Hello there.

The irregular menses you have is due to PCOD.

The treatment you are taking is right. This is the most common and feasible approach you can follow to conceive in PCOS.

The main aim of treatment of infertility due to PCOS is use of ovulation induction drugs along with metformin.

Metmin-a is metformin which is the main drug to treat hormonal imbalance in PCOD. It reduces insulin resistance , improves hormonal imbalance and when these are corrected automatically your chances of conceiving increases. There is no risk to the baby if you conceive while you are taking metformin.

Folfit is folic acid tablet, vitamin essential in pregnancy and when you plan to conceive. It helps in proper development of the baby and avoids many causes of miscarriage.

Adova is anastrazole which is used for ovulation induction. This is a procedure where the ovaries are stimulated with use of drugs to produce follicles releasing egg(ovulation). These tablet are prescribed for five days starting on cycle day three, four or five. Chances of conceiving varies.
80 % females ovulate and Only about 50% of women will conceive with ovulation induction. In each cycle there is 20-25% chance of conception occurring even if the medication is working properly.
I-sure ovulation detection kit is a convenient way of ensuring that you optimize your chances of pregnancy by knowing your ovulation time, thus knowing your fertile period and accordingly plan the time of intercourse during this predetermined fertile phase.
If it was negative for you in all strips that means in this cycle , ovulation did not happen even after using adova tablet.
But you should not lose hope. Ovulation induction treatment has to be used minimum for 3 cycles( 3months) and maximum for 6 months. Every treatment cycle has 20-25% chances of pregnancy.

The more aggressive level of ovulation induction is called superovulation. This treatment uses gonadotropins or sometimes a combination of clomiphene( another ovulation induction drug) and gonadotrophins. But this is used only when treatment with clomiphene/ anastrozole fails and requires intensive follow up and monitoring with ultrasound.

I suggest you to continue your treatment for minimum 3 months.
If you are overweight, even a modest weight loss can help correct your hormonal imbalance thereby causing ovulation if it has stopped. Losing weight before you conceive can also reduce your risk of developing gestational diabetes during your pregnancy and other complication like miscarriage and hypertension in pregnancy.

I hope I have answered to your satisfaction.
Kindly revert back with any doubts.

Wishing you good luck.
Take care.

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Hello there.

Thanks for writing back.

Menstrual irregularity itself suggests that you have hormonal imbalance.

The rule is if ovulation does not occur then there will be no periods.

So your problem of irregular periods is because your ovulation is not proper.

Months where you do not ovulate is known as anovulatory cycle.

Also if you have an anovulatory disorder, menses can occur each month though its NOT A TRUE menstrual period. This is an anovulatory bleeding and it is not normal.

This is in contrast to a normal menstrual cycle where in there is a follicular phase (follicles develop in ovary), ovulation phase (egg is released) , luteal phase and menstruation (when egg is not fertilized) or pregnancy (when egg is fertilized).

I understand your anxiety regarding the irregular timing of ovulation due to irregular periods.

A simple way to know when your fertile period is likely to start is by subtracting 17 days from the length of your usual cycle. So, if you have a 45 day cycle, start testing on day 28 and carry on for six days.

Other ways of knowing when you are having ovulation is by feeling for any mucous discharge per vaginum. Soon after periods you will notice a few days of no mucous, then your mucous will get more abundant and more wet as you near ovulation. During ovulation, it is referred to as "egg white mucous" because it's clear, thick and stretchy like egg whites.

I will tell you your fertile days for the coming cycles keeping 22nd september as your last menstrual period and 40 days cycle.
It was from 15th october to 20th october in this month.
Next fertile period would be 24th november to 29th november if your cycle remains at 40days interval. Lastly between 3rd January to 8th january 2013.

Cycle length is calculated by taking into account the average cycle length in the past 6 months.

If you had a 45 days cycle then this month your ovulation period was between 20th october to 25th october.

So considering the above dates, you should stop testing. If your cycle was of 40 days or 45 days , in both cases your ovulation phase is over.
But considering the irregularity you have in cycles, you should not stop having contact. There is no harm in contact. It should be continued throughout cycle to ensure maximum chances of pregnancy. Then you need not do your ovulation tests and be so mechanical.
What i suggest is you keep taking your tablets as advised. Keep having a healthy and frequent intercourse. If ovulation would happen , you would definitely conceive.
By keeping a record of your ovulation , you will develop more anxiety and less benefit as it would in turn affect your cycles.

Hope I have answered you.

take care.

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