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  1. #1
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    Default IVF and PCOS Advice

    Hi all, I just wanted to ask some advice from any of you doing IVF with PCOS. I’ve had one cycle cancelled due to under stimulation and my clinic thinks that I’m going to be a “tricky” case, so I was wondering if you had any advice on what has worked for you?

    I have the classic “string of pearls” cysts with the PCOS, but not a lot of the other symptom’s. As far as we know, I do ovulate every 3-6 weeks, but we are doing IVF because my partner has a very low count (3 million). The first cycle we started on gonal 112 and it made the two larger follies grow, but none of the smaller ones. I don’t have low AMH so they thought it wasn’t worth it to go ahead for 2 or 3 eggs.This time we are trying 142 of puregon. They don’t want to put me on higher doses straight away, because I’m at high risk of OHSS.

    Was just wondering if you’ve had any success with different types of cycles or doses. Any advice would be great! I’m worried about having cycle after cycle cancelled.

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    Hi Clementine

    We only discovered in my first cycle that I have PCOS. We were originally doing ICSI for MFI but then I decided to be difficult. I hyperstimulated on 150 Gonal-F and the cycle was cancelled before EPU. The cycle I just did in January was a nightmare. I stimmed for 19 days, starting at 75 Gonal-F, then 100, then 125 and finally 150. My fs said with PCOS slow and steady is the best way. We started a little too low though. In the end I had well over 40 follicles but only about 3 that were of a half decent size as one follicle turned into a follicular cyst and sucked up all the fsh so the others were small and just not growing. He was going to cancel my cycle because of poor response, saying we may get up to three mature eggs and we may get none. I chucked a hissy and we decided to go to epu anyway. I was freaked as i knew we may come out with nothing but at least the cyst could be drained and we could try again sooner. Bottom line is, I am now just short of 6 weeks pregnant nothing to freeze but it just took one!

    It really sucks that it is trial and error but maybe talk to your fs about gradually increasing your dose and stimming a little bit longer? Having cycles cancelled is so disappointing! I really hope you have better luck next time xoxo


    Sent from my iPad using Tapatalk

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    Have they discussed with you about switching to iui if you aren't getting many follicles? I have a poly cystic ovary but not pcos so started off an iui cycle which was cancelled because it took too long to progress. Went straight to ivf but after upping the puregon doses I still only had one follicle. We switched to iui and I'm currently nursing my almost 3 week old son. Could be an option for you too?

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    Thanks Bec, i’m SO glad it worked for you !

    I was thinking if this cycle or the next does do a bit better, but still not good enough, we might just do the EPU up anyway. They were worried about us spending money for nothing, but we can afford it, it might be worth it to just see how many we get. Hopefully this upped dose does better. They seem to monitor me very closely bt’s and scans every day or 2nd day. It sounds like it does work upping the dose slowly, but when you start off too low at the beginning, one of the lead follicles sucks up all the drug!

    Thanks kschoey, we talked to our FS about that but she said we’d only waste money as it’s such a low chance of it working because of our MFI. If we didn’t have that, we would have been doing clomid cycles or she thinks we prob wouldn’t have much trouble conceiving. I did my trigger and we dtd lots over those days, but knew it was never going to work. He just doesn’t have enough swimmers. Congrats on your little one J that’s so great it worked for you.

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    Hi Clementine

    I have PCOS and I was always cautioned at my scans that we may cancel due to OHSS. I was on Puregon. My FS started me on 116iu. I was on that for 5 days. But at the time I wasn't injecting my self properly lol. User fault. I then went up to 124iu. Again for 5 days. I was then increased to 180iu until EPU.

    I had 15 eggs retrieved at EPU. I had mild OHSS. I don't have a low AMH though so you may respond differently because of that.

    As Bec has said. It really is a trial and error thing and it is so frustrating. Sometimes you respond better on the higher doses and othe times you respond better on the lower doses.

    I'm also on a string of different supplements as well. Zinc, CoQ 10, Folic acid, Berrocca & Cartia. My DH is on supplements as well.

    Good Luck.

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    Hi Clementine
    I have PCOS but have no issue with ovulation either (my problem seems to be that I don't produce progesterone and egg quality issues). My first cycle was almost cancelled as they started me on 100 of Puregon (everyone was cautious that I didn't get OHSS). The second cycle they put me on 150 and it was all ok.

    The third cycle I did a process called IVM instead of IVF. This is where you only stim on a low dose of puregon for 3-5 days and they collect immature eggs and mature them in the lab. It is designed mostly for PCOS woman to prevent OHSS and assist with egg quality as PCOS women are prone to getting lots of egg but not that great quality. I'm pretty sure IVM is only done in Perth at the moment though unfortunately.

    As the other girls have said a lot of it is trial and error unfortunately. Us girls have to have a lot of patience in this IVF game. Wishing you all the best

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    Hi Clementine!

    I have PCOS aswell, although I was told it seemed a mild case.

    I was started on 150 Gonal F, but I think my FS had other plans as she told me she changed to 150 as I am thin and didn't want me to OHSS. So who knows what my original dose was going to be and if it would cause me to OHSS.

    I was terrified of it as I know that it is common in those with PCOS.

    After all that, they only got 5 eggs from me and 4 fertilized with 3 to freeze. Which I think was a pretty poor number from someone of my age and AMH levels, but they kept telling me its quality over quantity, and mine were great.
    At one of my scans, the guy said to me something about something looking like a string of sausages
    I thought that I was going to OHSS from that comment, but I didn't.


    Goodluck with your next cycle!


 

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