tag:blogger.com,1999:blog-57644621261583551.post7918035906546978027..comments2023-05-23T14:31:22.445+05:30Comments on Stork Stalking: The WTF consultsAnonymoushttp://www.blogger.com/profile/15553205805046479504noreply@blogger.comBlogger12125tag:blogger.com,1999:blog-57644621261583551.post-57232765370257898072011-01-18T11:12:22.418+05:302011-01-18T11:12:22.418+05:30That's interesting that your RE suggested more...That's interesting that your RE suggested more tests. I have expressed my confusion and frustration in puzzling over my own test results and findings with my RE re: the lean pcos diagnosis and his attitude is that whether we decide the label applies to me or not is irrelevant to the way that he will treat me (as someone who can't get pregnant on her own and over-responds to low levels of ovulation induction), so he has suggested we just drop the issue for now. I do think that it is worth me asking about met, though. It seems many 'classic' PCOSers are given the met before they add even Clomid, and that there's been great success with this approach (as you point out), so I agree that adding met is probably worth a try, at least before making the jump to IVF.A.http://journeytobabyg.blogspot.com/noreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-83837206579033432742011-01-18T04:58:06.962+05:302011-01-18T04:58:06.962+05:30Jay, I've only counseled parents who have chil...Jay, I've only counseled parents who have children with chromosomal conditions (livebirths).. and their recurrence risk is 1% or 1 in 100 (does not matter what maternal age is).. but I don't know the recurrence risk chromosomal conditions in first trimester loss.Thebabychaseprojectnoreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-81766171775895160652011-01-18T01:01:12.903+05:302011-01-18T01:01:12.903+05:30Thanks CC..no resolution from the phone consults y...Thanks CC..no resolution from the phone consults yet- hopefully should get some by the end of the week.Jayhttp://aboutplanb.blogspot.comnoreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-34417888116058562062011-01-18T00:29:38.520+05:302011-01-18T00:29:38.520+05:30Haha, I've been uttering that exact phrase ...Haha, I've been uttering that exact phrase 'my pcos diagnosis is many shades of gray' to a lot of people lately. We have a LOT in common. <br /><br />I don't have the high LH to FSH ratio either. I have a feeling that is a big factor interfering with healthy ovulation-- if your LH is too high it causes your egg to be released prematurely. My ratio (not done on a true CD3 though) was 0.5, my LH was half my FSH. Since I've always had very nice looking ovulations, its logical that this parameter was normal in me.<br /><br />About testosterone, the jury is still out. I've had 3 tests. <br /><br />4 months ago, blood drawn in the evening: - 17 <br />2 weeks after D&C; blood drawn first thing in the morning- 85 (!!!)<br />2 weeks after that, blood drawn in the evening- 26<br /><br />All my readings fall in the so called 'normal' range for women, but if total testosterone is over 60, they consider it PCOS range. I recently found out that testosterone (and DHEA) are hormones that have huge diurnal variation, levels are highest in the morning and taper off as the day progresses...maybe that explains my crazy 4-fold variations?!?! I'm going to have another fasting testosterone test, see what that shows.<br /><br />Though I've never considered myself to be 'hirsute' ie hairy like traditional PCOS cases, I decided to look up how one decides that one is 'hirsute'. This is the way to do it...<br /><br />http://www.hirsutism.com/hirsutism-biology/ferriman-gallwey-score.shtml<br /><br />If you have a ferriman and gallewey score of above 8 (even above 6 might work)- they will give you the 'hirsute' diagnosis. Its kinda hard to evaluate one's self, but I *think* I might be over 6, even 8.<br /><br />What I'm trying to say is a PCOS diagnosis is seriously hard to nail down in some people. I've very clearly got the ovarian anomaly found in PCOS, and I'm in the gray zone for hyper-androgenism. If I am hyper-androgenic, I'm just barely over the threshold.<br /><br />Right now, my phone consultation with my San Diego RE ended with him saying I'm not at all sure you have PCOS, lets run more tests. I'm being absolutely bulldog- like about all this, so we'll explore every avenue and lets see what turns out.<br /><br />Have not talked to my Indian RE yet, but he seemed to be more willing to say, if you have polycystic ovaries and high AMH, you have PCOS so lets throw metformin at you.