt79	ok thanks i have been trying to get pregnant for 8yrs and 4 years of infertility treatment i finally pregnant i never been prenant before am i still high risk i have pcos also
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mrsfite24 To[Private] sweetandsassybbw	Glad you could make it!!
Scott_Roseff_MD	jenwatt - I did answer, and said yes, due to infertility and PCOS, you are considered high risk. Greater odds of things such as pregnancy induced hypertension, preeclampsia and gestational diabetes.
jleighcr	I have PCOS but do not have the weight problem. I am currently pregnant via IVF and am wondering once I give birth if there is anything I can do to begin having normal periods?
nithasha	yes. I had all the test done like anticogulant, chromosomes etc........ everything seems to be ok i usually miscarry around 6-7 weeks
sweetandsassybbw To[Private] mrsfite24	Thanks, I just got your email...just in time lol
jenwatt79	thanks
Scott_Roseff_MD	jleighcr - You should see a board certified RE who can best manage your cycles.
lisagban	What new developments/progress have been made with PCOS this year?
mrsfite24 To[Private] sweetandsassybbw	Yep...How have you been?
hmzaiter05	My GYN recently put me on Premarin to force me to get my periods. It isn't working yet. Would going on Clomid help this to happen so I can get pregnant?
Scott_Roseff_MD	mithasha - What did your partner's sperm DNA fragmentation show?
jleighcr	ok thanks.
sweetandsassybbw To[Private] mrsfite24	pretty good, busy
Scott_Roseff_MD	jenwatt - you're welcome!
sweetandsassybbw To[Private] mrsfite24	I was just thinking about you today and was going to email you but haven't had a chance
Corey_Whelan	Lisa next, then hmzaiter
Scott_Roseff_MD	lisagban - nothing much new in PCOS except the realization that metformin alone or in addition to Clomid is no better than, and in fact is worse than, Clomid alone in achieving successful pregnancies!
mrsfite24 To[Private] sweetandsassybbw	I understand...We are some busy ladies now!!
Scott_Roseff_MD	hmzaiter05 - Premarin doesn't bring on a period. Are you sure you don't mean Provera?
tony67	wow my doc has always advocated metformin with clomid, it good to know these things
hmzaiter05	I'm sorry, Prometrium
famke	I was diagnosed with PCOS in 2002 and insulin resistance. I was on the BC for a while and I got off of it about 3 years ago. I recently gained about 40 lbs and with no periods. I went to the RE who initially diagnosed me with IR and he says I am no longer insulin resistant but I don't have any periods. My question is I don't want to go back to BC what are my options?
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coachlizzie	why is met with clomid worse than clomid alone?
sweetandsassybbw To[Private] mrsfite24	I know lol....we are actually looking into moving back to Hot Springs within the next month. Mike is wanting to go back to his old job
danac262	it is good to know....i was going to start taking metformin this cycle with the clomid
Corey_Whelan	guys, seeing a doctor who really understands pcos is key.
casper19	My RE started me on a 5 day dose of Prover to induce a period before starting my fertility meds. It has been 11 days since my last dose and nothing, does it usually take this long?
nithasha	what does DNA Fragmentation mean?
tony67	they seem like a rare diamond to me majority of the docs i see dont know squat about pcos
Scott_Roseff_MD	hmzaiter - Clomid doesn't bring on a period either. Your doc needs to do this with a proper type of progesterone.
hmzaiter05	thank you. it is so hard to figure out with having FVL as well as PCOS
mrsfite24 To[Private] sweetandsassybbw	Cool...is that something you want to do?
Scott_Roseff_MD	famke - You MUST have fairly regular periods. This can be induced with progestins (progesterone derivatives) on a regular basis.
sweetandsassybbw To[Private] mrsfite24	Yes, I feel so isolated here, all my family and friends are back in Hot Springs
Scott_Roseff_MD	casper - it can take up to 2 weeks, unless you were underdosed on your Provera.
jneencruz	hi, I am almost 35 and 2 yrs ago did two rounds of ivf. retrieval of 11 and 16 eggs respectively, during both times only 2 eggs were viable for implantation and neither took, would you recommend this new CGH testing? Have you used it yourself?
