QuestionI have never had regular periods. The only time was when I was on birth control pills. After a year of TTC, I was diagnosed with PCOS because of my symptoms, and the appearance of tiny cysts over my ovaries. Luckily, I conceived on 100mgs of clomid. That was 6 years ago.
I am TTC #2 and went to a new Reproductive Endocrinologist. I am 33 years old, and I am currently on CD31. Here is what I've done thus far: clomid 50 mg CD5-9; clomid 100 mg CD 12 - 15; follistim 100iu CD 20 - 25; and currently menopur 150iu CD 27 - 33. I have been monitored through bloodwork and ultrasound about every 4 days, with follie growth shown once (12mm and 14mm), only for this to "disappear" 3 days later. Yesterday, I was told to have relations with my husband, and take menopur 3 more days and come back for monitoring before possibly taking the trigger shot of ovidrel. My question is with all of these medications, is it even possible for me to ovulate and/or conceive on this cycle, esp. so late? Why would I be instructed to make love and continue taking menoupur if the ultrasound showed no follicles? Should my RE have screened the PCOS better to see if metformin should have been prescribed?
AnswerHi Jennifer,
I'm afraid I can't explain what is going on here. It is not any type of protocol that I have ever seen. It seems very haphazard.
If there are no follicles to trigger, then ovulation cannot occur, and of course, pregnancy will not follow. I am not sure what your doctor is doing. You will have to see when you have your next ultrasound if there is anything to ovulate. In my experience, once a cycle has gone past the 16th cycle day, it ultimately will not be successful. Studies have shown that as well.
I think you need to have a discussion with your doc.
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.