<br /><br />From what I've read, metformin can really fix the ovarian anomalies (polycystic ovaries, high AMH) by itself and that is what I am waiting to check out. I know what you are talking about with the side effects of metformin, I'm nervous about that too. The one way to avoid that (or so I've heard) is to take a low dose and slowly go up. But I'm too nervous to go in without trying it the next time because the stakes are too high, and it seems likely that metformin is my best shot at getting this to work.Jayhttp://aboutplanb.blogspot.comnoreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-59120694369111450412011-01-17T21:14:08.105+05:302011-01-17T21:14:08.105+05:30I haven't tried metformin but the literature I...I haven't tried metformin but the literature IS convincing that even for those of us who are lean and non-insulin-resistant, it's worth a try. In truth, I hesitate to bring it up with my RE because it seems everyone I "know" in IF land who has been on it, has gotten horrible diarrhea from it (yeah, I know, a small price to pay for you know, getting pregnant! Just to clarify, when I said I didn't have elevated androgens, I didn't mean just adrenal androgens but testosterone as well. Also, I had a 2.0 lh:fsh ratio on my first cd3 b/w but it was happily sitting at 1.0 on my last round. In short, I think my lean pcos dx is many shades of gray. Anyhow, enough about me! How did your phone consult go? What is your current plan? Will you be starting met?A.http://journeytobabyg.blogspot.com/noreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-21510269609616740962011-01-16T22:45:38.513+05:302011-01-16T22:45:38.513+05:30How did your phone consult go?
Also, I also trul...How did your phone consult go? <br />Also, I also truly believe that if a soul is meant to be with you, it will come back to you. I know you are so tired - but hang in there. Sending you strength and support as you navigate your way through to answers.Hopefulcchttp://hopefulsinglemommatobe.blogspot.com/noreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-9573639971886843842011-01-15T05:46:22.493+05:302011-01-15T05:46:22.493+05:30I'll ask, but I'd think the risk would rem...I'll ask, but I'd think the risk would remain unchanged. From what I understand, aneuploidies arise because of random errors (chromosomes not separating properly) during the cell division process. The only way your risk for this could go up is you have some OTHER error in your chromosomes, like say, a balanced translocation, which predispose to errors in the cell division process.<br /><br />So, in such cases both parent's karyotypes are examined. My donor's karyotype is normal (and he has produced 4 healthy babies, though one of these is still in utero :)) and so no worries there. My karyotype is 'apparently normal' too.<br /><br />My only worry is about the sensitivity of karyotyping as a test, but its not something we can really address. I'm getting the microarray results in a week, my headache will be how to interpret that data, I'm going to need some serious help doing it.Jayhttp://aboutplanb.blogspot.comnoreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-64973287763106618762011-01-14T01:43:47.524+05:302011-01-14T01:43:47.524+05:30Hi Jay, I am now catching up on your blog. let me...Hi Jay, I am now catching up on your blog. let me know the outcome of your genetics consult. What is the recurrance risk of having a livebirth with chromosomal conditions once you have a fetus with XO? I would be interested in finding out your recurrance risk.Thebabychaseprojectnoreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-29247491438070755332011-01-13T11:51:57.638+05:302011-01-13T11:51:57.638+05:30Thanks for the articles! Yes, definitely the loss...Thanks for the articles! Yes, definitely the losses may have been unrelated, and thyroid could have been the main contributing factor with the first loss, but can't be too certain anymore.<br /><br />What I cannot comfortably buy is the fact that with the second pregnancy, that genetic error occurred by sheer bad luck, I think there could have been a physiological issue driving it.<br /><br />Remember I was so scared that my days of high estrogen had fallen from around 3-4days, to just 1 day before the LH surge began? This change happened after my loss, and the shift in patterns was very clear to me.<br /><br />That was, in retrospect, quite likely to be the problem. WHAT that change was due to is the million dollar question.