Need Advice..TTC - PCOS - Hypothyroid

[TiffanyM11]

I am 32 years old, was diagnosed with hypothyroidism 13 years ago,(been on synthroid), diagnosed with PCOS in 2005. My husband and I ttc in 2005, but with no luck (6 rounds of clomid) I was obese and in 2009, I had gastric bypass and have lost 185+ lbs. I am now close to 4 years out and my husband and I have started TTC again since July of this year. My period started coming on its on about a month and half after taking my last birth control pill. In December, my gyno put me on Metformin 750mg 2 times a day. Then in January added 5mg Femara (days 3-7), also did that in Feb. Then this past month (March) she uped me to 7mg of femara (and still taking Metformin, too). My 21 day Progestrone levels for December was 2.87, January was 1.76, Feb was 7.87, and this last one was 9.82
She also did tested 4 other harmones on day 3 of my cycle, everything was normal, except the TSH which was .282, which she said was a little underactive. So now I have been  referred to an Reproductive Endocrinologist. So, what is there to be expected? What other things should we be doing to increase chances of TTC. Od there any other tests that should have been or should be done? Shots? I am really confused and nervous.

[Elaine Brown, MD]

Hi!
If you were my patient, I would advise you that your doctor has done exactly what I would have done. Metformin and Femara are both excellent medications.  It sounds like you may be ovulatory at least  this most recent progesterone level was OK.  I am not certain what the RE will do--possibly continue Femara or switch to Clomid (I like Femara).  OR possibly add Intrauterine Insemination (has your hubby had a semen analysis?).
You might benefit from injectable medications, but orals have a lower chance or higher order multiple birth as a side effect.
Over all, sounds like your doc did a good job, and I'll bet you'll get a baby if you are patient!
Hang in there!
PS excellent job on the weight loss -- NO NEED to regain if you do conceive!!!!!
Dr B

[TiffanyM11]

Thanks so much for your help. I am heading to a Reproductive Endocrinologist tomorrow. My husband had a semen analysis back in 2005 and got a real good report. That is on my list to discuss tomorrow as well as the injections and other medications.
Thank you.. I am proud of my weight loss.. however, I am really scared of gaining weight if/when we get pregnant.
Thank You again..