PCOS/Clomid/HSG Questions

[jbenny75]

There is so much knowledge and experience here. If anyone would be okay with sharing, I'm curious about your personal experiences with:

1) PCOS- How were you diagnosed? What were your symptoms?

2) Clomid- What were your side effects, if any? Were you successful?

3) What is an HSG (Hysterosalpingogram?) and at what point should you be getting that?

[tlew12778]

I can only answer question 1 bc we are not TTC. The only symptom of PCOS that I had (right when they first suspected it) was acne. I have never had acne in my life and I am 27. Before that episode, I could have counted the number of zits I have had on 2 hands. But with that one episode, I literally had about 100 on my face :eek:. I thought I had a disease so I went to the dr. She suspected PCOS and ordered a free testosterone test and a transvaginal u/s for me. Luckily I live in a country with national health care so they are very proactive about ordering tests to make diagnoses. My FH is a dr and he spoke to a friend who is doing her residency in gyno and she told him to have me do a FH:LSH ratio test done as well.

On CD28 I had the transvag. u/s done. It showed micropolicystic ovaries on both sides.

I had the blood work done on CD34 and but by this point, I knew that the u/s was right bc I had previously ovulated regularly btwn CD17-19 every cycle, but still had not ovulated that/this cycle.

I just got back all my blood work yesterday on CD54 (still no O). I spoke with my gyno on the phone yesterday and I brought them to my GP this AM. End result is that I will be put on progesterone to induce a period then back on BCP (Diane) since we do not want to TTC for a couple years. If I have negative side-effects like last time I was on BCP, I can stop taking them but it's not recommended I do so until we want to TTC.

ETA: I'm Asian. This apparently has a lot to do with the fact that I am pretty much asymptomatic for PCOS. I'm not overweight, I don't have facial hair, or even painful cycles... just the acne that one time and the anovulation now.

[jennylou]

1) PCOS- How were you diagnosed? What were your symptoms?
I had super long cycles. It took two doctors to get a diagnosis. The first one I went to about 90 days into a cycle, wherein I was told it's perfectly normal and not to worry about it. Yeah, right. The second doctor gave me a clinical diagnosis right away. She then sent me for bloodwork (LH/FSH), thyroid. Both the u/s and the bloodwork confirmed the PCOS.
In addition to the super long cycles, I had more zits than I had when I was a teenager. I couldn't lose weight on traditional diets like WW. I have dark patches of skin. I have hair where it should not be. I have a few skin tags.

2) Clomid- What were your side effects, if any? Were you successful?
I had hot flashes with clomid. We were successful, we conceived on our first cycle of trying.

3) What is an HSG (Hysterosalpingogram?) and at what point should you be getting that?
An HSG is a test that is used to see if you have any blockage in your tubes. My RE told me that if I ovulated 3 times, she would send me for the HSG as the next step. She wanted to give me a chance to get PG without the HSG though, since I didn't ovulate.

[jbenny75]

Thanks for the responses. I'm going to see my dr. in a couple of weeks and I'm just trying to find out as much as I can. I suspect I could have PCOS because I have a definite acne problem and I've been off BCP for 7 months with no O or AF. I don't have any of the other syptoms, so I was wondering if anyone else had PCOS with just those two. My dr. did have bloodwork done awhile back, and told me it was normal. I haven't been to see him since then, so when I do see him, I'll ask what exactly he was checking with the bloodwork. I know one thing was my thyroid. I'm not sure if he checked the FSH/LH. If that's the norm to check, I'm sure he did. I'll be going on Clomid after I see him on August 18. I talked to him the other day, but he pretty much just told me that if I wanted to get pregnant, I'd have to do Clomid, make an appointment to see him and keep track of my questions, he'd examine me and go over everything with me then.

[karlatta]

1) PCOS- How were you diagnosed? What were your symptoms?
When DH and I started TTC, I started charting. I charted for a full year and only ovulated once. I had terribly long cycles. (My doctor had me take Progesterone after 90 days to force AF to come. He's a gynecological oncologist, so he worries a lot about cancer.) He was willing to put me on Clomid, but without u/s monitoring and without bloodwork. I said "No, thanks" and asked for a referral to an RE.

