TTC'ing for around 1.5 years

Hi

We have been TTCing for over a year now. When things did not work out, we visited a gynae, who ordered a variety of tests.

(Background : 29 years old female Indian, Height 5'2'', Diabetic Paternal Relatives, Regular periods)

Abnormal Results:
Date: 29/01/11

Fasting Insulin         : 151.56 mU/L
Fasting Glucose       : 116 mg/dL
Glucose PP             : 151 mg/dL
TSH                         : 5.27 microIU/mL
Total Cholesterol   : 198 mg/dl
Triglyceride             : 175 mg/dl
HDL                         : 26 mg/dL
LDL                         : 137 mg/dL
VLDL                     : 35 mg/dL
Hb1Ac : 5.8
Weight                     : 89 kgs

100 gm OGTT:

0 hrs Fasting : 110 mg/dl
1 hr : 214 mg/dl
2 hr : 160 mg/dl
3 hr : 56 mg /dl

Doc put me on 500 x 3 mg Metformin, 25 mg Eltroxin and Folic Acid + Diabetic diet + Exercise since 8th Feb 2011.

Date: 12 / 03 / 2011

75 gm OGTT:

0 hrs Fasting   : 99 mg/dl
0.5 hr             : 183 mg/dl
1 hr                 : 210 mg/dl
1.5 hr             : 153 mg /dl
2 hr                 : 85 mg/dl

TSH                         : 2.906 microIU/mL

Weight is now down to 82 kgs with Meds, Diet (No sugar, No white rice, No junk food) and light walking.
Doc has increased Metformin dosage to 850 x 2 + 500 mg.

Please suggest whether I am on the correct track and if there is something  I can do. Also what is the future? Am I a diabetic?

How soon can we TTC again? All other test results are normal - LH, FSH. Prolactin, Husband’s Semen analysis, Pelvic Ultrasound (save a cycst which Doc says may go away on its own).

Appreciate your feedback.

[Elaine Brown, MD]

Hi!
Sounds like you are definitely on the right track--good job on the weight loss and also on lowering your blood sugars.  The current trend seems to be to use the Hemoglobin A1C value for establishing the diagnosis of diabetes.  The cut off is 6.5.  You may wish to ask your doctor about this test if you haven't already.

If you were my patient, I would not hesitate to advise you to get started again with TTC.
Having your sugar in good control, and your weight optimized is going to really improve your chances.  The metformin may also help.

I think the next testing that I would consider would be documentation of ovulation.  I would recommend using OPK for a few cycles, and also checking progesterone levels on cycle day 21(or so),  If we documented regular ovulation, I would then probably suggest an hsg (hysterosalpingogram) to check for blockages of the fallopian tubes.

Hope this helps!
Dr B

[minx44]

hi, we have also been trying for a year now,,and then went to do checkups,,my husband doesnt seem to have any problems,,and my ovaries, and everything else also seem s to be normal, except that when i was scanned (day 10th no dominant follcile/Endometrial thickness 3.4mm, day 13th , 8*10mm dominant follicle on right ovary/Endometrial thickness 4.6mm, day 16th the same thing measure 10 *9 mm,/Endometrial thickness 6mm)

i weighs 59 kg, and we have been married for 2 years now,,am 23 year sold , husband 28...

doc prescribed me fertomid 50 and i started taking it from day 5thof my cycle for 5 days

am so worried now since doc asked me to lose weight and he thinks i wont ovulate this month :(

(oh an dmy operiods rnt regular, sometyms i wud take 38 days, but mostly every month i do get my period)

would really appreciate ur help :),,thank u in advance

[llclark1]

there several natural ways, of regaining normal cycle and as a result normal ovulation, Vitex is one herbal remedy that as worked for a lot of people. I have PCOS, diagnosed 15 years ago, although I think I might have it longer, I had normal cycles til 14 and they started when I was 12. I have been on Metformin, clomid, and regularly take nd still do take Provera to induce my cycle. Within the past 2 months I decided to take charge and loose some weight so far Ive lost 20 lbs, with excercise and a better diet, i also started taking vitex which caused me to ovulate for the very first time in my life. this month I will add a regimen of 1 baby asprin per day, to help with implantation. you should look into herbal remedies, they do work, w/o alot of side effects.

[minx44]

20 lbs? wow,,thats great,,although i dnt know how exactly im goin to lose weight,..somebody said ginger tea would help,,anyways i will look into vitex see whether it is available in ere

i hope and pray that ur dreams come true soon :) the way u r working im sure it wud make a difference in no time

im just worried about that small follicle,,i was thinking may be the process is slow cause my cycle is longer? or need to increase the dose sinc emy body didnt seem to respond to it this time except for the hot flashes when i took them,,,all for nothing lol

thank u for the wonderful advise :)

[dd020182]

Thanks for the reply :)