Hallow Dear,
Polycystic Ovarian Syndrome (PCOS) is a complex dysfunction of multiple systems in the body. Irregular delayed menses and
infertility is one aspect of it; the other being high insulin levels and high male hormone (androgen) levels. To have success in the management, comprehensive treatment should be taken.
Ovamet is
Clomiphene citrate which helps the ovaries release the eggs. You are taking the pills as per the prescribed timings. However, after ovament, egg release should be ascertained and the day should be located. This is done by
Ultrasonography ovulation monitoring. It will show you the evidence of ovulation, will inform you about the size of the follicle before ovulating and also will inform you about the thickness of the endometrium.
Knowledge about the day of ovulation helps to plan the sexual relations.
Follicles between 18 mm and 21 mm size release the healthiest eggs having more success rate in terms of pregnancy. Endometrium of thickness between 9 mm and 14 mm is most conducive for
implantation of fertilized ovum. If the eggs are not getting released in the proper size of the follicle, Inj. hCG will help this. If the endometrium is thinner, first get it well built by oestrogen treatment before you go for
ovulation induction. Clomiphene is known to affect the endometrial growth adversely.
If Clomiphene fails to induce ovulation, it may be supported by Inj. hCG.
Medicines to lower the raised insulin levels help to release eggs.
Metformin or Myo Inositol are useful in this aspect; the later is claimed to have better results.
Clomiphene citrate is not advised to be taken for more than 6 months. If it fails, you will have to shift to HMG/hCG combination with the help of Infertility consultant.
In PCOS, obesity is a classic symptom and needs to be controlled. Exercise and diet control will help you do that. You should try to maintain your BMI between 18 and 24.
Please follow all the instructions of your consultant. Erratic treatment will not help you.
I hope you get the message.
Dr. Nishikant Shrotri