QuestionQUESTION: Hi Doc,
I had a periods problems earlier since beginning of my teenage like absence of periods for years then i started haveing contraceptive pills for rugularizing my periods but it didnt help me. But after that I tough it would be ok if i get married but then I didnt get pregnant for 1 year after that I had Laparoscopic ovarian drilling done and with no medicine till now after the surgery i got two times perios on my own 28 days fifference but on the 3rd month i didnt get my periods at all I thought I got pregnant then but I had blood tests done twice but it showed me negative. Before the surgery I had taken injectibles, clomid and what not but it didnt ovulate actually. both of my tubes were blocked but now after the surgery one of them is working. doctor said i have less hormone right now i am in primolute to get periods. so after consuming primolute for 10 days when should i expect my periods???? and what has to be done for my hormones??? By the way my age is 21 and my height is 162 cm and 1 and half years of marriage and my husbands semen test said that its normal.
Thanks
ANSWER: Hello Isra from the U.A.E.,
It sounds like you have PCOD (polycystic ovarian disease). Ovarian drilling is a very very old fashioned treatment for PCOD. We don't use it very much in the west any more.
You have two problems in regards to your fertility: (1# because of the PCOD you don't ovulate and #2# you have a tubal problem. First let me deal with the tubal problem. In reality, there are NO surgeries that can correct a tubal problem. Surgery can be used to open the ends of the tubes, but the major damage is usually within the tube and this cannot be repaired. The fallopian tubes are not just pipes. Opening them is not enough. They are working organs with muscle layers and small hairlike cilia that help to move the egg and sperm together. Because this damage cannot be repaired, the only realistic treatment option is to proceed with IVF #in vitro fertilization#. This allows us to bypass the tubes.
The second problem is PCOD. In this case the ovaries are difficult to ovulate safely #only allowing 2-3 eggs to ovulate). For that reason, the majority of PCOD women have to proceed with IVF. This is because we can extract all the eggs and control the number that are put back in. This is necessary because PCOD patients tend to over-respond to injectable medication, which is the only medication that will work to stimulate most PCOD ovaries. Clomid usually doesn't work.
So my recommendation is to see a fertility specialist and undergo IVF.
The primolute is a progesterone, I believe, and is only being used to induce a period. it is not doing anything else.
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf
---------- FOLLOW-UP ----------
QUESTION: So what do u say doctor just Laparoscopic ovarian drilling and clomid will not work after getting my periods thru primolute? I am waiting for my periods to come and start wilth clomid and injections. this is the first clomid cycle after my surgery?
Well what i think let me wait and see and then next we will go for IVF
AnswerHello Again,
There is a good chance that the Clomid might stimulate your ovaries to ovulate. The ovarian drilling can sometimes make the ovaries more receptive to this medication. However, the chances are not good. The biggest problem that you have is a tubal problem. Because Clomid with either timed intercourse or IUI rely completely on the fact that there has to be normal tubes, if they are not, that is what will prevent you from getting pregnant. In any case, miracles do happen and you may be the exception to the rule. So as long as you don't mind trying the Clomid, then it is okay to try. Good Luck.
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf
