Irregular Spotting with PCOS & Clomid: What to Do?

Question
Hello,
Here is my story. I am 32 and have been diagnosed w/PCOS. Mt doc putt me on chlomid of which I have taken two rounds with ovulatiom being present in the second round at the 100mg dose.  However no posite HPT. My last cycle begain on Oct 11. Typically I haven't gotten my cycle on my own in the last 6 years.  About 12 days ago I began spottin brownish red but only enough that I had to wear a pantyliner. I called my doc and she had me do another HPT which was negative. I did see some large clots (about 2) and kept spotting. My doc decided to give me another round of prometrium and 150mg of chlomid. My concern is that now it seems that the spotting has gotten heavier where I have to wear a pad. I am also now on day 2 of a 10 day supply of prometrium 200mg.  How will I could day 5 for the chlomid? During the spotting I expereinced no cramps or bloating or anythibg else.  It has been since I started the prometrium that now I feel bloated. What advice do u have for me? Could I have miscarried and not known could that have been why I witnessed the clots? Any help is appreciated..- do plan to call the doc again today..

Answer
Hello Lia from Canada,

I'm afraid that I can't explain the spotting completely.  It could be just dysfunctional bleeding since your hormones are abnormal from the PCOD.  It is possible that it could have been an early chemical pregnancy, but there is not way to know that since your pregnancy test was negative.

For now, just continue on the Prometrium for the full 10 days.  Hopefully, the bleeding will stop then at the end of taking the Prometrium you will have a normal period.  That is cycle day # 1.  You will then take the Clomid after that when you doc instructs you.

I am a little concerned that your doc does not look with the ultrasound to gauge your response to this dosage of medication, to know when to give HCG (if she does at all to trigger ovulation) or to instruct you when to have intercourse.  If you search through my many letters and/or the internet, you will find that this is not the correct way to prescribe Clomid or do ovulation induction cycles.  In addition, I usually recommend progesterone supplementation for the luteal phase.

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