Sunday, April 28, 2013

Myo-Inositol for fertility and PCOS: Share your experiences!

This post is a very long answer to Josie's question in the last post, where she asked me how I picked my myo-insoitol dose. Well here goes my experience with this so far. Just some background information you need: In most studies, women receive 2000 mg myo-inositol twice a day, along with folic acid.

My experience with this supplement:

Despite being aware of the dose used in studies, I arbitrarily went with a lower dose initially, because I was frankly nervous about what it would do. I started with 1000 mg/day, of supplemental (and not the prescription preparation myo-inositol) and things looked great that cycle: I ovulated a bit later (CD 19) than that in my recent cycles (CD 17).

Just FYI, in my pre-vitamin D, pre-supplement days, my best-looking ovulations were on CD 20. Sadly, none of my pregnancies were conceived during these cycles, they happened in shorter, crappier-looking cycles where I ovulated on CD 16. 

Anyway, coming back to the present day, after that first great-looking cycle (with a nearly 16-day luteal phase) where I was taking 1000 mg/day, I shifted to 2000 mg/day, and stuff pretty much went to hell the next cycle, in a manner never seen before - no EWCM, or CM of any sort, no detectable LH surge. I was not even sure I'd ovulated, except my temperature did go up. The luteal phase was a markedly short 11 days.

Alarmed, I shifted back to the 1000-mg dose. The next cycle (still ongoing) is interesting...there was one alarming day where my temperature short up, making me think I had ovulated, and prompting my last post. But happily, I was wrong, I have not misplaced my surge, this turned out to be a nice-looking cycle; got lots of CM, did show a strong surge, ovulated a bit late (on CD 22).

So,phew.It looks like myo-inositol may not be bad for me, but only at low doses. It has changed my O date. Still have not settled into a pattern, but it will be interesting.

How many women, if nothing changes, ovulate on a certain day every month? I'd really like to know.

Also, if you are a PCOSer, or a non-PCOS infertility case on myo inositol, I'd really love to hear your experience. Please do share, sometimes anecdotal information can also be useful!

Also, some information to note, if part of your issue is low progesterone, this may really be something to try out, since both published literature and my experience (with the 1000 mg/day dose, with the longer luteal phase) suggest that this can increase progesterone levels.

Updated: I did an IVF cycle a few months after this post: I took myo-inositol for THREE CYCLES at least, and then went for IVF. Myo-inositol is supposed to increase the percentage of oocytes that are mature at pickup. We got 14 M2 eggs, 2 M1 eggs, and 3 that crapped out, from a total of 19 follicles.All my M2s and my M1s fertilized too. Overall, this was pretty darned amazing: My first IVF, where the protocol used on me was far from ideal, produced 4 M2 and a few M1 eggs out of 11 eggs, and only the M2s (3 out of 4) and none of M1s fertilized, in contrast to my second cycle, where everything did. I attribute the improvement from IVF#1 to IVF#2 to two things: a very different protocol, and maybe, in part, the myo-inositol.

I have gotten emails asking about a good supplement: I would recommend this (see above),
which combines myo-insoitol and folic acid, and appears to have been used by many women with PCOS successfully.

Sunday, April 14, 2013

On myo-inositol and new blogs

First, lets get the annoying news out of the way- I seem to have mislaid my LH surge. The ONE thing, which is dependably seen in every cycle ever the past 3 years, is gone. I can't see a pattern anymore; I did ovulate last month based on a temperature rise, but it was a shitty cycle in that there was no CM, and the LH was an itsy-bitsy 12 days. GRR. 

Given all the stuff I do, I have to say that I'm really good at figuring out what is responsible for which effect, and this one I'm blaming on myo-inositol (down from 2000 mg/day, to 1000 mg/day). Its playing havoc with my cycle. Its freaking amazing for my skin. Definitely cause for shaking my fist at the universe.

I'm not going to give up on it just yet through; I'm going to keep taking it over the next 2 months and see if things change/settle down, and maybe I'll keep taking it till IVF anyway, and just use a trigger. 

The amazingly frustrating part is that myo-inositol is supposed to do GOOD things

  • It is great at fixing the issues in women with PCOS. It can, to a large extent, shown by multiple studies, fix acne and hirsuteism, bring down LH and androgens (definitely doing that with me) and restore ovulation in women with PCOS.
  • It can increase the proportion of mature oozytes at pickup during IVF (!!!!).

