PCOS Doctors and alternative docs for conception

can any recommend a doctor if you have PCOS and want to get pregnant. i'm not sure i do have pcos i had a ultrasound 3 years ago and it showed nothing but i had been on the pill for about 6 years. now gone off the pill in november and my cycle is 35 to 41 days so am thinking it might be pcos. interested in checking out alternative therapy for helping conceive such as chinese medicine or a good natropath - any recommendations

Hi


Various things you can try.


I am not sure of any one fertility specialist that deals specifically with PCOS. But I could be wrong. It can take a while for your periods to return to normal - up to a year for some. There are quite a few fertility Drs here and mostly it is who you gel with. I would not nec go to a OB/GYN but a fertility specialist such as Philip Ho, Dr Doo, Milton Leung, Stevenson, Danny Chan.


Besides long periods what else makes you think you may be suffering form PCOS? There are various websites that can help inform you.


These are some of the symptoms of PCOS:


infrequent menstrual periods, no menstrual periods, and/or irregular bleeding


infertility or inability to get pregnant because of not ovulating


increased growth of hair on the face, chest, stomach, back, thumbs, or toes


acne, oily skin, or dandruff


pelvic pain


weight gain or obesity, usually carrying extra weight around the waist


type 2 diabetes


high cholesterol


high blood pressure


male-pattern baldness or thinning hair

patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs


skin tags, or tiny excess flaps of skin in the armpits or neck area


sleep apnea―excessive snoring and breathing stops at times while asleep


WHAT TO EXPECT FROM YR DR


There is no single test to diagnose PCOS. Your doctor will take a medical history, perform a physical exam—possibly including an ultrasound, check your hormone levels, and measure glucose, or sugar levels, in the blood.


If you are producing too many male hormones, the doctor will make sure it’s from PCOS.


At the physical exam the doctor will want to evaluate the areas of increased hair growth, so try to allow the natural hair growth for a few days before the visit. During a pelvic exam, the ovaries may be enlarged or swollen by the increased number of small cysts. This can be seen more easily by vaginal ultrasound, or screening, to examine the ovaries for cysts and the endometrium. The endometrium is the lining of the uterus. The uterine lining may become thicker if there has not been a regular period.


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ALTERNATIVE MEDICINE

Integrative Medical Institute will not treat PCOS per se but will put you on a programme to be in the best condition possible for pregnancy. It also involves removing any amalgam filling you may have and a hair analysis. The jury is still out on that so depends how far you want to go and how much you have to spend on it.


Owen Trodd and Partners do the Fertility Hormone Saliva Testing over a month. It sounds odd but it backed up my friend's convential medical tests so must be something in it.


Personally, if I were in your situation I would get a medical diagnosis.

Find a good acupuncturist, Troy Sing or Cecilia Te to name a couple.

Get the book "The Infertility Cure" By Randine Lewis

Visit her website www.easternharmonyclinic.com look on the left, choose Article and look for article RL-06.


If overweight start thinking about a low GI/GL diet. See www.patrickholford.com and www.thefooddoctor.com for good books. Most available at Bookazine. Plus at Bookazine there is the book The Low GI Guide to Managing PCOS.

There are some good personal trainers here in HK I can recommend.


I think that is about it.


Oh and a good prenatal multivitamin.


Remember that the ovaries need 3 months to recruit a new set of eggs. So allow that for the minimum time while doing any alternative therapies (or even conventional medicine ones like taking Metformin if prescribed for you).


Good Luck! (getting pg and reading all this!)


Please note that studies show PCOS sufferers may only show up abnormal glucose tolerance levels after the 3 or 4th hour. This means the standard 3-hr GTT (Glucose Tolerance Test) may be insufficient. Ask for the long one.


PLUS you do not need all symptoms to have PCO/PCOS

Hi JJB


Thanks so much for your response and all the information. I am going to read the article now - I think i will see tro y sing and a fertility specialist - I was thinking of Dr Christina Choy - I notice you don't mention her specifically - maybe one of the others might be better but I guess as you say I can try and find out.


not too keen on getting my fillings removed so might leave that for now! The symptoms i have are acne and the hair and dandruff although i didn't know that was a symptom. i have been referred to a endocrinologist in the past due to the blood tests and increased male hormone they thought it might be PCOS but ultrasound showed nothing however they basically said - go on the pill to control the skin and come back if problems when you want to come of the pill - partly why I took so long but should have looked into alternatives. my skin is not too bad now mainly on the neck.


anyway thanks again for your advice (you really know a lot- are you a medical professional or have PCOS?

Hi Pinkie


I have done a lot of research on the whole issue of fertility/IVF etc, plus I am in the field and I have mild PCOS.


