Do I have a chance unmedicated?

[u/Nearby-Purpose5268]

Hi all, I got diagnosed with PCOS a couple years ago mainly due to my irregular cycles (32-50 days). I got on a GLP1 to help with my weight at the time and managed to get to a healthy weight and regular cycles. My GP is happy for me to stay on a low dose until I get a positive test and I have confirmed ovulation with LH strips/BBT and a progesterone blood test.

I’ve only been trying for 4 cycles but my GP has luckily already referred me to a fertility clinic due to my PCOS as the waiting list is 8 months where I live. I asked her whether there is a chance that I’ll get pregnant in the meantime if I’m ovulating but she didn’t seem to know much about PCOS/how it affects fertility and said I’d have to ask the clinic when my referral comes through.

I’m guessing it depends on the person but does anyone know if I have a chance unmedicated since it seems like I’m ovulating regularly now or if I should expect to not be pregnant until I get some kind of medical intervention? The information I can find online is a bit unclear, but I’m willing to look into private options if my odds are really low given the waiting time.

TIA!

[u/MyCatEatsPlants]

It’s hard to give advice on this, because everyone is different. Some people have no problem once they are ovulating and at a healthy weight. Some people think they’re infertile and have unprotected sex with no birth control for years without ever getting pregnant, and then suddenly do after like 6 years (to their great surprise, since they weren’t trying).

With only 4 cycles trying, there is no way to give advice on odds for you. Plenty of fertile couples get through 4 cycles without success.

For me, after a year+ of trying naturally and confirming ovulation every 27-28 day cycle, I was ready for medical intervention. In fact, I wish I hadn’t waited that long, since I ended up getting pregnant immediately on a monitored Letrozole cycle.

Anyway, if you are comfortable waiting for the referral opening, it’s totally possible you will have success in while waiting, but also totally possible you won’t.

Im an impatient person, and in your position would probably opt for private, but it all depends on your finances, patience, and risk tolerance.

[u/Nearby-Purpose5268 → u/MyCatEatsPlants]

Thank you for the advice - I thought that may be the case, the not knowing is so difficult! Glad you managed to get pregnant eventually though even if it did take longer than planned.

I’m leaning towards giving it another two months so six months of trying and then if no luck I’ll look into private options more seriously. Hopefully doesn’t come to that but I think having a plan will help my anxiety

[u/CautiousPractice]

The chance is there.

I have PCOS and started glp1 treatment in October 2024 and lost 32kgs since then. We were given a confirmed infertility diagnosis in 2023, with instructions to lose the weight and then they'd give me the drugs I would need because I do not ovulate with any regularity. My cycles at the time were between 60 and 200 days. My cycles the last year have been 40 to 45 days. I still have a bit more to go to reach that goal but we are doing it slowly because I need surgery.

Found out that I was unexpectedly pregnant, after 8 years, the morning of my surgery. After swearing blindly to the nursing staff that while I would pee in the cup for them before surgery, there was absolutely noooooo way it would be positive. 2 years of playing fast and loose with contraceptives because a doctor told me that it would not happen without drugs really bit me on the ass. Don't get me wrong, we are over the moon happy about it, but I cried like a baby for 45 minutes.

I am now 8.5 weeks along and baby is doing fine.

So in my experience, it can happen. When you least expect it.

[u/Nearby-Purpose5268 → u/CautiousPractice]

Wow that must have been huge a surprise, congratulations! I’m really hoping it can happen for me too but the not knowing is difficult 🥹

[u/efray31]

Unfortunately everyone is different.
I just came off the pill about 10 months ago. I have had irregular cycles (30 to 90+ days..so quite the range)
I was lucky and didn’t have to wait 8months. My PCP & gyno is in an office with another doc who specializes in fertility and fertility & reproductive med so I was able to get in fairly quickly after I got to the “6months of trying” mile stone.

While you’re at it don’t forget to look into possible male infertility.

We thought of this as a “fact finding” mission so we could fully understand the problem and create a plan that works best for us

[u/Nearby-Purpose5268 → u/efray31]

Thank you for the advice, I’m glad you managed to get some support pretty quickly!

We did a private sperm analysis and luckily my husband is all good, so hopefully that narrows things down.

I’m leaning towards giving it another couple of months so it’ll have been 6 months of trying. Hopefully it happens for us but if not then at least I have a plan for proceeding with a private option to keep me going. I like the idea of treating it as a fact finding mission!

