intro and a question (long)

Question:

I have PCO and have been TTC for 3 years. We have done numerous treatments and tests. We took clomid for 12 cycles 3 of those cycles with IUI. We have taken pergonal with IUI several times and are currently on a 6 month break.

Hi Joni– What is your LH/FSH ratio? If you have too much LH (due to PCO), you might be better off with an FSH-only ovulation drug, such as Follistim or Gonal-F, rather than the Pergonal which contains LH. Many REs don’t treat PCO patients with LH/FSH combo drugs for this reason. I am PCO and my RE has always used Follistim with me. Good luck! Lisa B

Response:

Joni, I can’t offer any help regarding med purchase, but I do have a concern/question… My RE will not prescribe spironolactone if I am trying to conceive and until I am finished having children. (and even if she did, I wouldn’t take it) Since you are on a break, are you using birth control while on the spironolactone? -Kay

Response:

I am taking the spironolactone twice a day every day to help control the hair growth associated with PCO. I have been on it for about 3 months. I have not started the birth control yet (I have to do a sunday start and I am not bleeding yetI just got the script on tuesday) I will start it soon. I am to continue taking the glucophage and spironolactone while I am taking the borth control. My doctor told me that both the spironolactone and the glucophage are ways of trying to help with the effects of PCO for women who wish to conceive. I researched both before I started taking them and didnt see anything that would sway me not to take them. What would your concerns be with taking the spironolactone? Joni

– Hide quoted text — Show quoted text – Joni, I can’t offer any help regarding med purchase, but I do have a concern/question… My RE will not prescribe spironolactone if I am trying to conceive and until I am finished having children. (and even if she did, I wouldn’t take it) Since you are on a break, are you using birth control while on the spironolactone? -Kay

Response:

I have read this board for about 2 years now. I am mostly a lurker but have posted the occasional question. I have seen some very special ladies dreams of becoming pregnant come true along with the heartache they had to endure to get there during my time reading the board. I have learned alot of valuable information here as well. I have PCO and have been TTC for 3 years. We have done numerous treatments and tests. We took clomid for 12 cycles 3 of those cycles with IUI. We have taken pergonal with IUI several times and are currently on a 6 month break. I am taking three glucophage every day along with spironolactone twice a day. I have been on these drugs for six months. I am not responding as well as I was hoping to these treatments. I *feel* better when taking the glucophage but it has not regulated my cycles. I went to the dr on tuesday because I am having a full period every fifteen days. He told me he didnt really know what else to do because I just dont resond to the treatments very well and he has tried everything he can think of. He told me to take birth control to (hopefully) control the bleeding until we are ready to take the fertility drugs again. We are going to continue the glucophage and spironolactone while taking the birth control. If the birthcontrol doesnt help with the bleeding he wants to check for polyps. We want to wait at least another three months before we start back on the fertility drugs again. I have to take around 33 amps of pergonal per cycle which is about $2,000.00 for just the drugs every month let alone all the ultrasounds and dr visit copays and blood work. So my question is for those of you who have bought fertility drugs from pharmacies in Mexico. We are working on saving a good lump sum of money and flying to Mexico to get about a six month supply of pergonal because it is such a savings. Buying it here will stretch out my finances about three months. I am hoping and praying it will work the first try but hoping for the best and preparing for the worst just in case. Does anyone have an idea of what kind of pricing I can get doing this so I will have an idea of how much money I will need? Does anyone have any suggestions on where the best place to go to make this purchase would be? Does anyone know of a good (accurate) way to research this? Any advice or information you can give me will be extremely appreciated. Sorry this was so long. Thanks, Joni

Response:

Thanks to everyone who replied to my post. I knew I would find some helpful answers from this group. I will definately check into the sugestions you have given. Joni

– Hide quoted text — Show quoted text – What would your concerns be with taking the spironolactone? http://www.ivf-et.com/pcosstate.html "Anti-androgens This group of medications can be used only when not attempting a pregnancy or without some form of adequate birth control. There is, at least a theoretical, risk of feminizing the genitals of a male fetus. The value of the agents for PCOS patients is to improve the skin problems that occur with PCOS. None of these medications are approved for treatment of hirsutism or PCOS. Some may have potentially serious side effects. Examples are spironolactone (Aldactone), Flutamide, cyproterone acetate, and Finasteride."

Response:

What would your concerns be with taking the spironolactone?

http://www.ivf-et.com/pcosstate.html "Anti-androgens This group of medications can be used only when not attempting a pregnancy or without some form of adequate birth control. There is, at least a theoretical, risk of feminizing the genitals of a male fetus. The value of the agents for PCOS patients is to improve the skin problems that occur with PCOS. None of these medications are approved for treatment of hirsutism or PCOS. Some may have potentially serious side effects. Examples are spironolactone (Aldactone), Flutamide, cyproterone acetate, and Finasteride."

Response:

<<What would your concerns be with taking the spironolactone? http://www.merck.com/pubs/mmanual/section18/chapter235/235d.htm "For anovulatory women who have polycystic ovary syndrome, are hirsute, and *do Spironolactone is a mild diuretic that inhibits the biosynthesis of androgens and competes with androgens for their receptors in target tissues. Doses of 100 to 200 mg/day po are effective. Adverse effects include initial diuresis, postural changes (eg, syncope, hypotension), mastodynia, and irregular uterine bleeding. Its long-term effects are unknown, as are its effects on a developing fetus; thus, contraception should be used."

Response:

Dear Joni, I can’t help with the PCO. But you might want to look into buying your meds from this Italian pharmacy instead of going to Mexico. http://www.farmaciacerati.it/frameuk.html Good luck! Janet

Response:

I’d suggest being checked for the polyps, for sure – maybe one of those laprascopies to see whether there are any problems inside. Beyond that, if you feel a lot better using the glucophage, I’d also suggest that you have all the possible tests for hypothyroid. I was having a lot of bleeding and my RE found that I was hypothyroid. After a month of being on Synthroid for the hypothyroidism the excess bleeding has stopped and I feel even better than I did when I was just taking glucophage. I’ve never cared for these doctors who go around putting women on birth control pills when their cycles are off. All they’re doing is forcing the cycle by pumping hormones into you, without looking to see what the *real* problem is. Teri

Response:

Teri, Thanks for the suggestions. I am going to do some more research on polyps and possibly get back with my doctor before starting the birth control. I have had my thyroid checked 3 times. Once in 98 by a doctor I have since stopped seeing and twice by this doctor. Once in 99 as part of the fertility workup and again this last august to be sure it hadnt changed as part of some of the bloodwork he did before starting me on the glucophage. I dont think my thyroid has changed since august. Are there any other symptoms I could recognize to indicate it has? I had a lap a year ago after I had a mc, but they couldnt find anything abnormal when it was performed. Do you know if there is any way to tell if there is a polyp without having an invasive procedure done? Thanks again for the info and the speedy reply. Joni

– Hide quoted text — Show quoted text – I’d suggest being checked for the polyps, for sure – maybe one of those laprascopies to see whether there are any problems inside. Beyond that, if you feel a lot better using the glucophage, I’d also suggest that you have all the possible tests for hypothyroid. I was having a lot of bleeding and my RE found that I was hypothyroid. After a month of being on Synthroid for the hypothyroidism the excess bleeding has stopped and I feel even better than I did when I was just taking glucophage. I’ve never cared for these doctors who go around putting women on birth control pills when their cycles are off. All they’re doing is forcing the cycle by pumping hormones into you, without looking to see what the *real* problem is. Teri

Response:

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Polycystic Ovary Syndrome (PCOS)

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