bkschaper	When my cycles first started (early teenage years) I had very regular cycles. After high school I went on birth control pills for 10 years. After getting married we went off of the bc pills and have been trying to get pregnant for 3 1/2 years. Doctors say I have PCOS due to non-regular cycles after stopping bc pills and being overweight. Is there a connection to now having PCOS and being on bc pills for so long? I had a post earlier also about have 3 miscarriages in the past 2 years. Is there hope for us? My husbands counts are good.
jenwatt79	i got pregnant with bravelle baby aspirn gluphage pre nantal vit and predisone to lower my testorone levels we were success ful after 8 years
Scott_Roseff_MD	nithasha - it's a test to see if the DNA in the sperm is "broken" or "fragmented". If highly fragmented, it can cause recurrent miscarriage.
jneencruz	what is bravelle?
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casper19	Dr. Roseff, in your opinion which medication is better Clomid or Femera?
mrsfite24 To[Private] sweetandsassybbw	Cool...then may the force be with you....LOL
sweetandsassybbw To[Private] mrsfite24	LOL
tony67	are injects better than clomid for pcos?
sweetandsassybbw To[Private] mrsfite24	so you going trick or treating lol?
Scott_Roseff_MD	jneencruz - CGH isn't ready for prime time. Most times, when only 2 mature eggs are retrieved, it's usually a result of a poor choice of stimulation protocols, inadequate time given on meds for follicle development, or poor hCG absorption after injection.
jenwatt79	injectable medication for infertility
red	Hi all, Dr, I had two dermoid cysts removed a couple of weeks ago, one being very large.. are my chances of fertility increased now? if so, for how long?
mrsfite24 To[Private] sweetandsassybbw	I'm hiding out in my house and going to sleep. Without kids, it is really not fun unless it is an adult party.
Scott_Roseff_MD	bkshaper - no connection between being on bcp's and PCOS. You need to have testing done to see WHY your cycles are irregular.
mrsfite24 To[Private] sweetandsassybbw	In my opinion, that is...LOL
sweetandsassybbw To[Private] mrsfite24	sounds like what I am doing lol
mrsfite24 To[Private] sweetandsassybbw	LOL
famke	Dr. Ro, I tried alternative medicine vitex and a natural progesteronwhen I got off BC but I stopped taking that as well. I stopped seeing my period this past May and in September I started having abnormal bleeding. I recently visited my gyn who sent me to do a pelvic sonogram..they discovered that I had some thickening of the endometrial lining and I am scheduled to have a hysterosonogram. I am currently on a 10 cycle of Provera to start my period...and it seem to stop the abnormal bleeding. I am really trying to find other options
Scott_Roseff_MD	casper - Each medication has its own particular advantages. Femara will probably win out between the two.
casper19	Thank You!
bkschaper	What tests should we need to have done?
sweetandsassybbw	Hi Dr, I have heard that it is possible to ovulate and concieve if you are not having cycles....Is this true??
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Scott_Roseff_MD	tony - it needs to be HIGHLY individualized. Clomid has advantages over injections, and injections have some advantages over Clomid.
tony67	thank you
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Scott_Roseff_MD	red - Your odds may be increased, but it's impossible to say by how much.
michelle	If I am able to get pregnant on Clomid and with an IUI but miscarry, is there any benefit to looking into IVF?
Corey_Whelan	sweetandsassy next, i think!!!
jenwatt79	just curious what is the advantages of clomid vs inget
Scott_Roseff_MD	famke - Ask your doctor if you need an endometrial biopsy to rule out hyperplasia.
nithasha	i am not sure about the DNA fragmentation shows. Since I went through a ivf cycle is there any chance that My Doc would have checked this
jneencruz	i used gonal f injections, and lupron, maybe something else but I can't recall right now and I remember being up to a 900 dosage of the gonal f injections, what kind of medication would you suggest?
Scott_Roseff_MD	michelle - No, IVF has no benefit for miscarriage.
Scott_Roseff_MD	sweetandsassy - Not true.
tony67	what is the average dose for injects?
osuzzana	Hello Doctor! I have had irregular periods for a few years, after being on Depo. Now, I'm getting periods every 45-60 days and have been testing for ovulation and nothing. Started Clo last month and will try again next cycle. Is there hope for me?
Scott_Roseff_MD	nithasha - No, not unless it was done ahead of time.