Once you do the alternative stuff and maintain low GI diet (different than low carb) you will anyway probably see a difference in your skin and hair. Make sure you are also getting enough Omega 3 in your diet.


You may well benefit on Metformin which has the side effect of (it seems)improving egg quality. I'd recommend you buy that GI book (and the Randine one). It has great concise info about the syndrome it is not just a about food/diet.


I don't know Christina Choy but must say I have recently heard good things about her. I would be blunt when you meet any new dr and ask her about her experience about PCOS and what would be her game plan.


Troy is good.


I personally agree about the fillings. It seems too controversial. Good arguments on both sides. Best to research and see what makes sense to you. Gut instinct really is something we should lsiten to.


BTW Acne from PCOS responds very well to Metformin, although in some stages antibiotics or androgen blockers may be nec.


All the best and keep me updated when you visit C.Choi.


Check out www.ivfconnections.com bulletin board and on the left you will see PCOS you will gain a lot of information there too.


Have a good weekend!

than wks again jjb - appt with dr choy went really well - she is very efficient but not cold and seems experienced in dealing with PCOS. she has put me on metformin after ultrasound and hormone tests so that is good - just hope it works! i have one of patrick holfords books (op nutrion) and will look at that one you recommended on pcos - i am pretty healthy but a few habits i can change. thanks again for responses - it has been a big help!

Hi all,

What is the diet plan for PCOS ?


Anyone has a good recipe for PCOS conditions for weight loss ?


regards

Basically it is following the GI (glycaemic index and load) way of eating.


There is a book called 'The Low GI Guide to Managing PCOS' bu Dr Brand-Miller.


Also the recipe books by The Food Doctor - Ian Marber are great! Also look on his site www.thefooddoctor.com.


That is really all you need.


GI eating is way of life. It is not a diet for a few weeks etc. Once you get used to it, it can work well.


Ian Marber has only 10 principles that one should follow. Let me see if I remember them:


Eat fat to lose fat (good fats that is)

Stay hydrated

Exercise

Avoid sugar

Eat breakfast

Follow the 80/20 rule. 80% good and 20% a treat

Fuel up often

Eat protein with every meal (w/complex carbs)

Eat a wide variety of foods

Make time to eat


PCOS sufferers should be on Metformin (no less than 1500mg a day I heard recently.


In HK there is a PCOS specialist at the Queen Mary. He has a private clinic there too. Dr Ernest Ng (sorry no other contact details)

Hi all,

Why everyone saying that Metformin pills apply to 3 mths with min 1500mg. For non-diabetic, I had taken for 1 mth (PCOS lots of immature follicles thru scan).....feels so awful metallic taste that my doctor give me to stop.

As I am clomiphene resistance & block tube, I had pain on my left ovary swollen....


He suggest that I had the diagnostic lapro surgery to correct tube problems & ovarian drilling.... after 2 mths, I may conceive naturally or by low dose clomiphene up to 3 cycles trying.

Anyone had gone thru laparoscopy surgery yet ?


What should I wear on that surgery day ?

1 pcs dress, do you need to take out bra & underwear ?


Anyone has good internet link or info I could do research on ?


Shall I get second opinions or can I avoid surgery ? anyone or Doc online known ?


regards,

sad. age 18 no periods but to induce by hormone pills Diane 35 till recently on clomid + metformin.

Hi


3 MONTHS

In regards to the 3 months and Metformin 1500mg, that is simply because Metformin (glucophage) has the effect of increasing egg quality. Eggs need about 100days from being 'recruited' in the ovary as the egg that would be used for potential pregnancy in 3 months time. You will only see the results after three months. This is the same for acupucnture, herbs, chinese medicine and any supplements or vitamins. You will not normally see the results any earlier. The same goes for men. It takes about 100 days for any treatment to take effect. There are some new studies that show it may be less - around 70 days. This counts as intake of alcohol, caffeine etc.


DOSAGE

1500mg is the basic pharmaceutical dose that amy effect on glucose tolerance is seen.


SIDE EFFECTS

It is very common to have those side effects you mentioned. It is worth persevering. It can take up to 3 weeks to feel normal on them. I suggest you get the XR (extended release) version and take them at night with dinner. If you cannot get the XR version, try taking the tablets with food/during a meal. Some girls take the whole dose at night with some yoghurt or milk. Most of the side effects will be at their worst when you are sleeping (assuming you are not in a night shift job).


