PCOS and ovulation

[allyackles]

I have recently been diagnosed with PCOS. I have had two blood tests, on the 21st day of my cycle, both have come back as showing no ovulation. Now this is where I am confused. I have always had regular periods, until last moth when my period was about a week late. My doctor has said that there is no way of telling if my 2nd blood test was accurate or not because of the lateness of my last period.  Now that my cycles are messed up I could be in this position every month. So how am I meant to know if I ovulated or not?
My doc has also mentioned a drug for possible future use called Metformin. How effective is it? Any advice would be could.

[Elaine Brown, MD]

Hi!
From the sound of it, you must ovulate sometimes, it could be that you just missed on the cycle that you were testing.
To know if you are ovulating, you could:
start counting on the first day of your period--this is cycle day one.
Begin ovulation predictors on cycle day 11 continue through 16.
If they are positive, have an ultrasound done on the same day (often day 12)
The ultrasound is to look for follicles, a healthy one should be about 2 cm in size.
On day 21 of the cycle do a blood test for progesterone level.
On day 25 or so, do an endometrial biopsy to see if the lining is synchronized with the ovaries and hormone levels.

If you truly have PCOS, you won't ovulate regularly, and will typically have irregular periods.  Metformin works very nicely to help this process.  Clomid or Femara can be added for an even better effect.

Well now there's some homework for you!
Hope this is helpful!
Dr B

[higginsbl]

Hi, I understand how frustrating this is for you.  I was diagnosed with PCOS about 9 months ago and also was placed on Metformin.  My periods have never been regular, but it was still concluded that I had PCOS.  My doctor said that there are many things (not only blood tests) that can help diagnose PCOS.  I was also prescribed metformin due to hyperinsulinemia caused by PCOS.  I was told that increased insulin in the body has been linked to infertility in some studies.  Being a nurse, I knew this medication is for diabetics and had never heard of its use in infertility.  I think my doctor,  based on the studies, put me on the medication in case there is a chance of infertiltiy with increased insulin.  Hope this helps some.