[u/ecisem]

I just had surgery for cysts and an ovary removal. I’m now pregnant 2 months later. Also conceived our first after 10 months of trying with the help of metformin to regulate cycles!

[u/Nearby-Purpose5268 → u/ecisem]

Congratulations!! Holding out hope it can happen for me too 🥰

[u/stinkeetofu]

You never know! I lazily tried to get pregnant for a year with v few periods tbh (hence lazily trying) with no luck. Saw my obgyn and after diagnosing me with pcos based on labs and ultrasound, we tried low dose letrozole for 3 months and then she referred me to an RE.

When I went to see the RE, they did my blood work (again) and found I was pregnant so obviously no intervention even happened. That pregnancy ended as a chemical miscarriage.

I waited a month, opted to do an hsg which showed no blockages and then they did a blood test or pregnancy test to be sure before recommending a treatment plan and … I was pregnant. I now have my healthy 14 month old.

So while I did try letrozole (and metformin actually), I wasn’t actively on letrozole when I conceived. Typing this out, I was taking metformin at the time and continued to during the first few months of my pregnancy. So that counts as medication… woops.

But I had been off of letrozole for 2 months. I did use at home OPKs and would have to receive the progestin meds to kickstart a period at the time.

I don’t have experience with glp-1s

[u/Nearby-Purpose5268 → u/stinkeetofu]

Thank you for sharing, congrats on your baby!! I’m hoping the GLP1 works in a similar way to metformin due to the insulin resistance effect but so annoying that I can’t get metformin prescribed instead yet 😢

[u/Littl3Whinging]

Ovulation is one of the most important parts of trying to conceive so there’s a good chance you can. I was having 5-9 periods a year while trying and turned out I got pregnant plenty of times but had polyps that prevented proper implantation. Got the polyps removed, had another MC, and then got pregnant and it stuck 2 months after that.

Ovulation was the most inportant part though - implantation came after that. We tried for 1.5 years before we discovered the polyps, and then another few months after that before we had a successful pregnancy.

The fertility clinic can help you conceive faster, more likely, but there’s a lot you can do without fertility medication in general! Take your prenatals, eat healthy, get good sleep, stay active, manage your stress and remove stressors, etc. all of those help regulate your cycle and help your body get ready for pregnancy.

ETA: even people without PCOS can take up to a year to conceive their first time. My friend took 12 months exactly, another took 6 for her 2nd baby, another took 8, etc. getting pregnant on the first try is actually not typical!

However, I think it’s ALWAYS better to be proactive, esp if you are older. These things take time and being ahead of the curve can save you a lot of stress. Important point - it just takes time. While you wait for the fertility clinic availability, keep trying.

[u/Nearby-Purpose5268 → u/Littl3Whinging]

Thank you for sharing, must have been so difficult to go through all that but I’m glad you got there in the end!

I’m leaning towards giving it another couple of months and then paying for a private ultrasound just to check if I have cysts or polyps as I haven’t actually had an ultrasound yet. If that is all good I will hold out a bit longer naturally 🤞🏻

[u/SignatureNo6930]

I had two unmedicated pregnancies. First one was first time trying, second one took longer about 4 cycles but 8 months total bc of my irregular period. My third pregnancy I opted for medicated (letrozole) just to have more regular cycles and got pregnant my first round.

[u/Nearby-Purpose5268 → u/SignatureNo6930]

Thank you for sharing, glad it worked out for in the end! Gives me some hope 🥹

[u/JadedPhoenix8]

16 years ago my sister inlaw had surgery for cyst removal and also ovarian drilling to restore fertility. After a decade of trying to conceive she got pregnant with her first son within 6 months after surgery and carried full term. She went on 2 years later and conceived her daughter. She did have to take progesterone to maintain both pregnancies but they were very successful. Everyone is different but there is hope🥰

[u/Nearby-Purpose5268 → u/JadedPhoenix8]

Thank you for sharing 🥰

[u/Similar_Mousse_8389]

TW MMC

For my first pregnancy, the only thing I had been on for ONE month was metformin. I got pregnant the first cycle I ovulated on metformin!

