Question for the ladies

Ok everyone, I need some help. I am 4 months out and have an appointment with my doctor on Thursday to discuss birth control options.  I have been researching here and elsewhere on line for days and everyone's opinion on what is best after surgery differs.  When I talked to Dr. Brader he said something along the lines of no one is sure if BC pills are malabsorbed and saw no reason no to take them but don't sue me if you get pregnant.  I laughed, but I really want to know what anyone has used, etc.

I have PCOS.  I decided on the surgery with my husband after almost 3 years trying to conceive with no success-- I tried Metformin, Clomid and everything short of in vitro.  I came off Metformin a few days before surgery and have not been put back on it.  I sincerely hope this process ultimately restores my fertility, but I don't want to get pregnant before I am cleared to try again.

IUD is out, I think, since I don't have children and they recommend it only for use in women who have had children.  I used to do ok on the pill years ago, but don't know if it is feasible now. I am little "wierded out" for lack of a better term at the Nuvaring and have heard many negative things about Depo Provera and Implanon regarding weight gain and difficulty in resuming ovulation after stopping either. I think I am now on information overload.

I would love everyone's thoughts here  . . .

Thank you!

Dawn

Oh-- and I turn 35 this year so I am a bit worried about increased risks associated with some  birth control options . . .

Dawn I have PCOS too. I actually went off the BC pill over a year and a half ago ( not to get pregnant was just worried about being on it for a long time) I have to say I think that was a mistake. My weight has been creeping up and I have seen some of my PCOS symptoms coming back, The BC Pill has an anti androgen property and keeps the testosterone at bay. I am going to have to go back on it.
I have know people who got pregnant on the pill after the surgery so I would assume that it is possible due to malabsorption. So for awhile we used it and an alternative as well. I dont have any advice for you I am sorry other than to say might want to consider staying on the pill for the PCOS benefit until you decide you want to get pregnant but use a back up method

this surgery will change your fertility for sure! I was on birth control pills for years pre-op to regulate my cycles. I had PCOS with Insulin Resistance and was told at 20 years old that I would never conceive. After hearing that I wasn't too worried about my birth control. Well Dr Brader warned me that the pills are more then likely malabsorbed so we used condoms for the first 6 months (I HATE them but we used em anyway). After that I was soley on the pill until I hit 2 years out. Got the OK from Dr Brader and my OB to start trying. I went off the pills the end of January and was pregnant in April! Unfortunately I had a blighted ovum and miscarried in the middle of June, given the OK to start trying again in July and was pregnant in August! I'm now almsot 31 weeks and all looks good.

There is hope! Just be cautious for now, it isn't in anyone's best interest for you to get pregnant too early out.

If I can answer anything else feel free to ask or PM me if you want

Liz

Considering all the issues involved, I would see a reproductive endocrinologist to find out your ovarian reserve at this age and to do other hormonal testing to give you an idea how quickly you should move on TTC.   Thyroid anti-bodies (don't show up in the normal thyroid blood test) can cause infertility; lots of things cause infertility.   PCOS is often corrected with weight loss, it is also often blamed when other issues are really the culprit.   Age, however, is definatley an issue past 35, more so if you've never conceived before.   Clomid and IUI are pretty standard past 35-37, the IUI more so if you used Clomid before with no result.   I'd head straight to an RE and BOTH of you be tested and let the RE advise you on what to do until you are cleared from your RNY.  I was 41 and Dr. B cleared me at 6 mos. after losing 105lbs., earlier than usual but time was of the essence and the majority of my weight loss and healing was done.  Unfortunately, it was too late.  8 IUIs later and nada.  Fertility is at its highest in the first 6 mos. post-op because of all the hormonal instability from rapid weightloss.  What have you been using since surgery?  If nothing, and nothing happened, then you definately want to start investigating why.   The whole process will take a few months anyway before you get in, get tested and get some answers.  

Thank you everyone for your insight.  

Liz-- I watch all your posts about the baby and am so excited for you.  

Nicole-- Thank you for the sharing your experience with BC pills.  I gained significant weight when I went off pills 3 years ago when we started trying to conceive.  I remember thinking how unfair it was that they helped me maintain when all my friends complained they gained weight with them.

Jackie-- thank you for sharing your story.  It meant a lot to me-- I am sorry you weren't successful in your efforts. 

To answer your question, we have been relying on barrier method (i.e condoms) and abstinence since surgery, lol.  I am very worried about getting pregnant tooo early because I want to be cleared first.  Because of that, my OCD kicks in and poor hubby probably deals with more abstinence then he would like.  I definitely want to explore the testing you mentioned. Does anyone have any recommendations for a good reproductive endocrinologist, either in PA or in MD?  I was working with the Fertility Center near me previously specifically because they worke with one of two RE's my insurance listed but I was very disappointed in going through the process when I tried to ask questions about the PCOS, etc. and was told that they weren't worried so much with why I couldn't get pregnant, their goal was just to get me pregnant.  I never understood that thinking because I didn't understand how they thought they could get me to that goal if they didn't know what my problem was. 

Oh well. I will chat with my doctor tomorrow.  Sounds like BC and condoms and abstinence are the best way to go. 

I have PCOS and it is a crazy kind... metformin about killed me... i got very sick on it... and when that happened I started to look into WLS... after surgery my OBGYN (who was amazing and didn't suck like all the other docs i saw to treat my PCOS... all the ones in Reading, Pottstown, and a couple other places all wanted to help me get pregnant and didn't care if i was 341 pounds... on and they were endo docs... they knew better)...

And while i did get pregnant on my own (was told that would never ever happen... ha) I was 310 pounds... so after Lorelei... My OBGYN put me on Seasonel but it kept making me bleed... so they put me on Depo shot because they knew i was going for WLS... the depo worked great till about 8m after surgery... by then i had been on it for 2+ years... went on nuvaring and HATED IT... it would pop out during workouts... it would snap Jeremy when we had sex... super messy to put in and take out... bleck... and it was super expensive with our insurance... went off that to try to get pregnant... my OBGYN was thinking it would take us 6m to a year... um... didn't take that long took less than a month... Annabelle was born 2 days before my 2 year surgery annv...

but for the most part it depends on your body... every case of PCOS is different... and each BC will work differently for you vs one of us... hang in there...