At the RE's office, I got CD3 bloodwork which showed a textbook case of PCOS. U/S showed the cysts on the ovaries.

I have most of the symptoms - skin tags, dark patches, acne, hair in wrong places. The only "classic" symptom I don't have is problems with my weight.

2) Clomid- What were your side effects, if any? Were you successful?
I never took Clomid - my RE had me on Letrozole (similar to Clomid in function). No side effects, whatsoever. We got pregnant on our second cycle with it. I've ovulated every time I've taken it.

3) What is an HSG (Hysterosalpingogram?) and at what point should you be getting that?
I think different docs will have different opinions. Mine did mine before he would begin any other treatment. His reasoning was very specific to my situation. My insurance would pay for it, but they will not pay for treatments like Letrozole, IUIs, u/s, etc. So he said we should go ahead and check out my tubes so we know if it's even worth it for me to spend my money on treatments.

Incidentally, I'm allergic to the dye that they use for HSGs, so I had what's called a Sonohysterogram. They inject a saline solution instead. The downside to that is that they can't see if both tubes are clear. Only if at least one is.

[tlew12778]

I had to do my blood tests on an empty stomach in the morning for LH:FSH and free testosterone. Just so you know...

[jbenny75]

hmmmm....my blood tests were non-fasting

[cc8]

1) PCOS- How were you diagnosed? What were your symptoms?
Diagnosed several years ago - went to an RE because my periods were so infrequent. Diagnosed via bloodwork (elevated FSH and prolactin levels). Other symptom besides absent period was hirsutism.

2) Clomid- What were your side effects, if any? Were you successful?
First round Clomid = 50mg - didn't work
2nd round Clomid = 100mg- didn't work
3rd round Clomid 150mg + IUI- didn't work
HSG = was pretty painful for me; I didn't really have a blocked tube but one that filled slowly (with the dye). It did eventually fill - I think the HSG helped "clear my tubes"
4th round TTC = injectables + trigger + IUI = success

Minimal s/e's, primarily hot flashes. I was very emotional too, but that may have just been the TTC anxiety/stress.

[Sparkles P]

1. PCOS: Do not have any symptoms

2. Clomid I had 7 cycles I believe on it at 50 mg. I took it on CD 5 to 9, it made me O between CD 16 and CD 21. I had no side effects and took it at about 9 pm, which is when I normally took my BCP.

HSG/SIS: I had the Saline Infused Sonogram that Karlatta had, due to being allergic to the dye as well. Which is a fish/seafood allergy in case anyone is wondering. Both my tubes showed to be clear during this procedure.

Having a SIS ( saline infused sonogram) instead/ along with a HSG, will show if both tubes are clear. It is a similar procedure, except you are monitored with saline instead of dye. My uterus is divided with a septum, and they manage to see both my tubes, and let me know they were open.

[karlatta]

Interesting difference, Sparkles P. I wonder if being able to see tubes depends on machines used or something. My RE said that he would not be able to see my tubes. He said that he would get a good picture of my uterus, but that he would not be able to see if only one tube was blocked. All he could see is if the saline ended up outside of my uterus, meaning that it had to go up a tube. It did, and he said that at least one tube was open, but that he could not tell me with certainty that both were. Now I really want to know if he could have done more!

[Sinclair319]

1) PCOS- How were you diagnosed? What were your symptoms?
I was diagnosed in October--I've never had normal cycles. I'm a "thin cyster" (originally they thought this condition effected overweight people, but it doesn't). I also had FSH/LH tested (mine were 15/5--the 5 should always be higher than the 15) and I also had an internal ultrasound where they could see the cysts. I've also been charting and only Oed on my own twice in a year.

2) Clomid- What were your side effects, if any? Were you successful?
Haven't taken Clomid--our RE won't prescribe it because he's gotten better results with Letrozole/Femara without the nasty side effects. If we're not preg this cycle, then we'll do letrozole next cycle.

