Clomid and still no LH surge

[littlehollybear]

I do not have periods without taking progesterone. I can go many many months without a period without the progesterone. I am on cycle one of  50 mg of clomid (5-9) now. I have been using OPKs and they have not shown a LH surge but I think I have noticed changes in my cervical mucus.  Could I have ovulated and it just didn't show on the OPK? I was also cramping something fierce on day 16. Is this common on clomid? It seems like such a long time to start getting cramps this late having finished the pills on day 9. I also feel dull and sharp constant pains in my left side which feel an awful lot like an ovarian cyst. I was put on birth control when I was 18 to help regulate my periods and to decrease the ovarian cysts (I'm now 30 and have been off the pill since Feb). I am frustrated because I seem to have all of the horrible side effects from clomid but no LH surge. Can OPK kits be wrong? People say your cycles are longer and that you ovulate later on clomid. It's day 18 now and I have pain, cramps and no cervical mucus nor LH surges. How do you know you ovulated? BBT never help me either as I'm a light sleeper and need to use the restroom several times a night. I've been trying to do these since Feb as well with the exception of this month since I've been using OPK. Does it sound like I did not respond to clomid? My dr thought I have symptoms of PCOS but not the full thing.

[Forum-M.D.-SP]

OPK kits can sometimes miss a surge. On the other hand, not everyone with PCOS responds to the initial starting dose of clomid. If you are only day 18, I would suggest:

1) Continue to test with OPKs for another 2-3 days
2) If no surge is detected, have a blood test for a hormone called progesterone on day 25.
3) If your progesterone level on day 25 is more than 3, this means that you ovulated (which might account for the cramps) but the OPK missed detecting the surge.
4) If your progesterone is less than 3, it means that you did not ovulate. In this instance, your doctor should prescribe provera 10 mg for 7 days to bring on a period, and then increase the dose of clomid next month to 100 mg from days 5-9 and repeat the process.

About 30%-40% of women with PCOS are resistant to ovulating with clomid, even at the highest dose (we will go as high as 200 mg for 5 dyas). Strategies if you are not ovulating on clomid include adding an antidiabetes medicine called metformin, trying another pill called letrozole, or trying fertility injection medicines. Whereas clomid is only 60%-70% effective, the injection medicines almost always lead to ovulation. The tradeoff is that the injections are more expensive, carry a higher risk of multiples, require an injection. Thus, we always try to see if the fertility pills, like clomid, can do the job first.

I would also recommend not taking BBTs. They will not help - even with women who clearly ovulate based on BBTs, by the time they know for sure that they have ovulated, it is past the time where the egg is capable of being fertilized by the sperm.

Hope this helps.

[hereshoping]

I did not show a surge until the clomid 150 mg...so I would guess that your doctor will go to 100 for your next cycle and if you tolerate that but no pregnancy, go to 150.  I also have symptoms of PCOS...frustrating, but finally did surge.....

[babygirl_garcia]

I have been diagnosed with PCOS at least 3 years ago now. I just turned 26 years old, and have not been able to get pregnant either. I can tell you that I was also on birth control as a teenager to help me have more regular periods. The docotor had told me that after I got off the pill it could take up to a year before I could concieve (Its been 3 years now and no baby).  I got all the way up to 150mg of Clomid with no ovulation results for at least 3-4 months. The doctor also had me on the max of Glucophage (Metformin) 1,500 mg/day, with still no ovulation. So we went to a Fertility specialist and he said my GYN was doing everything right, but the next step would me hormone injections...or we could do ovarian drilling. I did the injections for 2 months only and it was $5,000. So we stoped there...still no baby, but the doctor swore to me that I would get pregnant after 3 months due to my body getting used to  the hormones and that I reacted perfectly to them...my husband and I just decided to wait and I am back in school for now and so is he. So after that long story, I just wanted to say that YOUR story kinda sounds like my problems, and I just wanted you to know what we did to maybe give you some ideas. Those ovulation kits can be wrong, but it is usually if your urine is not concentrated enough....but maybe you just need to go up higher on the dose of Clomid.  GOOD LUCK!!!!!!!

[khunn]

Your problems are nearly identical to mine, and I do have a 2 year old son.  I got pregnant by luck, according to my dr.  We didn't realize I had signs of PCOS and annovulation, until I've been trying to get pregnant the second time.  I too had ovarian cysts at 17 and was on the pill until I was 24, and got pregnant pretty quickly after we started trying.  This time I've been off the pill since Feb, and it's been frustrating.  I've done prometrium and am on my second round of clomid, now awaiting an LH surge, and nothing yet.  I know your frustrations and can only wish you luck!

[conrad1999]

My doctor put me on prometrium to induce menses...took prometrium for 12 days then finally started 4 days later (my cycles had been ranging between 36 and 44 days.....this month was 60).  I then started letrozole on day 3...it is now day 14 of my cycle.  I started using the saliva ovulation test a couple of days ago and have seen no change (honestly really nothing at all).  Today I used an opk and no LH surge.  What day is "typical" for ovulation when taking clomid or femara????  This has been so frustrating.....can more tests be done?  This is my first cycle of femara but besides testing my TSH, prolactin levels and my progesterone last month they have tested me for anything else. I went to a fertility specialist to get a second opinion before even starting the femara hoping they would be more thorough.  My TSH level was a tad high and the specialist also put me on synthroid.  I'm 33...been off the pill since March.

I can sympathize with all of you.  The worst part is not knowing if there is something else wrong. I know I need to be patient but will the femara work to induce ovulation?  If so when????

Any advice or info would be greatly appreciated.