post severe PE and PCOS and low dose contraceptives

[bsherricca]

i developed severe PE at 26 weeks and infant died in utero (IUGR ). During my 6 week review a few days ago the doctor suggested i take low dose birth control to normalize my periods as i have PCOS ......Has anyone else recieved this advice from their doc and if yes were you able to get pregnant sucessfully a second time after coming off the pill ? i ask as i would like to try for a 2nd pregnancy

also the dr strongly advised that i keep my weight within normal range as he said high BMI ups the risk for PE ...i met with a nutritionist who suggested diet detox before starting new diet changes and excercise ....has anyone ever done diet detox ? are these safe and do they affect / interfere with fertility ?

nervous, scared and going through post traumatic stress any advice is welcome ..thanks !!!

[alexis]

I'm sorry for your loss.

BCPs don't really 'normalize' your period (I know doctors don't always explain this correctly). They create an artificial regular cycle; your "period" is a progesterone withdrawal bleed, like the one you get after taking Provera if you've ever done that. This is not a bad thing--it's predictable for you, and the lining is regularly shed and doesn't get to build up. By suppressing ovulation, BCPs will temporarily control your PCOS symptoms (since the cysts are caused by failed ovulation). In some cases, suppression allows the cysts to clear and CAN result in normal cycles when BCPs are stopped. However, this is far from guaranteed. PCOS may either improve or worsen with age--it's not very predictable. I have PCOS and have used BCPs to control my cycle. My first pregnancy was a spontaneous one on metformin; my second was on Follistim.

Overweight women are at higher risk for PE and weight loss helps PCOS; however, weight loss with PCOS (especially insulin resistant type) may be difficult. AFAIK, "detox" diets are not supported by evidence. Was the nutritionist an RD (registered dietitian)? Only RDs are licensed and regulated; the term nutritionist is not.

[angieb]

I'm so sorry for your loss.

I was overweight by BMI standards for both my previous pregnancies, but I actually weighed about 15-20 lbs more my 2nd pregnancy that was pre-e and hellp free. (I also have pcos.) I'm not a big believer that weight makes much of a difference either way, nor did my doctors have any concerns about it. So I personally didn't stress over dieting or losing weight in between my pregnancies (obviously!) I did manage to lose a significant amount of weight after my second pregnancy, mainly thanks to breastfeeding for over a year-not because I worried much about dieting, and while my doctors were happy I started this pregnancy lighter than my first two, they weren't convinced it had any effect on my odds of getting pre-e again.

I was on bcp for 5 years before ttc, it did absolutely nothing to regulate my cycles. My ob specifically said she would not put me on hormonal bcp after severe early onset pre-e and hellp because of the chance I may have had a blood clotting disorder as a possible underlying condition. So I'm surprised your OB recommended it unless they've already tested you for underlying conditions. I ended up getting pregnant with DD as a huge coincidence on day 100+ of a never-ending cycle which is normal for me. With DS, after losing DD, we jumped into fertility treatments for my irregular cycles fairly quickly, used femara to help me ovulate and conceive (and had a healthy DS), this time I managed to get and stay pregnant taking soy isoflavones for 5 days early in my cycle (works like clomid). TTC with PCOS can be difficult if you don't ovulate regularly (metformin has never helped me or made any difference in my cycles, but I do not have insulin-resistant pcos, I think it helps IR PCOS'ers more since it is a diabetes drug.) I think recognizing my OB's limits (she mainly deals with pregnancies and delivering babies, not fertility stuff), and seeking a fertility specialist (RE) early on to conceive DS helped us conceive fairly quickly.

I highly recommend consulting an MFM/perinatalogist before ttc. And going to an RE sooner than later for help with fertility stuff, once you've been okay'd to try again.

[blythe]

By detox diet did she mean "eat anything you want to reset your body" type diet? Or some kind of chemical cleanse? I'd be wary of the second...

I'm so sorry to hear that your baby died - too many babies around here lost due to this horrible disease. I'll second the suggestion to consult with an MFM for their recommendations pre-conception and their thoughts about how you should be monitored and treated in your next pregnancy.

[bsherricca]

its a system cleanse using herbs, fruits and vegetables that he suggested ..i am not sure what to think of it but he seemed to think that it would help take pressure off my kidneys by eliminating the toxins in the body naturally (at least that was his explanation) and then starting on trying to improve my diet etc before ttc in another 6mths or so ...
I am still not ready to TTC the pre-e experince is still way too fresh but i just wanted to know how persons PCOS was being managed ...last time around i had to use clomid (3 cycles) ...and i just dont want to do anything that will jeapordise my chances to have a child

I am still doing the tests to determine if i have any underlying condions ....terrified and depressed

[blythe]

Can I ask if you're in the US or somewhere else? A few things you've said have made me curious.

I'm no doc and I don't know PCOS very well, but I don't think you could do something right now that would hurt your chances of having children - please other folks correct me if I'm wrong... My heart just hurts for you worrying about that - hopefully unnecessarily - on top of everything else you're dealing with.

Again I'm no doc and in no way diagnosing or offering a treatment, but has your doctor considered metformin in your case? I found this relatively recent thread http://www.preeclampsia.org/forum/viewt ... in#p346058

Gentle thoughts and prayers for you.

[bsherricca]

No i am not in the US i am in the Caribbean (Jamaica) but i plan to visit the US soon (i am 6 wks post PE) as we only have one MFM and no NICU and my gynae has recommended that I see an MFM before planning another pregnancy ...you can now begin to understand y i am so nervous as i really dont know that much about PE nor do i know much about PCOS ( i was diagnosed with PCOSlast yr when i first started to try to get pregnant and couldnt and later found that i was not ovulating. the Gynae put me on clomid the following month and after three cycles i got pregnant despite only having one fallopian tube because of a prior ectopic ..... i am just trying to get some information so i am better prepared as the level of medical care here isnt great and information limited .......

[blythe]

Ah, I'm sorry your access to MFMs is limited, but glad you have a chance to consult with one soon. We've had posters from Alaska consult with MFMs long-distance during their pregnancies, maybe that would be an option for you?

There is *so* much to learn about PE and PCOS - and I don't know my PCOS info very well, so I'm glad there are other gals around here who do. You don't *have* to understand any of it - that's why the docs get the big paychecks - but I know I feel better when I understand what is going on and what to expect.

Let us know what you need, ask any questions you have. We're not medically trained but we've been there and read a lot, and at the very least we can help you figure out what questions to ask of your medical team.

I'm so sorry again about the death of your baby.