missed ovulation

Hi, I had a miscarriage Oct 2008 and started trying to conceive again in jan with no luck so far. My OBGyn put me on clomid 50mg in february which i took for four months. i was ovulating regularly every month but still no pregnancy. after taking it this month i haven't ovulated yet! and i am on my 21day of my cycle. what could be the reason for this missed ovulation even though i took clomid as directed?

[Elaine Brown, MD]

Hi!
Sometimes clomid doesn't work!  It may be that you have developed a cyst instead.  You might want to call your doctor and see about an ultrasound to find out what is going on in there!  Sometimes large cysts form instead of the normal "ovulation cysts" and they don't rupture according to a natural cycle.  If so, no progesterone is produced, and no period begins.
If you do go in for an ultrasound, ask your doctor about switching to Femara.  It works the same way as clomid, but just a little better.  (cost approx the same).
You may also wish to take a break.  Your body may be trying to tell you something!
Often, it is during these breaks that conception occurs.  In fact, I learned from my own RE that clomid works just as well in the next cycle as in the one in which it is taken.
(I assume this applies for Femara too.)
Hope this helps!
Good luck!
Dr B