3) What is an HSG (Hysterosalpingogram?) and at what point should you be getting that?
I just had this done 2 weeks ago today. Took 3 ibuprofin about an hour before. My tubes were clear, but it was still pretty uncomfortable. I was fine by 30 minutes after the procedure.

FYI--another really good PCOS related website is www.soulcysters.net
Good luck!

[gmb4503]

Clomid- What were your side effects, if any? Were you successful?
I had 1 horrible migraine the second day I took it and horrible hotflashes non-stop!!! It also lengthened my LP by 4 days. Cycle #1 was not successful. I start Round 2 tomorrow.

[angelgirl8]

1) PCOS- How were you diagnosed? What were your symptoms?
i was never officially diagnosed with PCOS. after my first IVF (unsuccessful), my RE determined that my ovaries "responded as though they were polycystic". so i was pretty much treated as though i had PCOS and i was put on metformin and a low-carb diet.

as for symptoms, i have absolutely none of the usual symptoms seen in women with PCOS. as i understand it, this sometimes happens! it's probably why it took so long to figure out that i might have it.

2) Clomid- What were your side effects, if any? Were you successful?

i did clomid for 3 cycles (although i was ovulating normal according to my charts). as for side effects, the major ones were hot flashes and moodiness. i think during the first cycle on clomid, i had some headaches. nothing too horrendous, though! i know it's worse for a lot of women.

oh, and we weren't successful on the clomid.

3) What is an HSG (Hysterosalpingogram?) and at what point should you be getting that?

i had my HSG about 9 months after we started TTC before we started any medications or interventions. as the other women have said, it's a test where the doctor injects dye into your fallopian tubes to make sure they're clear.

good luck!

[JennH]

1) PCOS- How were you diagnosed?
I got off the pill in January 2004. We started TTC in June and by November not only was I not pregnant, I had gained 45 pounds and was over 60 days late on my period, which was never the case before. She gave me a blood test, an unltra sound and a diagnosis.

What were your symptoms?
Mucho weight gain, hair grow on my cheek, toe and neck, hair loss on my head daily, mood swings, llllooooong cycles, and nasty acne.

2) Clomid- What were your side effects, if any?
Major bitchy mood swings.

Were you successful?
Yes, after two cycles. Unfortunately, I miscarried. We will go on Clomid again when we try.

3) What is an HSG (Hysterosalpingogram?) and at what point should you be getting that?
I'm not sure what this is.

[Chelsea524]

**Bumping this up**

I am thinking maybe PCOS is what I have, I am seeing my dr at the end of September but just wanted to get as much info as I can. I have always had long cycles, anywhere from 60-90 days, I had an IUD after my DS was born, never had AF in the almost 2 yrs I had it, and had it removed the begining of May, after never getting AF I got provera to start it and finally had AF on CD 75, now here I am at CD 34, no AF, no BFP so another long cycle again, I have terrible acne, just awful, and cannot lose weight for the life of me, I have been dieting for close to a year and in that year I have gained almost 20 lbs:eek: , never had any idea this all could have been tied together until I started looking into PCOS because it seems a lot of women suffering from long cycles have this, I didn't even know what it was, still dont really but looks like it has something to do with cysts. Any info you can give me would be great!

[texasbride]

An HSG is a test that they do to see if one or both of your tubes is blocked. I had this done last week. The first thing they did was take an x-ray of my uterus (you couldn't see much without the dye). After that they inserted a speculum (the same thing they use to do a pap), then they insert a catheter inside you that has a small balloon at the end of it (they then remove the speculum). You scoot back and lay flat on the table (the catheter is still inside) and they put the x-ray machine back on. They slowly begin to release the dye and watch as it flows through the uterus, into the fallopian tubes, and (hopefully) empties out into your abdomen. It was pretty cool because they had it up on a tv screen behind me so I was able to watch the dye flow through both tubes and empty out. Hope this helps!

[Janey]

Chelsea (et al) - You may want to read through the PCOS & TTC (http://www.constantchatter.com/forum/showthread.php?t=13546) thread; I learned a lot there. :)

[Chelsea524]

Thanks!!