Sit down with a cup of tea and a biscuit, or two, and join us for our follow-up Q&A with Maria McMaster.
Maria talks about the effect PCOS has had on her life, to the impact she now has through her business. Uncover more of Maria’s story, where she discusses her initial diagnoses, starting her family, and more.
Read part one of Maria’s story: Getting Pregnant with PCOS.
How did you first find out you had PCOS?
I was asked these questions recently and they really encouraged me to reflect on where I am and what my journey has been so far. After some deep thinking, numerous cups of tea and the occasional biscuit, I realised a few things. Firstly, PCOS has been part of my identity for so long, I don’t actually know the answer to this question. Thinking about it logically, I suspect I was told when I was a teenager. I had terrible acne, and big, bushy, ginger hair, as this was long before straighteners were commonplace. I went to the doctors where I was put on the contraceptive pill to try and regulate everything. The acne, oily skin and unexplained mood swings continued but it was probably a bit more controlled.
- A recent study showed that patients with PCOS were 1.6 times more likely to have acne than their non-PCOS counterparts.1
On reflection, the PCOS diagnosis, and fertility awareness had a major impact on me growing up. My self-esteem, confidence and at one point my aspirations to build a family had been affected. At one point I did not want children and I can’t help but wonder if the PCOS diagnosis had something to do with this.
At one point I did not want children and I can’t help but wonder if the PCOS diagnosis had something to do with this.
It’s not all negative though. One positive of having this diagnosis, particularly around the time my husband and I were trying to start our family, is that I now lead a pretty healthy lifestyle and have done so for a number of years. I exercise regularly and try to tailor the exercise I do to what I call ‘fertility friendly’ exercises. When trying to conceive I spent a lot of time reading journal articles around the best forms of exercise for infertility and I noticed the resistance (weight) training and HIIT (high intensity interval training) have both been shown to support those with PCOS, especially when it comes to women who may also have insulin resistance. So, I started ensuring my training was mostly in those forms of exercise either in the gym or when out running. I found that this type of training was (a) really enjoyable (so great for my mental health), I loved the intensity and really enjoyed running and being outside and (b) seemed to work really well for my body type. By this I mean, this type of training really helps keep my BMI within the normal range and this helped me to ensure that I could be prescribed the Clomid which I needed to do to my anovulatory cycles. I also try my best to eat healthily, quite often a Mediterranean type diet, low levels of refined sugar and very little alcohol, and this seems to work well for me.
What was your journey through fertility treatment like?
My experience of going through fertility treatment was quite strange in some ways, as I already knew I had PCOS when I first went to the doctor. I also knew that the guidelines stated you had to be trying to conceive for a year (I was only 32 years old) so I knew there was no point going to the doctor until this was the case. When I eventually went to the GP, I expected the process to be quick and easy. I had done my research and knew that the first line of treatment was likely Clomid, possibly with Provera to allow me to start the Clomid in the first place (you take Clomid on days 2-5 of your period, but if you don’t have periods you could be waiting a long time). I expected to be in and out in no time, drugs in hand, oh how wrong I was!
Looking back this was incredibly naive, but no one ever explains the infertility process so why would I have thought any different? From that appointment onwards, my experience was, like so many others, relatively slow and very frustrating. There are a number of scans and procedures you need to have to ensure that the Clomid may work (e.g. a HyCoSy to ensure my tubes were not blocked, yes it was painful and no I was not psychologically prepared for the procedure) and this just all takes time. I am however, incredibly grateful to the NHS, other than paying for the final Clomid prescription, I didn’t pay anything for any of my treatment and the staff were amazing.
- Provera is a form of progesterone that can be used to induce a withdrawal bleed in women with PCOS. It is often used in conjunction with Clomid to induce a bleed, allowing treatment to begin.
- A HyCoSy (Hysterosalpingo Contrast Sonography) is a tubal patency test that is done using contrast dye and ultrasound. In other words, it evaluates the structure of the fallopian tubes to ensure that there are no abnormalities blocking them. It is an alternative to an HSG (Hysterosalpingogram, which uses contrast dye and X-rays) or a laparoscopy (key-hole surgery).
Eventually I did get the prescription for Clomid and I was lucky that I responded very well on the lowest dose and this led to the successful pregnancy of my first son Jacob who is now 5 years old. Did I experience the Clomid rage? Yes! Did I have hot flushes? Yes! Did I have some quite extreme mood swings? Yes. Did my husband suffer? Yes!
