# Lean PCOS & Clomid



## Uber Barrens Club (Jun 6, 2015)

Hi ladies, first post, so apols in advance! I also posted this in the PCOS board, so if I’m breaking rules by posting in a different board - newbie and learning the ropes.

I've browsed some past posts, but wondered if anyone on here at the moment has any experience with lean PCOS (aka 'thin' PCOS) and TTC with Clomid..

I'm prone to verbal diarrhoea so will try and keep my summary brief (haha)

I'd been on the pill off and on for many years but whenever not on the pill, I'd never really had regular periods (could go months and months without) and so in 2010 (aged 2 I came off the pill to have a fertility MOT and find out what, if anything, was going on. Eventually 10 months later was diagnosed with PCOS - consultant said it was a misconception that PCOS went hand in hand with being overweight, although when I gave the GP the results to add to my records, they expressed surprise saying they'd never come across anyone who was thin with PCOS (oh dear).

I've always been naturally very slight, and based on BMI, have been considered underweight for most of my life. When I went to see a consultant obstetrician (private) about possible approaches to TTC, he said one of the things I needed to work on was getting weight on, as being even slightly underweight could be equally problematic as being severely overweight for conceiving. He recommended that I put on weight to get myself up to a minimum BMI of 18, preferably 18.5 (into 'healthy' BMI range), although said it was def a blunt tool and was more about having enough body fat to support ovulation.

He said that in his experience, Clomid often worked in an ‘all or nothing’ way for slim women: i.e. very often would find patients were either Clomid resistant (and need to move up to injectables to induce ovulation) or that they were very high responders - sometimes so much so that cycles might need to be cancelled if the scan showed too many follicles.

Wondered if any ‘thin cysters’ had any tips or thoughts for TTC with Clomid? I'm due to start, at a starting dose of 50mg, in the next few months. Thanks in advance and sorry for rambling x


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## lilac789 (Feb 6, 2015)

Hi bananafish. Thought I'd share my experience with you.

I'd been on the pill from 16-29. Had a 3 month break and had DUB. Was put into implant had had that for 5 years before ttc. While I had the implants I didn't have any periods at all.

No periods after implant removed and blood tests pointed to pcos. 

I too am a thin pcos girl! I have had 3 rounds of clomid at 50mg which were unsuccessful. I very just street a 4th round but have now been increased to 100mg. Fingers crossed a higher dose works. 

My consultant said that sometimes it is harder to treat pcos in thin people with clomid but he was willing to give me a higher dose to see of it made a difference. If these 3 rounds are unsuccessful, he said the next step was ivf.


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## Uber Barrens Club (Jun 6, 2015)

Hi Lilac

Thanks so much for sharing. I'm keeping my fingers and toes crossed for you for the 100mg  

What your consultant said seems to match mine - it's hard because so much of the advice for PCOS is 'losing weight can help restore ovulation'. Which doesn't work so well if you're a 'skinny cyster'! Similarly eating low GL - helps to regulate insulin (as there's evidence that even in lean PCOS patients, who are less likely to be insulin resistance, that we're more likely to be insulin sensitive - i.e. we don't have elevated levels of insulin, but our ovaries are way more sensitive to the insulin that's there and go bananas in response), but really hard to eat low GL and NOT lose weight!

Do you mind my asking if you're cycles have been monitored / did you use OPKs? 

I know they're supposed to be tricky if you have PCOS as elevated LH levels can give false positives, but lots of PCOS people on here seem to find them useful. Think that's equally applicable for lean and non-lean PCOS women though! So just wondered 

Big hugs and thinking good thoughts for this cycle


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## lilac789 (Feb 6, 2015)

Sorry for the late reply bananafish.

I had blood tests done on days 21 and 28 for 3 months and w I just have day 21 tests done.  

I did use opk tests for the first 3 months but I got false positives on them  I was gutted when I got my blood results back.

I'm now on cycle day 27 on 100mg and don't really feel any different. Don't think I've ovulated thus time 

How is it going for you? Have you started in clomid yet?


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## Uber Barrens Club (Jun 6, 2015)

Hi Lilac

Fx the next cycle does the trick!

Came off the pill to let one set of hormones get out of my body (I was on a double dose of the pill as my epilepsy medication can interfere with oral contraceptives, so was a double dose of oestrogen every month!) before pumping my body with another set of hormones. As I'd never really had proper periods - last time I came off the pill it took 9 months to have a bleed and that obv wasn't an ovulatory cycle - consultant said absolutely reasonable to start Clomid straight from the pill, or if we wanted to start in a little while also fine.

I was viewing the summer as an opportunity to start charting, try to get in tune with my body and try and recognise the signs and whatnot, so that when I start the Clomid I can understand what (if any) difference it's making.  Absolutely wasn't expecting to magically lay an egg, given I don't know if I've ever had an ovulatory cycle in my life - I certainly never had a time when I could say my period was due, or late, as I never knew if or when one would turn up.

So you could have knocked me off my chair when on CD20, I got a +ve OPK. I assumed it was likely a false positive due to LH surges with PCOS, but summoned the husband for duty nonetheless just in case! My temps have been up since then, so my chart suggests I did ovulate, but as I’m not yet having bloods, I won’t really know until AF shows up approx 14 days or so. If it doesn’t, I’ll know I didn’t ovulate, or that I should maybe take a pg test. If it does turn up, then I’ll be able to go and get CD3 bloods done. I’ve read some stuff about so-called ‘rebound fertility’ in the first month of coming off the pill, so even if I did miraculously lay an egg this month, I’m not necessarily expecting it to happen next month...

We shall see! 

I'm keeping all my fingers and toes crossed for you.  Are you finding the Clomid has any side effects while you're taking it?

xxx


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