 I'm not sure what to do. Yes, my cycle looks utterly shitty now, and what I took for gospel truth--that if you had perfect cycles, you would have good eggs--has not held true for me. Sure, I got pregnant almost everytime I tried with my natural cycle, but something was off, 2 out of 3 times, my eggs may have been aneuploid. So maybe the lower LH is good, and such crappy cycles may actually get me live babies. Unlikely, but knows right?

Plus, I like what its done for my skin. Don't want to stop taking it, at my current lowish dose, ever.

So there is my current conundrum. I'm ok despite it though. I really, really relax during my breaks from TTC, I have to say. Probably because TTC itself is such stress, and has never got me good news yet, not trying to make a baby makes me feel so much more better. Its like when the dentist stops drilling on the tooth with the exposed nerve. It is too bad I'm determined to have a child, and TTC will have to recommence at some point.

The other news is that I will be starting a wellness blog using my real name and identity. Having a widely- read blog is good for me professionally, given that I've started building a career in scientific communication. The face-palm moment arrives when I realize I've started a blog that is visited by people all over the word, has gone over 200,000 page views, shows up quickly in Google searches, and I most definitely cannot list it on my LinkedIn page about it because too much of it deals with deeply personal issues.

What I'm going to start doing, is take away all the science from here slowly, and move it to there, and incorporate it into the general health topics I will discuss. So there, I'll be talking about infertility, autoimmunity, fibromyalgia, autism, discussions on healthy practices, etc. What I do best is gather, assimilate and distill scientific information, and I flatter myself in saying that I do it rather well.  

When the new blog is started- most of the science on this blog (the stuff on vitamin D,  the science of infertility page) will go away. People who want the address of that blog, will have to contact me on an individual basis. I'm a little (actually very) leery about people linking the real me to all the deeply personal information that is on here, so I will have to think about how to handle things. Would have been so easy to just put a link on this site, but nothing in life is straightforward is it?

Thursday, April 4, 2013


I'm hanging my head in shame--I've been such a bad, bad blogger. In my defense, I've been really busy, all in good ways. I'm loving my new job. Its a new direction for me, and if I stick with it, it will give me the contacts to launch a completely freelance career in writing, which seems like the ideal career to complement motherhood. Plus, my other green card application (the one that gets me my green card immediately without having to wait in queue) came through! Ridiculously happy about it. I miss America, and want to get back as soon as possible, but yet, have plan B to think about. Still, its nice to have the option.

As for Plan B, it is on ice while I settle into my new job. I'm in this curious state of peace. If you think about it, I've gone through a lot-- 3 miscarriages, 1 failed IVF. But, when not actually going through pregnancy or getting 5 injections a day, I'm actually fine. This feels bizarre- how can I be so totally okay, given all I have been through?

In a couple of months, when I've settled into my new gig, I'll think about the next round of IVF. In the meantime, I'm loading up on the supplement regimen of CCRM;well, atleast some of it.

L-argenine was very bad for me, it messed up my system so badly after 2 days of being on it that I had to stop.

Myo-inositol is something I'm taking, and this is a very interesting one. It seems the best choice for people with PCOS. Its definitely causing changes in my system- whether these will help, hinder or do nothing at all remains to be seen. One of these days, I'll do a literature review of this in fertility- overall, it seems really promising.

Two really interesting things have happened: My antral follicle count is now sustained at around 25 (over the past 3 months), up from the average of around 14 when my Vitamin D levels were very high. The other thing, my DHEAS levels are coming down. This was around 250 when I was vitamin D deficient, climbed to around 350 while  my levels were super high, and now are around 180. This high levels of this hormone was my only concrete sign of PCOS, so this change has the potential to be important. I HOPE this is a good sign, but my physiology is so weird, one can never say anything.

Anyway, I apologize for the long silence. Sadly, I cannot promise to be a frequent blogger, but I'll try to say something atleast once or twice a month. I also want to say congrats to Augusta, who was, at long last, blessed with motherhood. Augusta, you have had such a long road here, I'm SO glad you have made it!