Diagnosis

Today my doctor told me what I was about 90 percent sure I'd hear: I have PCOS (polycystic ovarian syndrome).

For a while now I've feared this is what I have and what's keeping me from getting pregnant. With anywhere from 5-10 percent of women of child-bearing age being diagnosed with this condition, it is the leading cause of female infertility. If you read message boards on sites like The Bump or Baby Center you quickly discover all these women talking about their PCOS diagnosis and how many rounds of Clomid their doctor has prescribed.

The thing that tipped me off to the fact that I probably have PCOS is the fact that I have such horribly irregular periods. Even though my periods were fairly regular before going on birth control, there is no known link between PCOS and the pill or any other type of birth control. PCOS can develop at any time for inexplicable reasons, and there's nothing you can do to prevent it. Irregular periods are a tell-tale sign of PCOS. Another sign of PCOS is elevated testosterone levels. Well, guess what: I have really high testosterone levels. This is not the kind of thing you want to find out about yourself at 5 a.m. It makes you feel, well, ugly and unfeminine. So, add high testosterone to infertility and you feel rather man-ish. (Also, women with high testosterone and PCOS tend to have trouble with adult acne -- which is true for me -- and tend to be confident, Type A characters -- which is painfully true for me.)

As I was going through almost all the stages of grief during my 15-minute phone conversation with my doctor and I was in my denial/bargaining stage, I asked her if my elevated testosterone levels could still be a sign of the birth control hormones exiting my body. She said that I am officially past the point of being affected by my birth control pills (which also contradicts the point about birth control maybe taking one year to exit my body). So, as much as I would now like to say that my body is still adjusting to being off birth control, it really does seem that I have PCOS.

There is no way to cure or even really treatment for PCOS. My doctor told me that her goal for me is to get a period once every three months, and if I don't get that, then I could face even more serious health issues. I have two main choices at this moment: I can do nothing and continue on with my irregular but not medically concerning long cycles, or I can start taking a medication called Clomid.

Clomid is a drug that increases ovulation. You take it five days in a row at a certain time in your cycle to stimulate ovulation. My doctor told me that I could try it for three cycles, and if the medicine didn't help me get pregnant in three cycles, then she would have me visit a reproductive endocrinologist. After that she mentioned scary acronyms like IUI and IVF which just made me break down and cry while talking to her. But, my doctor added that the chances of conceiving on Clomid are quite good -- and I've read reports that say anywhere from 50 to 75 percent of women with PCOS achieve pregnancy on Clomid -- but maybe she just wanted me to stop crying.

As with any other drug, though, Clomid does not come without costs. Besides the monetary costs, which wouldn't be that substantial (yet), there is a 5 percent increased chance of having multiples conceived while on Clomid. Additionally, because women on Clomid often do what my doctor referred to as "super ovulate" it can actually increase your risk of developing uterine cancer. It also sounds like -- through some anecdotal accounts I've read on message boards -- that many women who are on Clomid also face extreme mood swings and hot flashes, though obviously everyone reacts differently.

At this moment, I am just trying to process this information. I don't know if I want to take Clomid quite yet. My doctor told me that I can still get pregnant without Clomid, but with PCOS the chances of conceiving on your own are really, really low. For people with normal fertility, the chances of conceiving on any given cycle are only 20 percent, so when you ovulate as irregularly as I do, that just means I get about as third as many chances to conceive as the average woman. I also want to research insulin resistance, because that is a side effect of PCOS and some doctors prescribe drugs to decrease insulin resistance which can also assist in restoring ovulation.

Obviously, I need to sleep on this information (for probably more than just a night) and figure out what's right for me. My husband is totally supportive of whatever I decide; he's truly a great man, and I'm so fortunate to have him.