Behind the Scenes: My Journey of Hope and Challenge with Lean PCOS

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Little update on my life since it’s been a while.

The past 10 months have been a wild ride. I’ve been preparing my body for another pregnancy, which has been more intense than usual due to my in-depth understanding of oocyte development. I know exactly what to do to optimize my body leading up to conception, and I started well before we actively began trying.

Now, I’m hopeful that all this preparation pays off.

After weaning Lux, I didn’t get my cycle back, which isn’t unusual for me. I’ve had lean PCOS my entire life, and even minor physiological or psychological stressors can cause months of amenorrhea. Not sleeping through the night with a toddler adds to my stress bucket too. I love my little Lux bunny, but toddlers are no joke!

Lean PCOS is caused by several SNPs that lead to elevated androgens, particularly DHEA-S, along with the characteristic polycystic ovaries. Unlike the far more common insulin-resistant PCOS, lean PCOS can’t be managed with diet and exercise alone. It’s often adrenal-driven, making stress management one of the biggest needle movers.

Androgens in women are made primarily in the adrenal glands, so there’s a direct link between adrenal function and high DHEA-S in lean PCOS. Being in a stressed state all the time (e.g., chronic mental stress, being too lean, being very active, not eating enough, etc.) really kicks up production. While lifestyle modifications such as diet and exercise are beneficial, they aren’t sufficient on their own to manage the hormonal imbalances.

Crunchy fertility blogs irritate the fuck out of me because they oversimplify fertility issues, suggesting diet and lifestyle changes as universal solutions. My diet, labs, and lifestyle have been dialed in for decades. While these efforts will improve my IVF chances, they haven’t magically made me fertile without interventions. Yay science, right?

During this period, I had to cut all training and treat my body like the sensitive snowflake it is. Remember ladies, training is a stressor on the body. This was probably the hardest part, as I rely on training for my mental health. Losing that outlet was tough, but I managed by walking a lot. When I set my eyes on something I’m all in. So, I approached this the same as I do everything in my life.

I got pregnant twice in the first six months. I get pregnant easily once I’m ovulating regularly, but tend to lose them due to various reasons. Medicated cycles work best for me due to an LH to FSH imbalance that affects egg quality in PCOS. All my cycles start with Femara to balance that out and get me ovulating again and we do IUI’s to give us a small boost.

I lost a little boy on Christmas and got pregnant again in March, losing that one early at just over six weeks. Alex had a high fever a few weeks before I conceived the second time, and his sperm parameters indicated it wouldn’t be good if I got pregnant that month (high temperatures are the worst for sperm). I remember calling Alex after the IUI saying if I get pregnant this month it won’t be good. And it wasn’t.

Which brings me to now. I know I can get pregnant with medicated IUIs, that’s how I conceived Lux, but I’m running out of time. At 39, I’d feel better with some embryos on ice. So, I’ve been stimming, and we are now doing our first egg retrieval in a week or so.

I’m responding well to the meds so far, so I’m hopeful. What many who haven’t been through this process don’t understand is that one retrieval may not be enough. We are prepared to do more, if necessary, but are still hopeful that numero uno will have our golden egg.

You can comment over here, there is also a cute video of Lux helping us!

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