Scott_Roseff_MD	jneencruz - The medication protocol must be (at least it is in my successful practice) HIGHLY individualized to each woman - This is based on MANY factors, and I don't know those factors about you.
Scott_Roseff_MD	tony - Average is not helpful, since EVERY woman must be individualized to what's right for HER!
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red	Are you familiar with the liquid form of Metformin
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jneencruz	that is what i thought you would say but it can't hurt to ask
famke	Dr. R she ordered to Hysterosonogram to rule out polps and fibroids
red	Does is have advantages over regular met in terms of side effects?
Scott_Roseff_MD	osuzzana - Sounds like there's hope, but MAKE sure you are monitored properly for ovulation on Clomid.
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nithasha	Doc, Any other suggestions for recurrant miscarriges. I will be undergoing FET on Thursday and I am on baby asprin this time. Does this help
Scott_Roseff_MD	red - Yes.
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Scott_Roseff_MD	famke - make sure she rules out hyperplasia with a biopsy!
famke	ok
Scott_Roseff_MD	red - no, just easier to swallow LOL!
red	thank u!
michelle	FET?
bkschaper	What tests should we have done to see why my cycle are not regular?
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nithasha	Frozen Embryo transfer
michelle	oh ty
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Scott_Roseff_MD	nithasha - Recurrent loss must be treated with the proper medication depending on the cause of loss. If no cause is found, BA and progesterone and estrogen would be used in an FET cycle. Make sure your blood estrogen and progesterone levels are high enough to support pregnancy.
nithasha	I am on Estogen tablets and Progestrone shots
osuzzana	Regarding monitoring for ovulation, is opk sufficient or are you advocating in-office testing?
tony67	am i missing something? what is a full workup i need to have i feel like they are missing something, i took clomid for 6 months 150mgs, i ovulated but no pregancy. the only thing i got was some blood work done. what am i missing?
jneencruz	someone asked about a comparison between clomid and another drug that started with an F, could you please type the name of the other medication as i have never heard of it and would like to learn more about it
Scott_Roseff_MD	bkschaper - many different blood tests must be done, and the list is too extensive to include herein. Any good RE should know what tests to do....
bkschaper	Thank you for your help Dr. Roseff.
Scott_Roseff_MD	osuzzana - OPK works for some women but not others with PCOS due to high LH levels. It can be tried, or one can do blood and ultrasound monitoring instead.
mrsfite24	I was wondering what would be the recommended way to go about getting pregnant with PCOS if money is an object? Thanks in advance.
Scott_Roseff_MD	tony - No ultrasounds??????????????????????????????????????????
osuzzana	Thank you =)
sweetandsassybbw To[Private] mrsfite24	very good question lol
mrsfite24 To[Private] sweetandsassybbw	Whew...even online I got nervous asking it...
mrsfite24 To[Private] sweetandsassybbw	LOL
mrsfite24 To[Private] sweetandsassybbw	Thank you.
tony67	not when i took the clomid, doc said i didnt need them
mrsfite24 To[Private] sweetandsassybbw	I didn't want to sound cheap but...
mrsfite24 To[Private] sweetandsassybbw	LOL
tony67	i was paying out of pocket and he said it would save me money
Scott_Roseff_MD	tony - ::down
sweetandsassybbw To[Private] mrsfite24	I think there are alot of us in that situation
lisagban	I second that thumbs down!
Corey_Whelan	mrsfite24 is next Dr. Roseff
Scott_Roseff_MD	mrsfite - it's important to be healthy first. Then, it's important to ovulate on a timely basis.
tony67	i know i know it sucks, but i am not seeing them anymore
Scott_Roseff_MD	tony - Good !
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mrsfite24	Thank you Dr.
sweetandsassybbw To[Private] mrsfite24	ok..that didn't answer your question lol
lisagban	Regarding your holistic approaches, do you recommend acupuncture during pregnancy for PCOS patients?
Scott_Roseff_MD	lisagban - YES, wholeheartedly. We work closely with an expert in fertility promoting acupuncture.
mrsfite24 To[Private] sweetandsassybbw	It sure didn't but he is pressed for time and after all he is a doctor...LOL
famke	Dr. R do you have any recommendation for a doctor gyn or RE in the DC Metro Area who is well versed in PCOS. I would like to get more specialized attention.
tony67	what is the benefit of acupunture
lisagban	Thank you.
mrsfite24 To[Private] sweetandsassybbw	They never answer questions the way we need them answered.
sweetandsassybbw To[Private] mrsfite24	LOL true...I am glad you didn't pay for an office call lol
Corey_Whelan	famke, please contact me after the chat for some recommendations in that area. corey@theafa.org
mrsfite24 To[Private] sweetandsassybbw	Me too!!
