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Is It Difficult To Get Pregnant While Suffering From PCOD?

Posted on Mon, 1 Jun 2015

Question: Hi
This is XXXXXXX married from Nov 2012. Planning for a baby now. We were not active for intercourse because of some major health issues with both of us and actively started intercourse from Feb 2015.
During this tenure I had surgery also and because of that I had to take several medicines. 1st surgery was in Nov 2012 and repeat surgery happened in April 2014 and my periods were not regular from that time. I consulted a doctor and she asked me for several test (Hormone and Thyroid etc) . All the reports were normal except for ultrasound which says I have PCOD. So Doctor prescribed me Dronis 20 and she asked me continue till the time we are no planning for baby. I stopped Dronis in the month of October. I had periods on 7th October and bleeding was very less then I had periods on 26th November and again bleeding was very less. Next period was on 18th December which lasted for 8 days with heavy bleeding. Then on 26th January I only had spotting no periods. There are no periods in February and then on 5th march I had spotting but no periods.
I consulted a doctor again. She asked me to reduce weight (weight was 63 kg thenand now weight is 59.8, age 26, height 5.2) and asked for some test ( Free T4, Prolactin, TSH , complete blood count with ESR and Glucose Random and ultrasound. Test results were again normal and ultrasound again says Bilateral Polycystic overies. She has given me tablets (Glycomet SR- 500 and MCBM- 69), Then she asked me for follicular scan from day 9th,12thand 14th. On 12th day left overy follicle growth was 18X16 mm and day 14th it was rapturemc and endometrium was 9 mm on day 14th.
Doctor asked me to continue with Glycomet SR- 500 and MCBM- 69 and also start Duphaston from day 16th and continue for 2 weeks and then stop. I stop on 30th March 2015 and got my periods on 4th April. She has also given me fertipro (Once in a day).
Then she asked me to start with the similar follicular scan from Day 9th. On day 9th ( Right ovary follicle was 6 X 7 mm, 7 X 5 mm, 5 X 6 mm and Left ovary was tiny and endometrium was 3 mm). On day 11th (Right ovary follicle was 8 X 8 mm, 9 X 9 mm and left ovary was 6 X 7mm and endometrium was 5 mm).
Then she told because of pomalycystic ovaries follicle has not growth. She prescribed me Duphaston from 1st May and continue till 4th May and once I will get periods I had to start CCQ- 50 from day 2nd but still I haven’t got my periods. Also did a pregnancy test today morning which was also negative.
Please suggest what need to be done further. Is the line of treatment is fine, or do I need to change any of these medicine.

Answered by Dr. Deepti Verma (37 minutes later)

Brief Answer:
Correct line of treatment

Detailed Answer:
Hi XXXXXXX I have gone through your question and understand your concerns.

Conception in polycystic ovarian disease is difficult because of irregular ovulation and hormonal disturbances in the body.In this cycle, your follicular study shows no follicular growth and endometrium is also not well developed. Since you have taken duphastone, which is a progesterone, from 1st May to 4 th May, you can expect your periods to occur within 7-10 days of stopping the drug. I would suggest you to wait for the periods till 14 th May 2015. If the periods still, do not occur, you may be required to take some different progesterone drug to induce periods.

CCQ-50 is clomiphene citrate which is given for ovulation induction and is the treatment modality for PCOD patients, who are not ovulating regularly.

Glycomet SR 500 is metformin which is given to improve the sugar levels and hence improve the hormonal profile in PCOD patients.

Fertipro contains folic acid and myoinositol, folic acis for decreasing the risk of congenital anomalies in the fetus, and myoinositol for increasing the chances of conception.
MCBM 69 is multivitamin drug.

The line of treatment given to you is completely fine and the medicines you are taking are appropriate.

Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepti Verma (25 hours later)

Thanks for your answer Dr. XXXXXXX

We are planning for a baby now. is there anything need to be done from my side apart from the above medicines.

Regards XXXXXXX

Answered by Dr. Deepti Verma (11 minutes later)

Brief Answer:
Be stress free

Detailed Answer:
Hi XXXXXXX thanks for responding. Your treatment protocol is completely fine and adequate. Both of you should remain stress free while planning conception, as increased stress levels decrease the chances of conception.
Hope you found the answer helpful. Please do get back for further queries.
All the best to both of you.
Wishing you both good health.
Regards,
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepti Verma (18 minutes later)

Thanks Dr. XXXXXXX

Yes, we will definately try to avoid stress.

I got my periods also today, please suggest further line of treatment now.

Thanks XXXXXXX

Answered by Dr. Deepti Verma (23 minutes later)

Brief Answer:
Ovulation induction

Detailed Answer:
Hi XXXXXXX thanks for responding. The next line of management in your case is ovulation induction.
So, I would advise you to take clomiphene citrate ( CCQ-50) from Day 2 to day 6 of your periods, as advised by your doctor, and rest continue same treatment. Do get follicular monitoring done from Day 9 onwards.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Prasad