Posted by: teica25

Dear Dr. Dmitrović,

We need advice. I am 26 and my husband is 30 and we have been trying to get pregnant for a year now. I have been diagnosed with PCOS in puberty but it wasn’t much of a problem for me back then. Now, when we are trying to have a baby we are experiencing difficulties. Since I was 18, I’ve taken Logest and Diane and then decided not to take any pills for about a year, until I got married. Then we started planning for a baby… I weigh 95 kilos and I’m 174 cm tall. My BMI is 31. My husband weighs 106 kg and is 184 cm tall with a BMI of 31.3. In 2009 I did a hormonal test. The results on the 4th day of the cycle were estradiol 92,1; LH 4.9; FSH 4.0; prolactin 18.7; testosterone, SHBG, androstendione and DHEA were normal. On the 21st day of the cycle progesterone was 2.8. We also did a sperm analysis that came back with 13% morphology result. A doctor in Petrova hospital put me on Metformin – 500mg three times a day, Duphastone 2x1 pill from day 14 to 26 of the cycle and she told us to start exercising and lose about 10% of our body mass.

I am asking for your opinion and advice, considering your experience with patients like us. We are wondering if it would help if my husband started taking some vitamins. I have heard from other patients with PCOS who are undertaking MAR that Swedish Bitters and Agnus Cactus may help, but I don’t want to take something on my own considering the medication I’ve been taking. But we really want to become parents and we need to start somewhere. Also, we’d like someone to monitor our progress. Thanks! T&A

Answer by: Romana Dmitrović, MD, Ph.D.

Dear teica 25,

You already got the best advice you could get. I would probably not put you on Duphaston because I am not prone to prescribing it, but it can not do any damage. You are such a young couple and there is a high probability of conceiving in the first 2 or 3 ovulations, especially taking into account your husband’s test results which are normal, according to the latest World Health Organization recommendations. Do not underestimate the advice you were given. There is a high probability of reaching over 70% ovulation should you exercise and lose 10% of your BMI. The vitamins you have mentioned will have an effect on your budget, but there is no proof (apart from anecdotal cases) that they really help. The treatment you were advised combined with BMI loss has solid scientific background. It would be a shame if you had to take the MAR procedure, when with just a little effort you could achieve desired results. This goes for your husband as well, because a change in lifestyle towards a healthier one will probably improve his sperm results.

You will see the results very soon. After a month or two of taking Metformin and exercising and losing weight you will have your period. Of course, should you follow the advice and still could not get pregnant after 6 months, additional steps need to be taken. Good luck!