Options

Options

Venus von Willendorf (fertility goddess figurine) 

After coming to terms with my PCOS, I started looking at options.  Now let me restate that I am a graduate student in the sciences, and have a very high capacity for learning a new subject quickly and understanding all the medical research jargon.   So once again, I went to the original research articles to see what treatments were working, the risks..  the cost analysis I had to do more by using google than research papers.  The options as I saw them were slim...  here is a list of viable treatments that I found, in the order of how they should be tried, plus a little statement of what I feel the literature says about my situation in particular as it pertains to this option

Metformin-  Doesnt really do anything involving fertility, but helps with some metabolic symptoms that may result in a slight enough change to get an egg to drop...  this does not really work for most people, it really only works for those who cycle frequently anyway, which is not me. But it is the first try for many doctors, so the chances are that if you have PCOS, this will be the first drug given.

Clomid-  this can be given at several different doses, with low risk to the womans health.. just some really annoying side effects like crazy dreams, night sweats, nausea, headaches.  Its efficacy in a lady should be seen right away with ovulation.. the chances of this working in people like me with no ovulation is said to be around 5-10%.. not very high, but worth a shot because it is non-invasive, low risk and relatively low cost compared to the next steps.  Oh let me also mention.. a women with PCOS always has a higher risk ratio for multiples, because of the way your eggs are built up.. so be aware.. if you ovulate with this drug .. it could be more than one egg.

Injectables with IUI (inter-uterine insemination)- This is a valid therapy, but now we are getting into high risk, high cost, with still a low efficacy.  The risk here is so high of uncontroled multiples for women with PCOS that many fertility clinics will not perform this procedure and suggest you go straight from clomid to IVF.   The cost here is very high.. thousands and thousands.., it is invasive, painful.. can result in hyperstimulation for women with PCOS which has very severe side effects including loss of ovaries and in some cases death. All that to say that this option is not really done on PCOS women that frequently anymore. (as a side note, Kate Gosslin has PCOS and did this option.. now she has 8 kids)

IVF- Again, because of the injectable hormones you have pain, invasiveness, expensive expensive plus an extreme risk for hyperstimulation.  The one plus with this is that they harvest the eggs, fertilize them then only put a certain number back in.. so you have way less of a risk for extreme multiples.  However, the outcomes are still really low for women in my shoes only 15-20% chance of pregnancy per cycle tried.. and each cycle is upwards of 25k without the unforeseen costs of hyperstimulation.

Adoption-  Expensive (depending on which avenue you chose), emotionally invasive, but not so much physically.. but has 100% outcome of having a child

In the next post, you will see what our plan is...  but as you probably can tell from my explanation that i really dont like the injectables and IVF options.. these options we will not be perusing because of all the research I have done, I do not feel comfortable using these options for us.  Do they work.. sure sometimes.. but with the risk analysis I did for our situation... we do not want to go down this road.  I think this is a very personal decision for each couple, and I would never be judgmental towards those that chose this path.. I would just hope that you do not go into it hastily and really really do your research to make sure this decision is right for you.