Hi Dr.
On CD 3 during my ultrasound they noticed left over follicles from Cycle #1. Just when I thought I was going two steps forward I feel as though I took two huge steps backwards.
My follistim injectables were 300 iu for 5 days and then they lowered it to 225 iu for 2 days and then I triggered with Ovidrel so I guess the RE really wanted to stimulate those ovaries. Guess what? It worked! When they did my Progesterone levels it showed I ovulated. So not sure what went wrong there.
E2 levels were so out of whack (263). Just a side note, I started taking Estrodial as the prescribed protocol as we were heading toward doing IVF if the IUI didn’t work. I’m 42 years of age and will be turing 43 in Aug. DH for our IUIs had 14 mill. sperm and 12 million sperm. Not exactly sure if that was a problem or not. However, after the IUI didn’t work and AF came early we decided to stay on course with another IUI cycle #2. Also, came off of the Estrodial. So my point here is that I am not sure if my body overloaded on the estrogen and this was a side effect resulting from it. Anyway, the RE recommended I force ovulation and trigger with Ovidrel and come back on March 27th for bloodwork to make sure I ovualted again. With ovulation, I am guessing you get another menstrual cycle and then DH and I will start another IUI cycle hopefully in early -mid April. Keeping our fingers crossed that by having 2 menstrual cycles back to back that all my hormone levels retreat back to normal and all the bad stuff in my body leaves and we can start the process again.
However, after extensive reasearch on the internet and your site, it seems that I now have Polycystic ovarian syndrome. I do have all the sign and symptons of it especially the weight gain around the middrift area.
Do you think I should request a check for insulin resistance to see if I should take metformin and start a excercise & diet plan? I notice the success rate is a bit higher once a good diagnosis has been established for PCOS. Maybe I am wrong it was just what I was reading.
Thanks a million for reading and looking forward to your advice or questions I should be asking my RE about here in NJ so I can be successful in having a beautiful baby.
Becca from NJ.
Dear Becca,
Thanks for sharing your story. Based on what you’ve described, the biggest obstacle, as you probably already know, is the degree of age-related DNA damage in your remaining eggs. In addition, it’s well known that PCOS hinders fertility even if you do ovulate. Now you mention that you “have all the sign and symptons”. Other than truncal weight gain, you didn’t go into detail on what those clues are for you having PCOS. But giving you the benefit of a doubt, I suggest you have your RE test your insulin resistance or alternatively, if they are agreeable to it, they can just empirically try you out on metformin for 2-3 weeks. For example, if you report losing 5 pounds in 3 weeks and noticing a huge boost in energy, it would likely be a good reason to stay on it.
You also asked if you should start an exercise and diet plan. You would have to ask yourself, even if you didn’t have PCOS, what’s stopping you from adopting a healthy exercise and diet plan anyway. Right? 
You seem to already have many of the answers to your own questions.
Best wishes and by all means, have that talk with your RE!
