Hello Khadija
Thanks for posting your query at DoctorSpring.com
I wish to request for a few more details.
When you took 3 cycles of Clomid, did you ovulate in response to it ?
Was ovulation study ( follicular monitoring ) done?
Also, is your husband's semen analysis carried out yet ?
Are your menstrual cycles regular ?
Please write back with these details.
Looking forward to hearing from you.
Regards.
Patient replied :
Dear Dr. Aarti,
Thank you for responding on my quirey, kindly find the below answer to your quires.
When you took 3 cycles of Clomid, did you ovulate in response to it ?
last year in Augest, September and October also I have tried this year on 31Augest 2014, yes i ovulate but no response.
Was ovulation study ( follicular monitoring ) done?
Yes, every step my doctor advise me when i have to do the intercourse and when i have to follow up through the ultrasound, however, all folicular are being rupture with no reason. this was done last year.
Also, is your husband's semen analysis carried out yet ?
Yes he has done semen test twice and all was postive
Are your menstrual cycles regular ?
No, following are the dates of my cycles for this year, most of the time it reach to 38 or 37 days
17-12-2013
14-01-2014
17-02-2014
20-03-2014
22-04-2014
26-05-2014
26-06-2014
03-08-2014
30-08-2014
28-09-2014
I have stop taken glucophage 500mg x2 and folic acid, since i dont find any result.
Hello again.
Your response is confusing, Khadija.
You say you ovulated in response to clomiphene, but there was no response !
The response to clomiphene IS ovulation.
If you did not conceive inspite of documented ovulation, then the interpretation is very different versus is you did not ovulate ( no response to clomiphene ).
Considering your history, at the most you can consider 3 more cycles of Clomiphene therapy.
If they fail, then yes, IVF is a good option for you.
DO not stop taking glyciphage and folic acid, they are important for overall metabolic control in PCOD.
Take care.
Remain positive and avoid stress, because you are only 31.
Make sure you exercise daily, remain healthy and eat sensibly.
At 31, your chances of conception are fairly good.
All the best
Please feel free to discuss further.
Patient replied :
I Mean I ovulated but I dont know why the egg and sperm does not meet after trying the intercourse on the ovulation date, maybe do you think becouse of urine infection or do you think i need to urine culture or full medical test inculding blood.
I am trying to be healthy but cannot resist the food, i feel more hungry after taking glyciphage.
Hello,
Well generally before diagnosing PCOS or giving clomiphene, full blood tests are routinely done.
A urinary tract infection cannot prevent pregnancy, and you would have symptoms of infection .
You should have the following complete assessment in case it was not done so far =
Complete blood count, blood group, urine routine microscopy and culture, viral markers of both partners.
IN your case - additional tests such as OGTT, TSH, DHEAS, Free testosterone.
A pap smear should be done too.
In your case, I think you can go for 3 more cycles of follicular monitoring with clomiphene citrate.
If no result is seen, then yes, IVF should be strongly considered.
Take care.
Patient replied :
Thank you I will do the test and will send the result