Funny Girls of Fertility

Along Came Poly(cystic Ovarian Syndrome)


PCOS is the real deal y'all.  PCOS is Polycystic Ovary Syndrome.  In super layman's terms PCOS ladies have a shit ton of follicles (cyst) on their ovaries.  Symptoms of PCOS include but aren't necessarily limited to; acne, irregular cycles, anovulation, weight gain, and fertility issues.  In women with PCOS there is a hormonal imbalance that can also lead to severe risk factors.  Some of these risks include hypertension, high cholesterol, and diabetes just to name a few!  I could write an entire blog post about PCOS (which will eventually come), but today is just a little PCOS success story (because those are my fave!)

If there was a competition for having the most textbook PCOS ovaries, a recent patient of mine would have taken the cake.  GINORMOUS.  She started off with a couple of rounds of Clomid.  The first and second cycle resulted in the same outcome; zero follicles.  Since she knew she wasn't going to respond to the Clomid, she decided to try injections.  We switched her to Gonal-F, and we really thought she was going to take off with all those follicles!

She started on a low dose of Gonal-F because our office wasn't trying to get famous for making another Octo-Mom.  The slow start wasn't cutting it.. she was on day 7 with no change so far.  The doctor decided to bump her up!  Now at day 12 and still no sign of growth.  ((Let me mention in a normal cycle the average medication day range is 10-12.))   By day 16, I think we were all wondering if this was going to happen!  The longest injection cycle of my entire career.....24 days.  I mean is that even possible?!! It happened.  She finally had one little follicle that took off.  After seeing us every other day for the last 24 days I'm pretty sure she was excited not only for that ONE follicle, but also for not having to come into the office anymore! Let me mention I LOVED having her and her husband there that often because it was during football season, and they are EAGLES fans!  Thats like finding a Chupacabra living in Dallas Cowboy Nation!

Her beta day came and she had a level, unfortunately it was a biochemical.  I honestly have some of the most amazing patients because even with the bad news she bounced back looking forward to their next step, which for them was IVF.

She started stim for IVF and this time had a fantastic response.  It did take us some time to get there, but it was less than 24 days so it didn't seem that bad to her!  She was nervous about getting OHSS (Ovarian hyperstimulation syndrome) sine her Estrogen was off the charts high.  (There is no magic Estrogen number that will tell you if you are going to get OHSS or not.)  Most women who do get OHSS have the mild version.  Fortunately, she only suffered thorough some severe bloating and discomfort!

She did get a bajillion and 10 eggs.  Sometimes it just takes a little work to get to the goal.  Now on to the next step of transferring.  Of course she is jumping in with a positive attitude, and lots of talk about whats going on with the Eagles and their offseason plans. :)