Scott_Roseff_MD	famke - Sorry, don't know anyone there. That's partly why women travel from afar to see me.
Corey_Whelan	guys, the AFA's referral list hangs on our website, we can help you with this. And for any of you in Fla - that's where Dr. Roseff practices.
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osuzzana	I recently had my FSH tested and it was 6.5, which of course is good. Is there any relation to a good number and not ovulating?
Scott_Roseff_MD	tony - The Eastern philosophy is that PCOS is an imbalance of or blockage of energy flowing through the body (called Chi). Acupuncture opens the channels and allows chi to re-balance in the body.
Corey_Whelan	Dr. Roseff's website is www.reproendo.com
Scott_Roseff_MD	Corey - Thanks.
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tony67	thanks doctor, but where do you find a acupunturist, and do they have to specialize in pcos?
Scott_Roseff_MD	osuzzana - An FSH must be evaluated along with an E2. We also test other hormones for egg quality above-and-beyond the FSH and E2.
Corey_Whelan	tony, we can help you with acupuncturist referrals as well.
Scott_Roseff_MD	tony - Ask a board certified RE who the acupuncturist is that they recommend.
osuzzana	E2 was 163. Is that bad?
tony67	ok i wil thanks again
Scott_Roseff_MD	Osuzzana - That's highly abnormal for cycle day 3.
lisagban	Have you seen a link with PCOS and Pancreatitis?
mrsfite24	One more question Dr. R. After getting healthy and getting the ovulation process to work, what do you suggest next?
tony67	i will be contacting corey about that too
Scott_Roseff_MD	lisagban - No.
Corey_Whelan	osuzzana, don't panic. Did they only test you once?
mrsfite24 To[Private] sweetandsassybbw	Who is Corey?
osuzzana	Sorry, that was 63!
sweetandsassybbw To[Private] mrsfite24	I am guessing maybe his assistant or something
Scott_Roseff_MD	mrsfite - prenatal vitamins, perhaps a baby aspirin, woman on bottom during intercourse at the time of ovulation.
Corey_Whelan	osuzzana, may I ask your age? approx?
osuzzana	44
Scott_Roseff_MD	osuzzana - that's better!!!
Corey_Whelan	mrsfite, also, please shoot me an email -corey@theafa.org
mrsfite24	Thanks Dr. R. I appreciate it.
Corey_Whelan	I may be able to help
sweetandsassybbw To[Private] mrsfite24	uh oh sounds like Michael has to do some work LOL
mrsfite24	Corey I will do that. Thank you as well.
Corey_Whelan	don't forget
Scott_Roseff_MD	osuzzana - What was your antral follicle count on u/s?
tony67	what is the best way to take the weight off, obviously there is exercise which i get 60 mins a day 5 days a week, but low carb diets dont work for me,and the weight still wont budge
osuzzana	doctor didn't do it (said I was too old) and I had to insist on the FSH and e2!
Scott_Roseff_MD	tony - Perhaps Corey can be of some help.
mrsfite24 To[Private] sweetandsassybbw	Yes Ma'am...I'm going to get something out of him aside his farts and money!!...LOL
jneencruz	someone mentioned a medication used instead of clomid that started with an F, could you please type it again, I accidentally kicked myself off before writing it down
sweetandsassybbw To[Private] mrsfite24	LOL oh my god...our Michael's are twins lol
osuzzana	I believe in miracles (God willing)!
Scott_Roseff_MD	osuzzana - FSH helps with egg quality - u/s helps with egg quantity. SO sorry to hear your doc doesn't believe in the AFC.
osuzzana	I know there's a lot more to it than numbers....but with mine, is it impossible?
Scott_Roseff_MD	osuzzana - Anything is possible. At 44, though, it's highly unlikely (sorry) ::rolleyes
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osuzzana	Truth be told, he was an arrogant *ss!
