Thin cyster

OK, now I know where I fall on the PCOS spectrum: I'm a thin cyster.

I can appreciate the pun here (for community support purposes). I can also appreciate that I found a virtual community of women with PCOS who are also thin here at the PCOS Support site.

Even though the following message below cut-and-pasted from the site may look bad, it gives me some questions to ask my doctor (also, this woman below just sounds a lot like me).

This is kind of negative, but this is what my RE said to me today:

Saw my RE today and this is what he said:
"About 33% of women have thin PCOS. Since you are thin, there is no environmental factor to it. You can't just lose 50 lbs and increase your chances of pregnancy like the other 66% of women with PCOS that have that environmental factors (weight, diet, etc.). So with thin PCOS, your infertility is all genetic. Therefore, it is a strong genetic factor against you vs. environment. Environment you can change, Genetics you can't. Most women with thin PCOS require more than fertility drugs."

I thought it was advantage being thin. I thought that automatically gave us that increased chance of getting pregnant that the overweight PCOSers get when they lose weight and that it was one less thing to worry about and one more thing on our side. Guess I was wrong!

So, even though I haven't reached any decisions yet about the next course of action to take, here is my list of questions I'm formulating to ask my doctor:

• What is my insulin level? Am I insulin resistant? If we don't know, if there a way to know based on blood work?
• Is my glucose high?
• If I am insulin resistant and/or have high glucose, can I control either of these factors by changing my diet, such as pursuing a gluten-free diet? Or is it better for me to go on a drug like Metformin? Or will changing my diet not really affect my chances of getting pregnant because I don't need to lose weight?
• What are the differences between Clomid and Letrozele/Femara (another ovulation-stimulating drug) for thin women? Is there any evidence that Femara is better at inducing ovulation in thin women than Clomid is?
• Is extended Clomid (an 8-10 day dose as opposed to 5-day) a possibility for someone like me, or is it necessary to start with a regular Clomid dose?

There is so much to learn, and I wound up getting two books yesterday at the library and ordering another book on Amazon. I want to be fully informed before I make any decisions, but at times like this I am grateful for the fact that I can email my doctor and she will respond to me quickly.