QuestionQUESTION: I am sorry to bother everyone out there, but I need help. I am in my twentys and i have been off birth control for 6 years and i still can't get pregnant. I only took birth control for two years prior to getting married and I wasen't that compliant with it anyways. I was told that i might have pcos, but i always have my cycle on time and i always ovulate. The only reason I was told that I had pcos was because my testotrone levels were high. I have been on clomid for 2 months this last month they just increased my dose to 100 mg. I had 4 mature folicles that were > 20 in size. I have been keeping track of my tempeture graphs and they always show that I ovulate. My doctor decided that IUI was the procedure to do, but still nothing I am not pregnant. I am so depressed all my friends are getting pregnant but me. I hate to be upset when i should be happy for them. But it hurts so much every month to get your hopes up and then all your hard work and nothing. I was hoping that someone would have some advice that maybe i am missing. I am having an exploratory lap next week. But maybe there is something that I am missing. If you have any advice I would love to hear from you.......... thank you leena
ANSWER: If your testosterone levels are elevated, and your other bloodwork is indicative of PCOS (elevated fasting insulin, elevated triglycerides), then you may benefit from metformin treatment even if you are already ovulating. PCOS has many more effects than just infertility, and one of those is a 60-70% rate of miscarriage (the usual rate is 15-20%). It's possible that you have been conceiving, but then miscarrying before a pregnancy is detected. Taking Clomid probably will not help you much if you are already ovulating; it will only increase your risk of multiples.
Have you taken a look at your husband's sperm yet? If his sperm are not swimming good, or if there aren't enough of them, then no amount of fertility treatment for you is going to help.
Good luck!
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QUESTION: yes my husbands sperm has been checked. the first time it was checked it showed morphology. we went to a specialist and he said that it wasn't that big of a problem that i needed to peruse my end further. I am taking metformin, 500 mg bid. I had an IUI (which was unsuccessful)and they checked my husbands sperm then and the doctor told me that the number were off the charts. That his sperm was great. I am just recovering from and exploratory lap and hysteroscopy. I was told that i do not have endometriosis and that everything looked great. This is so frustrating. I am not going to lie i am overweight. I am 5 "7 and i weight around 210. I asked if me shedding some pounds would help and my doctor told me he didn't think that was my problem in this case. I did the south beach diet last year and lost 60 lbs. I heard that the south beach diet and metformin can help pts with fertility problem. Is there any truth to that? I am sorry to bother you i really am just looking for any advice that could maybe help. I am seriously getting burnt out. I am 27 and i am really worried. I turn 28 in June i am so scared that i wont get pregnant by the time i am 30. I know this sounds crazy, but they say that it is really hard for women in there 30s to get pregnant and i don't need any other problems (ha ha).....thanks for your time......
AnswerYou should re-examine your metformin treatment with your endocrinologist, or get a second opinion. Minimum effective doses for PCOS are 1500 mg daily, and many patients take more than that. You may not be seeing positive changes in your fertility status because you are not fully treating and correcting the PCOS.
Once you get your PCOS fully treated, your fertility WILL return. Infertility is a secondary symptom of PCOS. And if it helps set your mind at ease, I am currently pregnant with a SURPRISE baby at the age of 32! I've been taking 1500mg (750mg XR bid) metformin for the past 5 years, and my fertility has bounced right back after my last two deliveries.
