There are a lot of things I wish I knew before I started this journey.
For instance, insulin and PCOS are highly related. Going onto essentially a diabetic diet has helped many women with PCOS conceive. Surprisingly, none of my doctors told me that. The closest to that advice I got was ‘lose some weight. count your calories’. (For the record, I’m within normal bmi range, albeit on the higher end. And a kid, I was perpetually underweight so this was especially shocking advice for me.)
Another thing I learnt was how difficult it is to predict ovulation. For PCOS women, it’s even more complicated than normal. I suppose one way to circumvent issues is to brute force your way through the problem. But ideally, one would want to be more efficient than that. Hence the need for ovulation prediction:
- The first thing every blog/doctor/person will tell you is to start charting temperature. It took a while before I was convinced but I eventually realized that your resting body temperature (BBT) really does give extra information about how you’re body is working. Ideally, it should go up right after you ovulate and then stay up till your period. The problem is it’s an extremely sensitive measurement and you have to be careful to take the temp first the thing the morning at the same time each day. I’ve definitely messed up at the latter point leading to incredibly noisy BBT readings. It’s still possible to figure out the trend but it’s much harder.
- Another means is to track your cervical mucus (CM) (which was a bit icky at first but becomes very matter of course by the time you’re a few months in). The reasoning behind it is when you’re at peak fertility, the desired egg-white texture appears. After watching a human body documentary, I actually understood a bit about why this might be the case — basically such CM is the optimal texture/viscosity to carry sperm so when you’re fertile, your body tries to optimize for more sperm. For PCOS, however, this is a very shaky indicator. Most observed CM is either watery or egg-white so there are a lot of false positives with this measure.
- Ovulation predictor kits, are of course another way. You pee on a stick and you see a line (or a smiley) or you don’t. It works because it measures LH levels which go up before you ovulating. But with PCOS, baseline LH levels are already pretty high. So you can get a lot of false positives (by a lot, I mean, even with AF, I was still getting positives).
At this point, I wasn’t sure if I even was ovulating. So off I tromp to the doctors office to measure ‘day 21 progesterone’. If the level is high enough, it means you ovulated. It’s a little tricky because you need to take the test 7 days after ovulation but as mentioned, predicting timing is hard. Two tests later, they confirmed that I wasn’t ovulating. Among other things, I’ve also taken tests for thyroid and sugar levels. Everything’s borderline but not quite in the ‘it’s an issue to deal with’ level.
At this point, my doctor said that I could start one one of several courses: clomid, thyroid meds or just give it more time. Now, I tend to have faith in nature and prefer not to have medical intervention, if possible. Clearly that wasn’t working. So after some hemming and hawing, we decided to start clomid.
I have to say, one of the more complicated parts in this journey has been timing – I travel for work and I have found myself trying to optimize trips around optimal times. And of course, never a word breathed to my boss or anyone in my workplace. That’s part of my reason for starting this blog — at some point, I got tired of holding it all in. I also wish there was a lot more openness about a lot of this. I’m at the age where so many friends are announcing pregnancies, accidental or otherwise. And the few with whom I’ve shared my status with have sometimes been (unintentionally) quite hurtful. Clearly I didn’t choose this path. I eat healthy, don’t drink or smoke. I’m doing all the right things – so more advice about any of that isn’t really helpful. ‘Just relaxing’ also doesn’t really change the fact that my body needs a little help in getting there.
My current status: I just finished my first cycle of clomid (ultrasound and blood test pending). No side effects thankfully. I started acupuncture a few months ago. (There seemed to be enough evidence in favor of it for it to be worth it. If nothing else, it’s a couple of hours of utterly relaxing me-time.)