provera/clomid/estradiol

hi doc i have pcos and i've been ttc for 3yrs...and on oct 28 i had a miscarriage i was 6wks pregnant it was ectopic i didnt need an d&c so they give me methro...any way i didnt have my periods after 2ms after the miscarriage so on jan 5th i went to the dr to start trying again so he prescribe me provera for 10days and clomid 3-7days and on estradiol 8-12days...my questions to u is combine this med is there a chance for me to cenceive?and with pcos should i start the clomid a little bet later cuz my ovulation is always late?and should i still take the robitussin and the baby aspirin?and when should i start scanning to find out are many mature folls i have ?

[Elaine Brown, MD]

Hi!
If you were my patient, the first thing I would do is an HSG. (hysterosalpingogram) I would want some more information about those tubes.   For example, did the ectopic pregnancy harm the tube, and is the other tube open or not.  I would want to have this information ASAP before I had you invest a lot of time and money in medications.
If your tubes are blocked, the only thing that really helps is IVF!
If your tubes were open ( at least one ) then I would have you go ahead and start the Clomid on days 3-7. and estradiol as directed.  I would encourage you to continue the baby aspirin and Robitussin.  I would probably go ahead and start ultrasounding to see how the follicles were developing and confirm ovulation with a progesterone level on day 21.  Actually, I like Femara better than clomid, and I would be inclined to use Metformin too.
If your tubes are blocked or damaged, I would send you right off for IVF.
Good luck!
Dr B

[FAFASHO]

hi dr i need ur expertise once again i took the meds as my dr prescribe and i dnt think the clomid as work for me this month if u remember i took provera to make my period come and i took clomid 3-7 and estradiol 8-12 today is cd 29 and i was suppose to do and preg test on cd27-28 and both test come back negative...and i had an hsg test done 2008 and i didnt have any blockage everything was fine...and with the ectopic pregnancy it didnt damage my tube cuz i was early and the give me the shot to  make it go away...
and that was on oct 28 2009...so now i dnt know wat to do cuz i really was hoping that i get preg this month cuz ii just turn 32ys...please dr advise me on wat to do or have my dr do cuz im so desperate...