((if tl;dr, skip to last paragraph))

I went to one doctor, jumped through all kinds of hoops spending a lot of time and money, and in the end he said I had to loose weight before he'd help me get pregnant.

A few years go by, I finally loose like 30 lbs and get brave enough to go to another doctor. After once again jumping all kinds of hoops, and despite having lost 30 lbs, he told me to loose more weight. As if the 30 lbs I had lost was worth nothing. He offered no suggested goal weight or anything.

Well, that kicked me down and I gained it all back again. So now a few years later i'm trying to loose the weight again. I'm debating if I want to go back to that doctor or not. He's supposed to be the best local PCOS infertility specialist. But I really don't like being used and put down like that.

Right now I need a new prescription of Metaformin, so I made an appointment with him, which I'm not looking forward to.

I know clomid and such meds work best the less overweight you are. Are there any suggestions regarding at what weight they become more effective? How much do I really have to loose to begin to consider it?

I can't comment on TTC since that's the last thing I want to do!

But the thing about weight loss and PCOS (and I am sorry your doctor wasn't the best about it, mine is probably also one of the best, but not my "type") is that as you lose weight and eat healthier, you begin to better regulate your hormones.

You need those hormones better regulated because it's not just about conceiving, it's also about NOT miscarrying your baby. And if the hormones are out of whack, you can not only have trouble conceiving, but also have trouble carrying to term. Not only that, if you aren't watching your weight/health you can also develop complications during pregnancy.

Personally, if I were to want to get pregnant now, I wouldn't do it until I reached a normal BMI weight. I'm almost as tall as you and I think you're looking at somewhere around 155ish to start with.

Lastly, as a piece of advice in regards to this, even if the doctors suck (and I've had doctors that have sucked) you have to do this for yourself. It doesn't matter what the doctor says, what matters is your health and your own goals and ambitions. Doctors are not trained to have a good bedside manner or to be your cheerleader or to help you get motivated.

Focus on your own goals and get there. You can do it.

Misty, I hope this doesn't offend you, but how old are you? Losing weight would be good. You mentioned a big reason, you will respond better to the drugs. You will have a healthier, happier pregnancy, and are less likely to have complications with your pregnancy.
BUT that aside. If you are trying to beat the clock, you might not have time to wait to start treatments. Are you periods regular at all? Are you ovulating? Clomid will more then likely be the first round of treatments you try. So if you are to the point of REALLY trying, you will need to find a Dr who will give it to you. Do you have any other PCOS friends, who could recommend a overweight friendly Dr? I was about 244 when my Dr started my treatments, but he also required me to have a laporoscopy first. (My first pregnancy ended in a miscarriage)
I hope this helps you some, if you need any other help, let me know. Obviously I've been down this road!

Thank you for your responses!

I'm about to turn 32. My husband and I have been trying without medical help passively for 7 years. When I lost weight before, I started to get irregular periods. And I have no idea if I ovulated then. Right now, i'm trying to get back to where I was when the doctor shot me down before. And no, I don't have any local PCOS friends. Thank you for any advise. No website seems to say anything about at what weight clomid has better chances of working.

Sorry, but this makes me a little irritated. I totally agree that losing weight would regulate your hormones and all...but... I HATE how the MD is with holding treatment. If you are losing weight/lost weight and are getting healthy I don't think they have the right to deny you treatment. Its fine to give advice but ultimately it is up to you! It just bugs me because Im going through fertility treatment and the last thing you want to do is to have someone tell you they won't help you when you are helping yourself. So frustrating. In my opinion, continue to diet and exercise and lose weight... and get another doctor. Good luck!

another thing I forgot to mention...for PCOS, they say a 5-10% weight loss is sometimes enought to trigger ovulation. If you had a period (even irregular) chances are you did ovulate and clomid might just work for you. Ive never had a period on my own. I got down to 170 (at that time 35lb loss) and still never ovulated but I did get pregnant within 3 months on the lowest dose of clomid. Now Im heavier and didnt respond to clomid.

I can only share my own experience.

I was at 240 and got down to 220 while TTC.

I was seeing an endocrinologist. He was not an RE, but was a diabetes center endoc at a good center here. He dx'd the PCOS and put me on 2000 mg Metformin XR. I figured I'd give this a year before adding the Clomid.

I was using www.tcoyf.com to chart because things like clearplan monitor were not going to work. I also happen to have a toy microscope here so I'd spit to check for ferning. Actually, sometimes the saliva ferning was able to be seen with the naked eye! These techniques helped me pinpoint ovulation even though my cycles were never better than 60 days apart on Metformin.

I applied what I could from the Low tech faq for TTC too.

And on the year when I went in to get the prescription for Clomid... it turned out I didn't need it because I was already pregnant at that appointment.

If I could have lost a little more I would have, but I was shooting for a certain age too so I was just happy to be LESS than before, whatever less was.

So I wanted to give you a shout out that you DO NOT ever have to be regular with Ovulation to succeed at TTC. I never have been regular. But you do have to learn how to spot it to best time sex, and even knowing how to spot it... it may take a bit to get it just right.

HTH!
A.

I did three rounds of clomid, I was probably around 260 at the time. They did cause me to ovulate (I was charting my temps) but no baby. I decided finally I was going to lose some weight. This was in September of 2007. I lost about 60 pounds and fast forward to February of 2008 - I went back to the doc and we decided to try Femara. The second round, success! Also, losing the weight (I think after the first 30 pounds or so?) my cycles began to regulate themselves a little bit and I even ovulated by myself once or twice.

After I had DS, my cycles became perfectly normal...and I had gained back to around 260. I conceived DD on the first try. Also, I haven't been diagnosed with PCOS, but I have many of the symptoms, and believe I do have a form of it, however it may be mild. Good luck to you!