- Clomid is also known as Clomiphene Citrate. It works by blocking oestrogen levels in the body, which tricks the body into producing higher levels of the hormones that stimulate oestrogen production – the same hormones that help the body ovulate; FSH (follicle stimulating hormone) and LH (luteinizing hormone). Like many medications that affect hormone levels, Clomid can affect your mood. Other side effects of Clomid include hot flushes, breast tenderness, abdominal bloating, nausea and vomiting.
Was it all worth it? Yes. Absolutely.
How did the COVID pandemic affect your journey?
A few years later we decided to try for our second, and so started the process again. Unfortunately the road was a bit bumpier this time and we did experience pregnancy loss along the way. This was devastating and we questioned whether or not we would continue. Pregnancy loss really takes an emotional toll on both the woman and her partner, and I think changes you as a person. The grief and trauma can really sit with you in ways you just don’t expect.
Pregnancy loss really takes an emotional toll on both the woman and her partner, and I think changes you as a person. The grief and trauma can really sit with you in ways you just don’t expect.
Eventually, we decided to have one last go and I am so glad we did as we are now lucky enough to have our gorgeous second son, Luca, 10 months old. Saying this, getting to this point was extra difficult as the Covid pandemic hit, meaning that for us and the timing of everything, after my 12 week scan (which I was a nervous wreck for, just hoping there was a heartbeat), I had to go to all hospital appointments on my own. Now this was tricky for a number of reasons, but particularly because having been through pregnancy loss in that same hospital, having been in the hospital early pregnancy unit, the cafe, the waiting room, all of these places were serious triggers for me. It was tough. It also meant my husband just wasn’t as involved as he couldn’t be there.
We also had a bumpy pregnancy (no pun intended), being diagnosed with an amniotic band (which I was told”….could kill my baby if it wrapped around the baby’s neck, or it could amputate one of the baby’s limbs, but that was okay as there was that famous paralympian who only had three fingers for that very reason…”) and the consultant asked if I wished to terminate the pregnancy as I could just start again. We moved hospital after that (you have to self-advocate on this journey). Later, despite being fit and healthy, I was also diagnosed with gestational diabetes, but it was relatively mild and I managed to keep it under control with my diet. As a result of the gestational diabetes, I developed polyhydramnios which is excess fluid in the uterus and the baby was measuring big. Eventually I was induced a week early, but that didn’t really work and after labouring all night on my own, with painful contractions every 3 minutes, on my own as my husband wasn’t allowed to stay, the baby was delivered by emergency C section, healthy and well.
What is Fitness Fertility? Why are you a personal trainer?
After all of this, I finally felt “free” to start thinking a bit about my life, and things other than trying to conceive. So, I am now a fully qualified personal trainer and have started my own business (https://fitnessfertility.com). I really want to help others on their fertility journey so my focus is supporting those with fertility issues such as PCOS and endometriosis. I can support those trying to conceive and needing to lower their BMI, support people with their mental health through setting healthy habits and mental health goals and provide a supportive community via community groups for everyone training with me. I check in with every client at least once a week and this provides further support whilst helping my client stay accountable for working out. I want to help as many people as I can so I use an amazing app and online training meaning I can train anyone, anywhere. I am also, at the time of writing, about to finish my pre and post-natal training so I can support those who are pregnant as well.
I really want to help others on their fertility journey so my focus is supporting those with fertility issues such as PCOS and endometriosis.
- Maintaining a healthy BMI can be massively beneficial for people with PCOS. It can help improve the body’s abnormal insulin response and reduce the risk of type 2 diabetes, reduce the risk of heart disease, improves symptoms such as hair growth and acne, as well as regulating menstrual cycles and improve chances of conceiving.
Take home messages…
I’m not really a spiritual person, but I am starting to believe that this is where I am meant to be and this is what I am supposed to be doing. I would not wish infertility or loss on anyone, but I do really hope that my experiences will help me to help others.
If I were to give advice to those just starting out on this journey….well, actually I probably wouldn’t give advice, I’d just listen. And I’d definitely offer them a cup of tea and a limitless supply of biscuits.
Sources
Authors
Maria lives in the UK with her husband and two children. She is a personal trainer and psychology teacher and loves trail running, the gym, reading, messing around with her family and supporting others on their fertility journey.
Fourth-year medical student at Newcastle University passionate about patient education and empowerment. Interests include Obstetrics & Gynaecology, Reproductive Medicine, and Sexual Health.
Matt is an NHS Consultant in Newcastle with over ten years of experience. His PhD research into subfertility and miscarriage involved developing a clinical trial and patient engagement.
