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Help/Advice on what I should do next... trying to conceive

I began having symptoms at 14. Resulted in paps every 6 months. By 20 I had a full diagnosis and because of the constant irregular pap results I had 2 colposcopes and a leep. After that I have had normal pap results. I am now 32 and basically have every symptom of PCOS. Over the years I have been on several different birth controls with the sole purpose being menstruation regulation. I have been months on end without a period,then had periods lasting for two months or more, extremely heavy with huge clots. Basically, I was not able to work, leave the house or do any of my normal routine because I was bleeding that bad. I've experienced bleeding like that three times over the years. Once I was even hospitalized and needed a blood transfusion due to the amount of blood loss. Currently, I have been spotting daily for at least a month. I have been trying to conceive for nearly 3 years now with no success. I have had blood work done recently and all the results were perfect. I do suffer with a lot of depression and other mental health issues. I have excessive unwanted hair which causes a lot of anxiety and stress. At this point I just want to be able to have one child. It seems like it is impossible for me to make it happen for us. Any suggestions for the next step?
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I'm sorry you are dealing with this. This link -https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome - has some tips such as losing 10% of your weight if you are overweight or taking prescription drug Metformin for insulin resistance. A fertility drug, Clomid, may work.

If the LEEP took a bit of cervical tissue, you may have cervical incompetence which may require extra vigilance or a simple procedure during pregnancy - https://*****************.org/getting-pregnant/incompetent-cervix-886.

Best of luck to you!
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Thank you very much. I had actually already been to the first website you mentioned. I've read a great deal of info within the past couple of years on PCOS in general. My PCP has been great with my concerns and helping me with blood work and tests to rule out possible bumps in the road. He wants me to continue with my OBGYN from here on in the hopes of being able to get pregnant and have a successful outcome. I originally contacted a local fertility clinic and was going to go straight to them. Even though we both have full health coverage fertility treatments are not included. After realizing how expensive the out-of-pocket expenses would become I started researching. Now, that I know for sure I have no other underlying cause for the inability to conceive and hormone imbalance I feel more confident about my chances. My PCP has been working with me on weight loss and quitting smoking as well. He seems to think that is my best start. He did also mention Progesterone, Clomid and Metformin. Oh, either a cream or pill for the hirsuitism as well. Pretty much in a nutshell I am reaching out to see what kind of success others have had, pros/cons and any advice from others as well. Thank you again.
Thank you very much. I had actually already been to the first website you mentioned. I've read a great deal of info within the past couple of years on PCOS in general. My PCP has been great with my concerns and helping me with blood work and tests to rule out possible bumps in the road. He wants me to continue with my OBGYN from here on in the hopes of being able to get pregnant and have a successful outcome. I originally contacted a local fertility clinic and was going to go straight to them. Even though we both have full health coverage fertility treatments are not included. After realizing how expensive the out-of-pocket expenses would become I started researching. Now, that I know for sure I have no other underlying cause for the inability to conceive and hormone imbalance I feel more confident about my chances. My PCP has been working with me on weight loss and quitting smoking as well. He seems to think that is my best start. He did also mention Progesterone, Clomid and Metformin. Oh, either a cream or pill for the hirsuitism as well. Pretty much in a nutshell I am reaching out to see what kind of success others have had, pros/cons and any advice from others as well. Thank you again.

Oh, I almost forgot. I was told when I had the LEEP (12 years ago) that the top layer of my cervix was in fact removed to get rid of all of the abnormal cells (benign). I still do struggle with my cervix being extremely sensitive. Almost every time I have sex I bleed a small amount. I have not heard much about "cervical incompetence" so I will look into it and make sure I mention it to my OBGYN. I appreciate your time and help. Thank you again.
I actually had secondary infertility although had very regular cycles and no symptoms or risk factors for PCOS. I and my husband went through some of the common workups. That was 27 years ago! Those I recall were sperm count and a procedure to check for open tubes. If I recall, my husband's sperm count was on the lower end of normal so not likely the cause (or only cause) of not being able to conceive. I was put on Clomid but it was not successful. I then did one round of injections and got pregnant with my second and last child.

There is a history of hypothyroidism in my family although it's mild. I don't recall if my ob/gyn checked my thyroid but he may have and didn't treat it because it was likely in range. However, it may have very well been near the hypo end as it has been since I started checking it (some years after I had my second child). You probably already know this (and assume your PCP does too) - Having a TSH well within range (under 2.5) is important for conceiving and maintaining a pregnancy. Here is one link about that (didn't look at others) - https://www.fertilitycenter.com/fertility_cares_blog/tsh-should-be-part-of-the-evaluation-for-infertility/. Best of luck to you!
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