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Polycystic Ovarian Syndrome - What chance of pregnancy?
My wife was diagnosed with PCOS. Her doctor prescribed Clomid® (clomiphene, actually). We are looking for some statistics of our chances of getting pregnant with this medication, and our chances of getting pregnant eventually with other methods given her diagnosis. I've talked to several people with the same syndrome each with different stories. Some got pregnant right away with Clomid®. Some eventually got pregnant with it. Some got pregnant by other means after trying Clomid. Others never got pregnant with any method at all.
I don't have any data for just Clomid® alone but I've enclosed an abstract that looks at overall success with Polycystic Ovarian Syndrome(PCOS). It looks like the overall rate is 70% in a good infertility program. That's about what I would expect.
Hum Reprod 1997 Sep;12(9):1939-1944
Cumulative pregnancy rates in couples with anovulatory infertility compared with unexplained infertility in an ovulation induction programme.
_moz-rs-heading=""> Tadokoro N, Vollenhoven B, Clark S, Baker G, Kovacs G, Burger H, Healy D
_moz-rs-heading=""> _moz-rs-heading=""> Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.
Using a retrospective analysis, we compared cumulative pregnancy rates, early pregnancy failure rates and multiple pregnancy rates in couples with polycystic ovarian syndrome (PCOS) (n = 148), hypogonadotrophic or eugonadotrophic hypogonadism (n = 91) and unexplained infertility (n = 117), who were treated in an ovulation induction clinic between January 1991 and December 1995. The women were treated with either human menopausal gonadotrophin (HMG) or purified follicle stimulating hormone (FSH). The cumulative pregnancy rate (derived from life-table analysis) after four ovulatory treatment cycles was 70% in the PCOS group, 74% in the hypogonadism group and 38% in the unexplained infertility group. The cumulative pregnancy rate in the unexplained infertility group was significantly lower than the other groups (P < 0.001) but there was no significant difference between PCOS and hypogonadism using the log rank test. The early pregnancy failure rate was 25% in the PCOS group, 27% in the hypogonadism group and 26% in the unexplained infertility group (chi(2) = 0.132, not significant). The multiple pregnancy rate was 20% in the PCOS group, 30% in the hypogonadism group and 17% in the unexplained infertility group (chi(2) = 2.105, not significant). Treatment of anovulatory infertility using HMG or FSH is effective irrespective of the cause. Couples with unexplained infertility are less successfully treated using HMG: correction of unexplained infertility may involve more than simple correction of possible subtle ovulatory defects.
I have had everything tested for infertility; FSH level is fine, tubes are not blocked. I do ovulate and have been trying, but no luck. I have seen a specialist who recommends IVF or artificial insemination. Any other ideas?
It's difficult to know all of the tests that your specialist has done to determine causes of infertility. If you are confident in that specialist, then the recommendations would seem to be the next step. Look at the site about infertility frequently asked questions at Infertility FAQs. This is a great site maintained by former infertility patients and it answers many questions.
Where can I find IVF Report Cards
The Center for Disease Control in Atlanta has listed report cards for Infertility Clinic IVF reports.
I am 18 yrs old (proudly a virgin) and have not had my menstrual cycle for approximately 2yrs. 3-months ago I went to see a doctor, she conducted blood and urine tests. Everything seems fine she said, so she referred me to a gynecologist, it will be another 3 months until I get in to see her. I am very concerned I won't be able to have a baby, also the fact that I might have a "reproductive cancer". Does anyone have any information for me? It would be greatly appreciated.
There are many causes of stopping menses after they have once started. See the list at skipping menses. Although the list looks complex, many of the conditions are treatable and will not affect fertility. Cancer is an unlikely cause of amenorrhea and would be extremely low on my list of concerns.
Unlikely - this is the least fertile time.
Very unlikely with normal (less than or equal to 7 days) length of period.
Your fertile period is 7 days before and 2 days after ovulation from the ovary. Ovulation from the ovary usually occurs 14 days BEFORE your next menstrual period (range 12-17 days). If you have very regular menses starting every 28 days. then most likely fertile period is day 7 after start of menses (7 days before ovulation) to day 16 after menses. The problem becomes if your menses are not always that regular, the timing gets changed. To optimize pregnancy chances, having intercourse every other day (at least) starting on day 12 thru day 16 (or longer if your cycle is sometimes longer than 28 days).
While the above are general rules of thumb, ovulation prediction has become much more sophisticated. You may want to discuss these with your doctor.
To be sure of ovulation, you need either a self-administered urine test called an ovulation predictor kit, or a blood test at your doctor's office. If you use the ovulation predictor kit (we have one in our on-line store), you should use it under the direction of your doctor.
By BBT, sometimes you can suspect ovulation by a small drop in temperature just before the rise in temperature in the progesterone phase. The finding is not that reliable to go by however, which is why most specialists recommend the ovulation predictor kit.
How long do I wait to see a doctor since this is my first month charting BBTs? My cycle was 27 days. My bio clock is ticking. I am 39 years old, but had 2 successful pregnancies 13 and 14 years ago without any charting!
Usually the doctor likes to see 3 cycles before intervening, if needed.
A general way to figure out when ovulation occurs is to subtract 14 days from how often you have a period. (eg., if menses occurs every 30 days, then 30 -14 = 16.) So on day 16 of your cycle (your cycle begins on the first day of your period) is the time ovulation is most likely to occur. Your most fertile period is 7 days before (because sperm hangs around in the cervical mucous for up to 7 days) and 2 days after ovulation. I hope this helps.
It is possible to get pregnant after you discontinue your birth control pills. It may be as high as a 20-30% chance on your first cycle after the pills, assuming you didn't have any problems with skipping periods prior to going on the pill. In fact, you can get pregnant on your BCP's but the chances are very low. Once you stop the pills your cycle will begin and allow you to continue a regular cycle. About 60% of women get pregnant within 6 months of trying and 80% within one year.
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