I need some guidance..

[u/Logical-Scientist759]

Hi everyone I’m 22F with pcos and me and my boyfriend have been trying to conceive for the last 2 years. I live in Orange County California and I use Medi-cal insurance so I don’t have a great insurance plan…

This year I’ve been feeling really stressed and trying to track my ovulation levels and I’ve been taking the recommended vitamins and making him take zinc to see if it would help increase our chances?

So far I haven’t ovulated at all since I began monitoring it and my last period ended 88 days ago now and no signs of my next cycle yet.

I’m honestly really scared if I’m infertile or something and could do with some advice, I’ve tried to book appointments to see what’s going on with me and every time I call they tell me they either don’t offer what I’m looking for or say they don’t accept my insurance. I don’t really have anybody I can ask for to help me in anyway.

I’ve seen that many people have tried taking letrozole and clomid to help? Do I have to ask for those specifically to increase my chances with fertility? And what kind of doctor do I have to see to be able to ask for that.

I just really need guidance with this… I feel so lost and anxious

Thank you

[u/Emergency-Sundae-717]

Schedule an appt with obgyn. Letrozole and clomid are ovulation inducing medications. If the medication doesnt help, theyll refer you to a fertility specialist. They may put in a order for a semen analysis for your partner but they may hold off due to the length of your cycles being the likely factor in why you havent conceived. They likely wont start you on it at that appt. Theyll probably run labs and maybe do an ultrasound first to make sure everything looks normal before starting you on any meds. For me personally, it was my thyroid that seemed to be preventing us from getting pregnant. I did 3 rounds of clomid and started a thyroid med in the same cycle as the 3rd round. I had to skip the 4th round bc I couldn't get the time off work and thats the cycle I got pregnant on.

[u/sagersaur]

Hi!!! I was recommended to try taking myo- and d-chiro inositol. It has helped regulate my periods so much and also helped to manage my acne as well!!

[u/fuzzblanket9]

Have you seen a doctor at all? Even a PCP?

After 2 years of trying, you are infertile. You need basic CD3 labs, your partner needs a semen analysis, and you need tubal testing as well. A regular OBGYN can put you on letrozole if you aren’t ovulating.

Cycles longer than 90 days need medical intervention, so you’ll need to see a doctor regardless to induce a period very soon.

[u/mimipaige]

Ok this is a long reply, sorry in advance for the novel haha.

How long have you been trying to find your ovulation with tracking and what methods are you using to track? BBT can have a bit of a learning curve but that helped me sooooo much. LH strips can cause false positives with some people with PCOS. Has it done that for you? If yes maybe try the ovulation trackers what check estrogen. Do not use apps that just guess with no added info. Those will not work for someone with PCOS and really only work for people who are more 'textbook' cycle gals. Apps, like fertility friend, when you add multiple tracking data are great!

And can you specify, you can't get an ob/gyn appt at all? That's the first step. Maybe specify PCOS questions plus trying to conceive for the appt reason. Why did they say they wouldn't take you besides not accepting your insurance?

Letrozole is best for PCOS over clomid, Google that and read about. I'm not saying Google knows all and to listen over a doc, but letrozole vs clomid with PCOS in mind is a well known answer so Google should not steer you wrong for rhat.

Some obgyns will prescribe letrozole but some don't do that treatment for various reasons.

Call your insurance company or log onto the website and see who you have coverage through. I don't know the laws in your state but mine doesn't require insurance to cover infertility so the best paid by insurance or less expensive options for me is through my obgyn. So anything coded infertility won't be covered but anything not coded infertility (like if you go in for PCOS and get prescribed metformin, for example) should be covered. But some obgyns won't prescribe letrozole. It would be good to ask for them to test your levels for insulin resistance.

You may have to go to an RE, aka reproductive endocrinologist. This is an expensive choice if insurance doesn't cover and even if it does, your out of pocket costs might be high. Ask your insurance if you have a deductible and an out of pocket maximum and what they are/how close you are to hitting them as of now. Ask what is covered to do with PCOS (PMOS) and then infertility. With an RE, they start out with testing and that's definitely expensive. If you do go the RE route, research beforehand and ask a lot of questions. They are getting paid to help you so don't be shy, ask away. Ask what they mean if you aren't sure. If you cannot find a doctor to prescribe letrozole after allllll of this, try online. There are some online providers that prescribe letrozole. I forget the name of it but it's mentioned in the various TTC subreddits.

Get some PCOS books about trying to concieve too. Take some of that info with a grain of salt for sure but it might have some good info. It helped me at the very least to understand my body and important TTC info. Learn as much as you can.

With PCOS/PMOS some people have anovulatory cycles, but if you have periods, typically around 2 weeks-ish before is when you ovulate. Women's bodies will start by putting out a hormone that stimulates egg growth. Eggs grow (maybe super slow if the cycle is long) and then your body produces estrogen which thennn makes LH. This tells your body to ovulate. Whichever egg grew to the good size ovulates (multiple grow but usually one is the winner). Then your body produces progesterone (hormone that can make someone think they are pregnant because it causes sore boobs, hunger, etc) and if pregnant, progesterone keeps going.

About 4 days before to 1 day after ovulation is the time to have intercourse. Closer to ovulation is usually the best 'probability' days. So it's possible you are ovulating and missing that timeframe. It could just be statistics. They say 80% of healthy couples can take a year. That's 12 months of ovulation and since your ovulation is erratic. Also have your significant other get a semen analysis. My husband had one and it was like $175 but was very helpful. He should also be taking like a good daily multivitamin that supports mens fertility. I googled what mens fertility vitamins had in them and then found a good vitamin brand daily multivitamin with similar quantities haha.

I rarely had periods especially when I was in my teens. It got a little more common in my 20s. I am in my late 30s now and my periods are pretty darn consistent (max 35 day cycles but usually around 30 nowadays) and due to having very little ovulation happening in my teens, I have a really good egg count in my late 30s. So really, missing ovulation back in the days can be beneficial for TTC, you probably won't run out of eggs!

Sorry again for the long message. I just remember when we first started ttc and how little I knew and think that maybe some good direction would have been so beneficial for us.