Background story for anyone who is in a similar position:
Husband and are 29, had two children twelve months apart at age 25 and 26! Each time were conceived with no problems and in less than three months. After I had my second child, I did not prevent, but was breastfeeding, even though my cycles returned at 8 weeks postpartum. Had normal cycles for a year but didn't get pregnant. Went for my yearly exam (2nd baby now 1 year old) and my dr. thought something might be wrong given the fact that we do not use birth control. Took blood work and found that I had low progesterone, and my dr. hoped I would be pregnant again within 3 months with progesterone supplementation. didn't happen. started charting and observing my cycles and realized I did indeed have low progesterone as evidence by a 10 day luteal phase. then cut out gluten and dairy, as suggested by my dr. and continued progesterone supplements. Improved to 12 day luteal cycles. after another 3 months, and continued charting, my dr. suggested possible lean PCOS and wanted to confirm ovulation. Did a follicular study, observed successful ovulation, but noted that one ovary was one cm bigger than the other. After 3 more months, my dr. suggested continued avoidance of gluten and dairy, but also now low carb diet, basically paleo. Still NOTHING! In November 2017 I opted to have a lap to check things out. Before the surgery we tried 2 rounds of clomid, but to no avail! During the surgery, my dr. found that my ovaries were 4 times the size they should be, indicating PCOS, I had a small amount of endo, and clear tubes. My dr. performed a bilateral ovarian wedge resection and used excision to remove the endometriosis and stressed for me to continue to eat paleo/low carb, and continue exercising. At this point I ate no more than 75 carbs a day and ran 4-5 days a week. three months after the surgery, I was still not pregnant! But saw an improvement of symptoms from the surgery (hair growth, low anxiety, better ovulation). We checked my progesterone and it indicated that I was ovulating, but it was not strong enough for implantation. (above a 5, lower than 10). We tried 2.5 mg femara in the fourth month after surgery, in addition to progesterone supplements at 3 DPO and no monitoring or injections. AND IT WORKED!!!!
As difficult as it was to battle infertility, I am so grateful to have found that my body was not functioning properly and I can fix it with diet and exercise. Lean PCOS comes with its own hardship... you cannot just lose weight to improve symptoms. The mechanism of hormonal communication is broken. I attribute everything to the wise surgery my dr. did for me, and to God who truly does everything in His own time.
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