Scott_Roseff_MD	osuzzana - sorry to hear it.
jneencruz	i also have blocked tubes, which is another reason why, besides the PCOS we had to do IVF, is there a way to unblock my tubes and insure that they stay unblocked? i know it sounds crazy but if they can put a stint in a vein, why not in your tubes
osuzzana	Even with my numbers???
Corey_Whelan	Tony - how low carb are you?
mrsfite24 To[Private] sweetandsassybbw	Yep...I told you...LOL
Scott_Roseff_MD	jneencruz - It depends on where the tubes are blocked. If the blockage is where the tube meets the uterus, I've opened many tubes with a catheter or wire inserted in the tube at the time of HSG.
sweetandsassybbw	are there any natural herbs that can help regulate your cycle??
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tony67	i was on the atkins diet but after doing it for about months i began to get daily headaches and wasn't feeling well so i had to start back eating again
jleighcr	if i have never had regular periods (am 30 now) , and am not overweight will i always have PCOS?
tony67	sorry meant to put in 2 months
Scott_Roseff_MD	sweet - herbs don't usually help. I've seen acupuncture help, though.
sweetandsassybbw	Thank you so much Dr.
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sweetandsassybbw To[Private] mrsfite24	lol
mrsfite24 To[Private] sweetandsassybbw	Acupuncture works? Since when does putting holes in a person skin help make a baby?
mrsfite24 To[Private] sweetandsassybbw	Hmmm?
jackiehaz	i have PCOS and have had 3 cycles of Clomid and I only ovulated once, then i had 3 cycles of Follistim w/ IUI which I did ovulate with but, the docs ar having a hard time getting my follicles to mature large enough w/out maturing too many... we are moving to IVF now, do you think that's my best shot?
Scott_Roseff_MD	jleighcr - There are different types of PCOS - one is from birth (genetic), and another can be induced by lifestyle. If you have the type induced by lifestyle, then you may be able to overcome it and have it go away....
tony67	dr what about those pills they have like fertility blend, are they helpful or just a waste of time and money
osuzzana	"Highly unlikely" with FSH of 6.4 and E2 of 63 at 44??? ;(
sweetandsassybbw To[Private] mrsfite24	lol....I am just wanting something other than birth control to regulate my cycles
Corey_Whelan	ok. couple of things. Atkins if done correctly is very healthy. Headaches are actually not associated with low carb eating. You have to do some trial and error when you are beginning but the rule of thumb is to eat healthy foods, like chicken, fish, good veggies, some fruit like cantalope, berries, that sort of thing. Around 30 carbs a day should do it.
mrsfite24 To[Private] sweetandsassybbw	Me too. Are you still having cycles?
jleighcr	how do i find out if it is genetic? none of the women in my family have had problems getting pregnant.
Corey_Whelan	Look out for hidden carbs and vary your exercise routine. Weight bearing exercise is crucial for pcosers. and of course cardio. you can do this.
sweetandsassybbw To[Private] mrsfite24	No, I haven't had a cycle in probably 4 or 5 yrs. I do a "little" bit of spotting every now and again
Scott_Roseff_MD	jackiehaz - IVF gives anyone their best shot at pregnancy, but I'm sorry to hear your docs can't get you to where you need to be on injectables with IUI. We do GREAT with our PCOS patients in our ovulation induction protocols, which are individualized to each patient according to various factors about her.
Corey_Whelan	tony a question. are you on any blood pressure meds?
Scott_Roseff_MD	tony - waste of time/$
Corey_Whelan	or cholesterol reducing meds?
tony67	yes i am
tony67	thanks doc
Corey_Whelan	that's the answer. That's why you didn't lose weight
Scott_Roseff_MD	jleighcr - usually by persona history.
mrsfite24 To[Private] sweetandsassybbw	Wow!! I have a period every other month, if I'm good. Wow!!
sweetandsassybbw To[Private] mrsfite24	Yeah...I am in really bad shape LOL
Corey_Whelan	don't go off your meds. Talk to your doctor about low carb eating and abide by his / her recommendations
mrsfite24 To[Private] sweetandsassybbw	Yep now that I read what he says, I believe he is his asst.
