Diagnosed With PCOD. Took Birth Control Pills And Menstruation Became Normal. Given APCOD. What Is The Use Of This Medicine?

Brief Answer:
PLAN OF ACTION OUTLINED.

Detailed Answer:
Hello
Thanks for your query.
As you have not conceived yet for 18 months, you should please consult an Infertility Specialist now.
Am sure the basic problem in conception is PCOD.
In this condition, due to unknown reasons, a widespread hormonal imbalance exists in the body.
The ovary gets studded with multiple eggs, none of which mature to form a follicle which ovulates every month.
First go for the following workup -
AMH
FSH and LH on day 2 of cycle
DHEAS and free testosterone levels
Oral glucose tolerance test
TSH and prolactin ( if not within last 6 months, then repeat )
Fasting serum insulin.
Next, you might be given treatment like Metformin to control PCOD.
You have not mentioned your height, so I cannot calculate your BMI.
If overweight, please aim at gradual weight loss as it will help PCOD.
APCOD contains Myoinositol , folic acid and vitamin D 3.
Its use is supposed to help to control the symptoms of PCOD, however PCOD has no absolute cure as such.
Most women with PCOD do conceive successfully, but often require external aid to induce proper ovulation.
NOrmally, ovulation occurs on day 14, and then the egg size should be between 18 - 21 mm, so on day 12, your egg size is not optimum.
However, in PCOD, often ovulation is delayed , so the egg might grow to desired size later on.
Mostly you would need help of ovulation inducing agents ( can be tablets and can be injections ) and monitoring to help you conceive.
Let me tell you the plan of action for you, which I would suggest to a patient of mine -
1. Get the investigations for PCOD done as suggested.
2. get your husband's semen analysis done.
3. Get one cycle of plain follicular monitoring ( ultrasound throughout the menstrual cycle at regular intervals to check if you are ovulating naturally ).
4. If you ARE ovulating by yourself, then try naturally for 3 months, with follicular monitoring continued to allow you to pinpoint probable days of ovulation, around which you should be sexually active.
5. If you are NOT ovulating naturally, try ovulation induction first with clomiphene citrate tablets for 3 - 6 months ( injections of gonadotropins can be added if you do not respond to clomiphene also, most women with PCOD do respond well to clomiphene alone ). You can combine cycles of ovulation induction with IUI ( intra uterine insemination ) to increase pregnancy chances.
6. If this fails, please go for hysteroscopy and laparoscopy to check if your fallopian tubes are open.
7. If tubes are blocked / if multiple cycles of ovulation induction fail to yield pregnancy, you can go for IVF ( in vitro fertilization ).

Continue taking APCOD meanwhile.
Do not stress out, you are young, and am sure in due time, you will see positive results.
All the best.
Please feel free to ask for further clarifications.
Take care.

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Brief Answer:
DETAILED BELOW

Detailed Answer:
Hi,Thank you for appreciating !
Your BMI comes to 25, which is alright, I would not call you overweight, however losing a couple of kilograms would do you good.
Please take APCOD in the dosage prescribed to you.
YOu do not need to take folic acid separately, it is already included in APCOD.
Sinarest and Cetirizine will not affect fertility, but I do not see any reason for taking it regularly, you should take it only seasonally or periodically for allergy, not on a routine daily basis.
All the best.

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