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Suggest Treatment For Difficulty In Conceiving Despite Going Through Infertility Treatment

Posted on Mon, 10 Aug 2015

Question: Took femara 3-7, had a vaginal ultrasound CD 11, was told I had no mature follicles, biggest was only 11mm ... and must of not responded to this round of femara. I used Clearblue advanced, clear blue digital regular OPK and ovacue fertility monitor with oral & vaginal sensor and all 3 sources gave me a peak positive result on CD12... I had another ultrasound CD 14, but largest follicle was only 12mm.. Is it possible I will respond later to the femara ? or is this cycle more likely no no response. Note I will not be doing a trigger shot this cycle.

Answered by Dr. Soumya (53 minutes later)

Brief Answer:
Details required

Detailed Answer:
Hi,

I need some more information before answering your question in detail:

1. Are your cycles regular ? Or delayed ? What is cycle length ?

2. Are you diagnosed with PCOS ?

3. What is your height and weight.

Let me know the details before answering your question.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Soumya (15 hours later)

1. Are your cycles regular ? Or delayed ? What is cycle length ?

My cyles can have some irregularity .. My last few cycles were 23, 42, 31, 30, 31. Usually last 5 days

2. Are you diagnosed with PCOS ?3. What is your height and weight.

I was told I have some characteristics of PCOS.. So not full PCOS diganosis. I had testosterone hormone slightly elevated, and get acne, and had minor facial hair. Height 5'3 Weight 152

Answered by Dr. Soumya (2 hours later)

Brief Answer:
OPK is wrong

Detailed Answer:
Hi,

You had false OPK due to increased LH hormone level that is commonly seen in women with PCOS. Since your follicle size is less, there is no possibility of ovulation.

You are overweighta nd need to reduce some weight. Weight loss will help in regulating cycles and also pregnancy.

I hope your doubt is cleared.

Let me know if you need any more clarification.

Regards, Dr. Soumya

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Soumya (2 hours later)

I see, since I had a false surge , and my largest follicle only showed to be 12 MM on CD 14... Will then my follicle continue to grow and then move to ovulation? or will this cycle just be more of a abulatory mentral cyle?

I don't think I have had a problem with actually ovulating (not sure) as previous to having ultra sound treatment, (this is the first time I am monitored under ultrasound).. I was was having progesterone blood draws 7 days after the assumed ovulation date and got progesterone levels of 11-14 (I was not on medication when progesterone blood lab done.

I am confused on if I would still have a period if I dont ovulate? as I always have a period each month?

Answered by Dr. Soumya (7 hours later)

Brief Answer:
You will ovulate late

Detailed Answer:
Hi,

You will definitely ovulate but possibly later. Serum progesterone hormones or OPK are not accurate in predicting ovulation.

Best way to check follicular growth and ovulation is to get regular follicular growth scan done and to assess the possible date of ovulation.

You can still try this cycle. There is chance of ovulation. You cannot have period if not ovulating.

Let me know if you need any more help.

Regards,

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad