Question: Hello,
I am a 35 yrs old female. I had my first child when I was 28.
At 34 yrs of age, I had an 18 week miscarriage. My weight was 87 kg(height -5ft 4 inches). Post miscarriage I was diagnosed with PCOS and asked by my ob-gyn to lose weight and be not more than 65 kg of weight. Currently my weight is 71.5 kg. I go to gym and do moderate diet control.
My question is:- While trying to conceive, can I continue going to gym and use cycle, treadmill, elliptical etc. Further, should I do abdominal exercises? If yes, what precautions to take.
Thanks.

Hello Dr. XXXXXXX

Thank you so much for your detailed reply. Please let me know, in your opinion, since I have PCOS and my glucose challenge test after 1 hr of 50 gm glucose was 126 value, which the doctor said is borderline, should I continue losing weight to 65 and then try to conceive or I can start at this current weight.

Best Regards,
XXXX.

Hello XXXXXXX
Seeing your reply, I had decided to go ahead with weight loss, but had already met my husband a day before which was cycle day 12, thinking it may not really end in pregnancy.
The next morning, I noticed red mucus and all signs of ovulation which continued over 1-2 days. Today morning ( cycle day 15 today) I noticed bright red bleeding which happened for 2-3 hours and is very less now. I got hopeful and thought it may be implantation bleeding(reading too much over the internet) and quickly got a beta hcg and home pregnancy test done. The urine test (I-CAN) showed a very light second line but the beta hcg results just now say hcg less than 1.2.
Can you guide me what I should do going forward, apart from waiting for the 2 week time?
Thanks,
XXXX.

Ok, should I be worried about the mid cycle bleeding since it has intermittently continued? This hasn't happened with me before. My gut feeling says though that I need not be worried but it could just be because of logistics involved in seeing a doctor.

Hello Dr. XXXXXXX

The bleeding in the previous discussion stopped in 5 days. I had gone to the doctor and she gave me antibiotics and said that the cyst that was detected in the ultrasound was not a matter to worry about. I am feeling better and looking at a fresh start at things.
The thing I wanted to ask you is:
In every cycle when we try, I tend to check early if there is any chance of pregnancy and most of the time, I get a slight second line in the home pregnancy test. Later on , period comes.
Am I lacking in progesterone because of age/PCOS, which is causing this. Is there a way that I can monitor my progesterone level through blood tests/any specific day that the test should be done? Any supplements I can take? I have heard progesterone creams are available...should I use those in case I see a slight second line.
Or the line can have come due to LH, which is always present due to hormonal imbalance of PCOS?
Can you suggest some tests to get better answers?

Hello Dr. XXXXXXX
Thanks for your reply. This is exactly the information that I was looking for.
My questions are as follows:

As you had said:
"Pregnancy test only comes positive when there is raised serum beta-HCG level.
Now whenever you will get second faint line during urine pregnancy test you must get your serum beta-HCG test done to ensure whether you are really pregnant or not."
1) I have noticed that I do get faint lines around my period time but as soon as I get my blood drawn, I get my period.
This may be a silly question, but was this because of ecosprin-75 mg(My doctor stopped it last visit after the mid cycle bleeding) -Or-the faint lines could have been false-Or-pregnancy ended very early with traces of HCG left in urine till many days. In that case, how exactly do I pinpoint the time when progesterone should start, can I do that as soon as ovulation happens so that I give support to the process( In case progesterone deficiency is detected).

2)What would be the form of supplement and can I take it on my own? My doctor says to come to her with a positive blood HCG report , and I think my body is not letting the process go till that point.

3)This leads to the third question: I want to try naturally for a couple of months from December onwards. Can I take the help of follicular monitoring to get the correct day. Can follicular monitoring be done without fertility medicines. For this kind of scan, who would give the prescription- my gynaecologist of any other infertility expert?

Thank you for your patience. Your replies mean a lot to me since I have been to few doctors but I haven't been able to get my exact questions answered fearing ridicule, and now I really want to work on this in a positive way.

Best Regards,

Hello Dr. XXXXXXX

Thanks for your reply with stepwise advice.

Since the past few days I am having PMS symptoms and breast fullness. Just to rule out pregnancy I checked with UPT kit and again got a weakly positive. As advised, today I went for blood test but HCG level is<1.2 and progesterone is 0.2
Today is cycle day 28 in case I don't consider the mid cycle bleeding as periods.
In this circumstance, please let me know what would be your advice.

Hello Dr. XXXXXXX

Ya I had figured out was not pregnant. I'm zeroing in on progesterone level to start the investigations with. Please let me know as a last question, should I continue with my gynaecologist(She is a very experienced lady/gold medallist) or start consulting an infertility doctor as there are chances of subfertility.

Thank you so much for your help.