<br /><br />Btw..I got the full text for the second article. Basically the authors say that AMH and AFC are excellent markers of 'ovarian anomaly' but to tie it to PCOS, you need either irregular periods, or hyperandrogenism. And I'm in a big gray zone for the latter, and dont have the former, so can anybody tell me if I have PCOS?!?<br /><br />But I keep thinking of Tiara's case- her doc did not do any of these brain-numbing tests on her (right Tiara, if you are reading this), they just looked at her ovaries with the many antral follicles, gave her metformin, and hey presto, antral follicles go down and everything goes beautifully the next time around.<br /><br />Sigh...I want that too.Jayhttp://aboutplanb.blogspot.comnoreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-65689663929007714482011-01-13T07:44:11.079+05:302011-01-13T07:44:11.079+05:30I've been dreadfully behind on my journal read...I've been dreadfully behind on my journal reading this past year, and have been depending on things like JournalWatch to keep me updated - and today I got an email I thought you'd be interested in. And it turns out it's from September! I don't know why it didn't show up on my searches at the JCEM website a few months ago, but anyway, this is something I thought you'd find interesting about thyroid and miscarriages: http://jcem.endojournals.org/cgi/content/abstract/95/9/E44 What I thought was REALLY interesting is that these were antibody negative women - and we'd talked before about how your antibodies weren't really terribly high in the first place. Makes me wonder if your two losses might truly have been completely unrelated, and the second one just really bad luck.<br /><br />That same issue also had a study in which the authors looked for an easier way to clinically diagnose PCOS using AMH, follicle counts (I'm assuming antral counts, I haven't read the study because I can't remember my password! LOL), markers of insulin resistance and ovarian hyperandrogenism. http://jcem.endojournals.org/cgi/content/abstract/95/9/4399 If you can't get the full text through your sources, let me know and I'll figure out my password.Shannonhttp://shannonsrainbow.blogspot.com/noreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-83325019095695118062011-01-12T21:57:10.437+05:302011-01-12T21:57:10.437+05:30There are so many things that can be dis-regulated...There are so many things that can be dis-regulated in PCOS, testosterone, DHEAS (the androgens), then there is LH, then finally you have AMH. If you have polycystic ovaries with ANY of these being high, I would believe the PCOS diagnosis, atleast long enough to see how it responds to metformin. I should add that even the insulin resistance of PCOS is not clear cut, and there are lots of women with PCOS with no overt insulin resistance too (who still respond to metformin). Overall, this makes you clutch your head and want to whimper!<br /><br />I'm grouching that syndrome has been so difficult to diagnose in me. But I should be grateful I I have so few of the manifestations, which is what has allowed me a happy, healthy life up till now. Classic PCOS (with all the problems that come with high testosterone) is no picnic!<br /><br />For women with suspected cases of PCOS like me (and you), I do believe our best shot is seeing how we respond to metformin. Have you ever been put on this drug??Jayhttp://aboutplanb.blogspot.comnoreply@blogger.comtag:blogger.com,1999:blog-57644621261583551.post-11841920162590513142011-01-12T17:00:32.910+05:302011-01-12T17:00:32.910+05:30Best of luck to you with your upcoming testing. I ...Best of luck to you with your upcoming testing. I am so, so sorry for your recent loss. I can relate to your frustration. I have been told at various points that I likely have lean PCOS but unlike classic PCOS, it is so amorphous and poorly defined what lean PCOS exactly IS in the first place, it is difficult for me to consider it a 'real' diagnosis especially in the absence of elevated androgens . Sure, classic insulin-resistant PCOS is a clear entity with at least a somewhat understood etiology but it only takes a little digging around to see how much disagreement there is in the literature regarding lean PCOS and based on the somewhat vague diagnostic criteria, I sometimes wonder if it's a label slapped onto almost every case of ovulatory dysfunction with unknown etiology.A.http://journeytobabyg.blogspot.com/noreply@blogger.com