LAPAROSCOPY

Laparoscopy is an operation under general anaesthetic. You usually go in the same morning as the operation after having fasted (no food, drink) since midnight the night before). The nurses there will assist you with what you need to do and wear. You will take off all your clothes, make up, jewellery, nail polish and wear hospital clothes. Some clinics like you to stay overnight. You can feel sore from the gas they use to inflant your abdominal area. This can also travel around the body and many people find it odd that their shoulder aches more. Your doctor and nurse should be the one to run through all of this with you. You should also meet the anaesthetist. You will als sign a consent form.


REASONS FOR A LAP

Laparoscopy is very useful - highly diagnostic. It can find things out that cannot be seen on ultrasound. Such as endometriosis, adhesions and so on. At the same time they will try and correct these problems.


Enter "laparoscopy gynaecology" into google and you can do a lot of research.


Your doctor should have some printed information too. Call and ask the nurse for more details.


You can get second opinion for sure. But usually at some stage in fertility issues, it is recommended. From what you say you have good indications for having the surgery.


More information please visit:


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All the best

Hi Pinkie, you are in good hands with Dr Choy i also saw her with infertility issues and she dicsovered i had PCOS. Once i went on the metformin i got pregnant the very next month. Unfortuntalty we lost that bubs at 9weeks but i kept on the metformin and got pregnant again and we have a 6month old baby girl. Dr Choy was so wonderful and it was due to her we got pregnant. Her monitoring is so thorough which made all the difference for us. She advised me to stay on the metfromin till 14wks (pregnant) as the risk of MC is higher for us i did this but was a little concerned about any effects on the baby she sent me many links to infomation on reshearch done in this field and of course i have to say our baby is perfect! All the best to you Pinkie

Poseidon:


If your are nervous about laparascopy, why not get a second opinion? If they also confirm you need the procedure, your mind will be at rest, and if they don't think it's not necessary, perhaps they might have some good suggestions on how you should proceed. If you don't want the surgery, have you thought about going back on metformin? I found it very hard initially also (in addition to the gastrointestinal problems, I also felt very exhausted), but it's gotten better. I had gone off it for month after being on it for 2 months. The second time was a bit better for me. If you don't show improvements within 3 or 4 months on metformin, maybe you can then move onto laparascopy. With laparascopy, there is a slight chance of damage to the ovaries and a moderate risk of adhesions.


My current doctor is Dr. Choy. I would recommend her for a second opinion.

hi JH1,

So far you're on Metformin for how long ?

Did you conceive yet ?

Did you went for Diagnostic Laparoscopy surgery to clear your tube ?

Thanks,

Regards,

Poseidon: I was on metformin for 2 months and stopped for 1 month because of concerns about taking metformin on a long term basis. My cycle deteriorated during the month off metformin (based on BBT chart and short luteal phase) and my acne flared up again. I went back on it this month and my BBT chart is improved and my skin has improved. I have not conceived yet. I have not gotten a laparascopy because my tubes are clear. I will give metformin another 3 or 4 months before considering IVF. I may have endometriosis, but do not want to a laparascopy because of its risk of scars/adhesions and since my tubes seem to be clear.

Thanks Perthites


I was very lucky and was actually pregnant at the time of seeing doc choy and writing that first post!! It was quite strange as i must have just got pregnant when I went to see her as it showed as negative at my appt by 5 weeks later i was very unwell and did a pregnancy test assuming it couldn't be true! Dr Choy did confirm PCOS so I thought it would take ages and yet I was pregnant at the time - amazing - still went on metaformin for first 14 weeks like you and now 23 weeks so getting very excited. I've had no complications - I worry though after seeing dr choy and confirmin i had pcos i really thought my chances of getting pregnant were low and I for the first time in months had 3 or 4 drinks on about 4 occasions in the first 7 weeks which I know is a crucial development stage. All the docs say it is ok but i still think about it and wonder. I also missed a few weeks of excitment and i was quite unhappy as i thought it would take a long time. oh well very ahppy now though but watching my weight (i've never been big started out 55kg and on 60kg now but dr choy really gives me a hard time about it - did she with you because of pcos? did you deliver vaginal birth with dr choy - any tips for me? congratulations by the way.

CONGRATULATIONS

Unfortuntalty we left HK around 18wks so i gave birth in S'pore without my preicous DR CHoy after being with her for so long it was hard to build up that trust and relastionship with another dr who only just filled Dr Choys shoes! I did have a vaginal birth though.

The only symptoms of PCO for me are the cysts so if anything Dr Choy was telling me to eat i was 53kg and am 10ft, i'm not sure your referring to watching your weight as being over or under weight. "tips" on what? would you be reffering to happy to advise.

Hi perthites,

So had u delivery baby boy or baby girl ?


By the way, Do you still remember is there blue black on Incision site after Lapro surgery ?


When should I resume laundry capabilities or making love again ? now only 1st week past....just can walk straight only with minimum internal pain on ovaries.