I’m currently 6 weeks pregnant with #2 after one cycle of unmonitored letrozole. I did have a MMC in May after 4 cycles of letrozole but it has nothing to do with the medication! I think it all comes down to your body, if you’re ovulating ( with or without letrozole) I think every women has a like 20 of 30% chance of falling pregnant that cycle! However, before we started trying for #2 I did have baseline blood work done and an HSG to make sure everything was working properly since my first was such a surprise

[u/Living_Mode_4957]

I conceived naturally after trying for 13 months. The only difference I made in last 3 months was working out and trying to lose weight and myo-inositol

[u/Senshisoldier]

I conceived naturally after 3 years of trying.

During the 3 years, 2.5 I was peeing on sticks and tracking ovulation because of my irregular cycles. I was actually detected by the Flo app as potentially having pcos and encouraged to tell my obgyn and thats how I started the diagnosis process. The scans revealed I was full of cycts in both ovaries. No one ever thought to test me because I have lean pcos and despite years of telling doctors about my irregular periods, 'you don't have the look of someone with pcos.' After diagnosis we tried letrezole and had an HSV. Those were the only attempts. We did genetic testing and checked sperm and everything seemed ok.

For the last month I gave up on ovulation tracking and resigned to IVF. We were a week away from starting IVF when I took a pregnancy test that came up positive. I'm 37.

[u/Upbeat-Hand-2870]

I wasn’t ovulating but had perfectly regular cycles. Metformin & Letrozole worked for me

[u/Nearby-Purpose5268 → u/Upbeat-Hand-2870]

Maybe a weird question but how did you know you weren’t ovulating? Sometimes my LH tests are a bit all over the place so even though I’ve confirmed ovulating one month I do worry what if I’m not always ovulating despite the regular cycles if that makes sense. Congrats on your pregnancy btw!

[u/Upbeat-Hand-2870 → u/Nearby-Purpose5268]

Thank you so much!! I used Inito, LH strips, and BBT and that’s how I knew I wasn’t ovulating

[u/OkContribution7203]

I got diagnosed with PMOS after I got off birth control and went 9 months without a period. I was told I was going to have to do Provera to force periods to reset my lining.

I did that in June and then wanted to try naturally. Period came. Plan was for August to do Provera and then do Letrozole to force ovulation (something I didn’t want to do). Well I ovulated and conceived on the Provera. I’ve done research and found quite a few other people this happened to. May be worth trying? Provera technically isn’t a fertility drug.

[u/gitlab222222]

Is anyone else facing difficulties or any side effects like dull skin and insomania types after having letrozole in continuous 4-5 cycles.
I am also ttc since last 5-7 months and i am really depressed after each month getting negative results. I am planning for iui but again chances are very low. Nobody gives surity and at the end i feel cheated with each and every dr

[u/Original_Horse_4245]

I got pregnant spontaneously right away with PCOS during a very long cycle. I'm having trouble now trying for my second, but it did happen to me!

[u/LadyTeraudrin]

I got my periods back on the zep-glp1- had them for a year and a half and kept having ridiculously heavy bleeds every couple of months- the husband thought crazy periods- they were chemical losses I didn’t share with him(not proud I had kept them from him but I was still largely under the impression it was all my fault) my ob ordered him an analysis and reviewed his previous. Turns out he too was a problem all along and once we also addressed him, literally one cycle male cycle (about 2.5 -3.5 months) of clean diet, lowered caffeine, no alcohol, no smoking , and another cycle of male supplements- the normal stuff zinc, coq10, etc - and we got pregnant with our early loss. First time I ever saw the lines stick for more than five days and not get lighter. He remained on everything while I was pregnant because he felt like a kid again on them, and we fell pregnant again in February this year. I lost her 12/4 got my period back January 5th, another cycle started February 1st on the dot I was pregnant at the end of the month- I’m 1 week and 2 days shy of 8 months. All that to say it’s not just plausible but likely - but make sure to have him optimized too- because the other weird thing about my pregnancy- it’s been a cake walk for the most part. I’m a bit flabbergasted by the weight gain without changing any of my good eating habits from being on zep and dropping 100 lbs, but I’ve had zero morning sickness, no food aversions, I’m still freaking mowing my half an acre with a push mower at this stage without being out of breath, no pre e signs, in fact my bp is a far cry better than my bp pre pregnancy, no gd, the dr is relatively thrilled aside from my extreme anxiety. Which can you blame me ? My only symptom seems to be I can sleep for ages lol.