PatyC	Hello, my name is Paty. I have PCO, been TTC for about 8 years and, one failed IVF attempt and.........husband just passed away. We have 9 embies. Anyone know of a woman with PCO attempting to have a child on her own.?
jleighcr	ok - thank you.
sweetandsassybbw To[Private] mrsfite24	yep lol
Corey_Whelan	whoa Paty, hi!
tony67	ok i will thanks corey and no cholesterol meds
osuzzana	My condolences =(
mrsfite24 To[Private] sweetandsassybbw	No, not really. We are supposed to be doing this together remember? LOL
Scott_Roseff_MD	PatyC - Sorry to hear your horrible tragedy.
tony67	so sorry to hear of your loss patty
Corey_Whelan	Ditto Paty
sweetandsassybbw To[Private] mrsfite24	LOL I know but its so hard not to get depressed and give up
Scott_Roseff_MD	Paty - We have single women in our practice trying to conceive on their own.
tony67	why would my high blood pressure pill cause me to not lose weight corey?
osuzzana	I'll speak for myself in that being a single parent is the hardest things I've ever done and espeically hard on a child.
mrsfite24 To[Private] sweetandsassybbw	I really understand that feeling. I've even began to dislike Michael somewhat because of it. I don't know why. He doesn't have ovaries. LOL
Scott_Roseff_MD	Hi Amanda!
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lisagban	I lost 30lbs 3yrs ago, kept it off and now have had a spontaneous pregnancy. I was on metformin until my 12 week. When will I need to resume the medication after the birth? Will I need to take metformin for the rest of my life top control my PCOS?
sweetandsassybbw To[Private] mrsfite24	LOL
jneencruz	i would still love it if someone could retype the name of the medication that started with an F so i can research it
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Scott_Roseff_MD	lisa - Metformin is helpful for insulin resistance. If you are no longer IR after delivery you may indeed not need to take the medication (you'll need to be reevaluated at that time by an RE).
jneencruz	what other meds beside metformin do you suggest as it upsets my stomach
PatyC	i know.....it's just that it was our dream and although it would be bittersweet
Scott_Roseff_MD	Follistim? Gonal-F?
Scott_Roseff_MD	Fortamet?
famke	can you take metformin if you are no longer IR
Scott_Roseff_MD	famke - You can, but why would you?
jneencruz	no i think they compared it to clomid asking you which you prefered those i have heard of
PatyC	it hurts not to be able to see him see them run around, but
osuzzana	I can understand and I'm so sorry for your loss.
meganhopes	Dr., my doc suddenly doesn't think I have PC
jneencruz	i think it started with FE
Scott_Roseff_MD	jneencruz - Femara.
Scott_Roseff_MD	It's a breast cancer drug.
jneencruz	that's it
jneencruz	oh
coachlizzie	was it FEMARA? that's what I was just put on
jneencruz	they use that for infertility?
Corey_Whelan	tony - the effects of the medication inhibit weight loss. I honestly don't know why but it's a consistent phenomenon. I don't know the mechanism by which this occurs, but it's a very VERY slow process to burn fat when you're on these drugs. You can do it but it takes longer. But you can't simply stop taking medications that your doctor has determined that you need.
mrsfite24 To[Private] sweetandsassybbw	These people are going crazy over this. They need another night.
PatyC	all i can think is what those embies mean to me more now than ever
Scott_Roseff_MD	Femara is used in women with breast cancer. it has been used for infertility but the company that makes it send us a letter stating it should not be used for infertility due to an unknown risk of birth defects.
sweetandsassybbw To[Private] mrsfite24	omg I was just thinking the same thing...get outta my head girl lol
tony67	how often should you be checked for insulin resistance
mrsfite24 To[Private] sweetandsassybbw	After you...LOL
Corey_Whelan	however, that doesn't mean that you have a free pass to eat sugar. No woman with pco should eat sugar.
osuzzana	Is there any relation to Clomid and weight gain (or hindering weight loss)?
Scott_Roseff_MD	tony - Probably once a year.
sweetandsassybbw To[Private] mrsfite24	lol
jneencruz	okay, scratch that off my list, i wouldn't want to take that chance, for the child's sake
tony67	thanks doc and corey
Scott_Roseff_MD	osuzzana - No. Some women on Clomid retain some water, but it's temporary.
osuzzana	That's good news!
tony67	i try to stay away from sugar but it is so hard sometimes
Scott_Roseff_MD	::rolleyes
meganhopes	sorry, hit enter, my doc doesn't think I have PCOS b/c my body isn't responding to the injections as normal PCOSer's do. Low estrogen levels and little endometrium lining. Have you ever heard of the combination? I have cystic ovaries, no ovulation, no facial hair and not overweight, feeling lost. What do you think?
