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  • Q&A with Australian Health Practitioners

    Next step in trying to conceive??

    Hi, I am 29 and have PCOS (not officially diagnosed) LH higher than FSH but not really elevated!! more than expected in luteal phase.Borderline elevated test/angrogen and cholesterol levels,normal insulin levels although havent had a glucose tolerance test.I have long cycles 35-40 days and have skipped a period twice since going off OCP. Periods last for six days and are not heavy. Using ovulation kits are hard as I have two or three positives in a month.Progesterone only 2.4 at day 27, so no ovulation that month.Just wondering what the next step will be? I am keen to become pregnant. Can I be put on Metformin/ clomid or do they need to do other tests?? What can be done to prevent miscarrage? I am a healthy weight.Thankyou Amber
  • Find a professional to answer your question

  • Women's Health Queensland Wide provides free health information for Queensland women. View Profile

    Perhaps you should consider seeing a specialist for an offical diagnosis and ongoing management.. Whilst PCOS can affect fertility is is NOT a given that you cannot conceive.Weight management is the first treatment approach in women diagnosed with PCOS, regardless of the desired treatment outcome.Losing as little as 5% bodyweight can help control insulin resistance,stimulate ovulation and reduce the risk of complications such as cardiovascular disease and type 2 diabetes

    You might find it helpful to watch some videostreams on this subjuct.. Just click on the link.

    http://www.womhealth.org.au/videostreaming/vs_index.htm

    Brenda
    Women’s Health EducatorHealth Information Line, Women’s Health Queensland Wide Women living in Queensland can also call our Health Information Line - a free information and referral service for Queensland women - on 3839 9988 or 1800 017 676 (toll free outside Brisbane). Please note that all health information provided by Women’s Health Queensland Wide is subject to this disclaimer

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    Katherine Ferris

    Hypnotherapist

    I am a Registered Clinical Hypnotherapist with more than a decade of clinical experience, specialising in issues caused by stress, anxiety, panic attacks, fears, phobias … View Profile

    Hi Amber,

    Are you perhaps exposed to a lot of stress and worry in life? Stress has been found to be an underlying factor in unexplained infertility. 
    Hypnosis treatments are particularly successful for those couples who have been diagnosed with unexplained infertility, that is due to the fact that hypnotherapy helps reduce stress and anxiety.

    Further information available in confirming the connection between stress and infertility is
     research carried out by the University of Western Australia which found: “significant associations between stress and fertility” as a cause of reproductive suppression in women.

    Other studies indicate “infertile” women using hypnosis have up to 55% success rate of conception, as compared to 20% for those not following these methods.

    Katherine Ferris - Clinical Hypnotherapist
    Sydney Wellbeing Centre
    www.sydneywellbeing.com

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    VARTA is a statutory authority based in Melbourne, Australia, providing independent, accurate information about fertility, infertility and assisted reproductive treatment (ART). View Profile

    Hi Amber
    If you are under 35 and have been trying to conceive for a year or more without success, you and your partner (if you have one) should see a doctor for a check-up. If you are over 35 and have been trying to get pregnant for six months or more, you should see a doctor. For more information about factors that affect fertility, visit www.yourfertility.org.au

    One of our partners in the Your Fertility campaign, Jean Hailes for Women's Health, has excellent information about PCOS management www.jeanhailes.org.au but it would be useful to get a diagnosis and specialist advice to suit your personal circumstances. Best of luck to you.

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    Dr Alexandra Bloch-Atefi

    Counsellor, Psychotherapist

    I am a qualified holistic counsellor & trained psychotherapist practicing in Melbourne, Australia. I specialise in stress management for women, offering one-on-one counselling sessions and … View Profile

    Hi Amber,

    Elaborating further on Katherine's point and how stress influences reproductive health. Your mind can affect your ability to get pregnant on multiple levels:

    Intense or repeated emotional responses to personal, social, and work-related stressors can cause a physical reaction in the body, throwing it into a state of emergency. The hypothalamus activates the so called fight-or-flight response to protect us from harm.As you might know, reproduction is one of the most delicate systems in our body. Over time, the prolonged cumulative effect of this stress can affect your reproductive system in a negative way. Since the reproductive system is not vital for immediate survival, its function is suppressed and the body’s energy is directed elsewhere in preparation to fight or flee.

