Ask a doctor on the topic of Gynecology

PCO and ovulation

April 20, 2012 | 30,00 EUR | answered by Dr. med. Hendrik Bernau

Dear advisors,

I am new here and I need your advice. Last July, I was diagnosed with PCOS, male hormones, insulin resistance, and also hypothyroidism. Since I have been trying to conceive since June 2010, the doctors prescribed me Metformin. I take this 3 times a day at 500 mg each, and for my thyroid, I take L-Thyroxine 75. After 3 months, I still had not become pregnant. My OB/GYN then prescribed me Clomiphene with timed intercourse. During follicle monitoring, we were able to see the follicles well, and we tried for 3 months, but it still did not work. Now we have switched to a fertility clinic and started directly with IUI, with stimulation using Puregon, Ovitrelle, and Utrogest. Unfortunately, after 2 IUIs, it did not work. Due to work, I have moved and now live in Switzerland. I found a homeopath who has also treated women with PCOS. She prescribed homeopathic remedies for me to take in the first and second half of my cycle. At first, I didn't believe much in it, the first month was unfortunately negative, but now I am in the second month and I have also bought a Clearblue Fertility Monitor. On the 11th day of my cycle, the monitor showed 2 bars, meaning I was fertile. On Tuesday and Wednesday (cycle days 19 and 20), the monitor showed 3 bars, indicating peak fertility. However, I only had intercourse on Tuesday morning with my partner. I notice that my first half of the cycle is very long, and I wanted to ask if despite this PCOS, I can still ovulate or if I should not rely on this Clearblue monitor. Regarding my period, I should mention that in the last 6 months it has been between 29 and 32 days. My cycle has been almost regular. I will give you the data as well:

1. Period after stopping the pill: 32 days (11.06.2010 to 12.07.2010)
2. Period after stopping the pill: 33 days (13.07.2010 to 14.08.2010)
3. Period after stopping the pill: 36 days (15.08.2010 to 19.09.2010)
4. Period after stopping the pill: 32 days (20.09.2010 to 21.10.2010)
4th period after stopping the pill: 68 days (22.10.2010 to 27.12.2010)
Laparoscopy and hysteroscopy on 06.12.2010 due to cysts in the left ovary
5. Period after stopping the pill: 60 days (28.12.2010 to 25.02.

Dr. med. Hendrik Bernau

Dear Florette,

Thank you for the detailed description of your issue. As you mentioned, you and your partner have been trying to conceive for some time now and have already undergone several common procedures - unfortunately, without success so far.

I will try to answer your questions chronologically.

1. The medications initially prescribed to you are the regular way (the "first" step) of fertility treatment. The "Fertility Monitor" you are using can be helpful and provide you with some guidance, but like any other test, it is not 100% reliable. Therefore, it is good that you are using it, but you should not rely solely on this device for all your expectations.

2. The dates of your period that you mentioned align quite well with your statement that your cycle is regular and chronologically normal. Upon first glance, I do not see any particular irregularities.

3. Regarding your weight (I am using your statement here as you did not provide me with a specific weight): A good overall health condition is certainly important for starting a pregnancy, but being overweight is not necessarily a disqualifying factor. Exercise and healthy nutrition are generally important factors, especially in relation to your desire to conceive.

4. Has your partner consulted a urologist? The cause could also lie with him.

Unfortunately, I am unable to access the patient file you uploaded (I do not see any available upload). Perhaps you can try uploading it again? In any case, I wish both of you all the best, especially in regards to your desire to have children.

I hope I have been able to assist you. If you have any further questions, please do not hesitate to contact me at any time.

Wishing you good health.
Best regards,

Dr. med. - anonymized -