Corey_Whelan	guys, we only have about five minutes left!
Corey_Whelan	tony, it's an ADDICTION. If you get off it completely you will stop craving it. I promise
mrsfite24 To[Private] sweetandsassybbw	Do see where they said that we can't eat sugar? Sugar or babies? Such a hard decision!!!
Corey_Whelan	that means corn and potatoes, too. and white bread
sweetandsassybbw To[Private] mrsfite24	exactly
bkschaper	What do you think of using Letrozole instead of Clomid?
Scott_Roseff_MD	meganhopes - Can't diagnose from afar, but has your doctor considered hypothalamic hypogonadotropic hypogonadism (HHA)?
sweetandsassybbw To[Private] mrsfite24	thats true about not craving it once you get off it....I know I did
lisagban	Dr. Roseff, thank you for your answers. They have been insightful. Thank you, Corey for moderating.
Scott_Roseff_MD	bkschaper - Same issue as Femara.
tony67	thanks for the advice corey and i dont eat white bread only wheat or whole grain, but potatoes are my weakness
Scott_Roseff_MD	lisa - You're welcome!
mrsfite24 To[Private] sweetandsassybbw	No potatoes, bread, no corn? HUH? Don't they know I'm from the south?
Corey_Whelan	but you're not a weak woman
mrsfite24 To[Private] sweetandsassybbw	That is what we eat!!!
sweetandsassybbw To[Private] mrsfite24	now I am backslidding some ::unsure
meganhopes	yes, that is what she mentioned. So this makes sense to you. What do you think the next step is?
sweetandsassybbw To[Private] mrsfite24	LMAO
PatyC	i appreciate the condolences ladies and gents - i'd love to stay and chat, but i gotta go - Thank you
mrsfite24 To[Private] sweetandsassybbw	LOL
tony67	bye paty take care
bkschaper	Thank you. That's good to know.
osuzzana	Thank you!
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sweetandsassybbw To[Private] mrsfite24	this Patyc person...was she in here trying to sell her embryo's??????????
Scott_Roseff_MD	megan - women with hha do great with injectable fertility drugs. If your RE can't do that with/for you, consider a second opinion. For me, HHA is almost a no-brainer.
mrsfite24 To[Private] sweetandsassybbw	I think so
mrsfite24 To[Private] sweetandsassybbw	Did you want one?
Scott_Roseff_MD	Paty - Bye.
tony67	thanks corey i will remmeber that next time i have an attack, lol
sweetandsassybbw To[Private] mrsfite24	uh no lol
mrsfite24 To[Private] sweetandsassybbw	LOL...Me neither...
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Corey_Whelan	Guys, clearly we're not done, but we need to let Dr. Roseff go rest! We worked him hard tonight! Dr. Roseff, thank you SO MUCH. I can't begin to tell you how grateful we are that you could join us tonight. Guys, please consider making a donation to the AFA's chat series and thank you all for coming so much. PCO women are CLOSE to my heart and I wish you all the best of luck. If you need me, call me. You can always find me. much love and good night! and thanks again Dr. Roseff, you did an AMAZING job.
bkschaper	Dr. what are the symptoms of HHA?
tony67	is taking too much metformin harmful
meganhopes	thanks
jneencruz	thank you
tony67	thank you
sweetandsassybbw	Thank you
	osuzzana left.
nithasha	thank you
mrsfite24	Thank you Dr. R and Corey!!
Scott_Roseff_MD	Corey - Thanks for the kind words. EVERYone - Thanks for having me, and BEST OF EVERYTHING! Thanks for coming! Dr. Roseff www.reproendo.com
michelle	thank you
Corey_Whelan	You can do this guys. sweet dreams.
tony67	thank you both
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tony67	good night ladies and good luck
sweetandsassybbw To[Private] mrsfite24	well girlie I gotta run...I will email you later. Tell Michael I said to give you plenty of treats tomorrow nite lol
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mrsfite24 To[Private] sweetandsassybbw	I'm getting off of here now...Same to you and your Michael...Night
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