    The hypothalamus gland is not only responsible for providing balance in our bodies but also helps control the levels of key fertility hormones LH and FSH through the pituitary gland. If the hypothalamus senses stress, the messages sent to the ovary to release eggs may be interrupted and cause stress-induced infertility.

    To break this pattern the underlying emotional tension must be addressed. You might carry negative beliefs such as: “My whole happiness depends on having a baby,” or “It’s my fault that I can’t get pregnant.” A recent study on mind body interventions and pregnancy rates in IVF patients (Domar et al., 2011) found that women who completed a mind body stress reduction program had higher pregnancy rates (cklick here for more info).

    Other options (which are by no means exhaustive) worth exploring when it comes to aid conceiving are:
    - Chinese medicine to enhance fertility http://www.sattvanaturaltherapies.com.au/articles/fertility-and-preconception/
    - Chiropractic treatment, as spinal health contributes to fertility http://www.wellnesschiropractic.com.au/
    - Fertility Yoga (specific postures to nourish and stimulate the reproductive organs) http://www.angeayoga.com.au/
    - Acupuncture to support your IVF treatments http://melbourneivfacupuncture.com.au/

    For more info click here

    Hope that helps,

    Alexandra
    www.cmbb.com.au
    Melbourne Counselling, Prahran Counsellor: Alexandra Bloch-Atefi, PhD, VIC
    Find me on Facebook


    Reference:

    Alice D. Domar, Kristin L. Rooney, Benjamin Wiegand, E. John Orav, Michael M. Alper, Brian M. Berger, Janeta Nikolovski. Impact of a group mind/body intervention on pregnancy rates in IVF patients. Fertility and Sterility, 2011; DOI:

  • Nikki Warren

    Naturopath

    Nikki Warren is committed to preconception care, natural fertility, and pregnancy through to postnatal care. Nikki is a degree qualified Naturopath, Medical Herbalist, Doula and … View Profile

    Hi Amber,

    I know exactly how you feel - I myself had PCOS and it was the success I had due to herbal treatment that inspired my career as a naturopath!  Although I did not want to conceive at the time, I just wanted to have a period (I hadn't had one for about a year).  I tried Metformin and spent a lot of money on specialists and got nowhere.  3 weeks after starting a herbal remedy I got my period, started losing weight and the acne on my chin started disappearing - amazing!

    First of all, LH surge strips aren't going to work for you because you have higher than normal LH levels.

    Secondly, when you say “not officially diagnosed” do you mean you have self-diagnosed or has a GP suggested it but you haven't had an ultrasound yet?

    PCOS is complicated because some women have elevated androgens, some don't, some have hyperprolactinaemia (high prolactin levels), some don't, not all women with PCOS are overweight, some have very high oestradiol (oestrogen) levels and some don't. 

    The herbal treatment I use is evidence-based (i.e. it has scientific studies to back it). 

    I would absolutely agree with Alexandra and Katherine as well - the mind is a very powerful tool and reducing stress can help considerably.  Have you had your prolactin levels checked?  Often women with PCOS have high prolactin levels and so do women with high stress levels.  This can be treated with dopamine agonist herbs.

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    Dr Teresa Wong

    GP (General Practitioner)

    I love medicine! My special interest areas are mental health, pain management, pediatrics and musculoskeletal injuries. Having said that there is no area in medicine … View Profile

    You sound so well informed !
    I think that you definitely need a proper diagnosis with hormone tests and ultrasound that are interpreted by a doctor. And I do believe you should do  a glucose tolerance test at 0, 1 and 2 hours including insulin levels at each  point in time. If needed Metformin can be helpful. Regarding Clomid, if we got to that point I would rather a specialist organise that as they can then discuss all the options with you. Having said that I know that most of my patients with PCOS have been able to have healthy happy babies!
    However most importantly talk to your GP - I know if it was me I would consider all possible causes of potential infertility and for example discuss with you how long you'd been trying for, how old you were and your family history.
    It's a difficult journey and having a GP supporting you can make it much easier…

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