therapy for infertility

[GRACE0783]

i have pcos, which is not helping me concieve. i have been trying for two years with no luck. when they found out i had pcos the doctor gave me metforming which were good because they made  me loose some wait. i also been on clomid for three cycles together with metforming before also didnt help. after all this the doctor did an ensamination which i came out pregnant -but with really low hcg. and low progesterone. which the doctor gave me vagina progesterone and didnt help, becasue i had a miscarriage at the second day of finding out i was pregnant. after the last try last year on june. i gave up. with no luck of becoming pregnant by myself. know i went to a different doctor and he put me on clomid citrate, estrogen, and prochieve 8%. what are my chances of becoming pregnant this time. when my only problem is pcos. i'm 23 yrs. and not to much over weight.

[GRACE0783]

thanks for that it makes me feel better. i will keep on trying. let see how it goes this month

[USF-M.D.-DK]

GRACE0783,
the first goal of treating infertility associated with PCOS is just to ovulate. this is best achieved by metformin, 2000 mg per day, and clomid, given for five days per month at the lowest dose which will induce ovulation.  once you know you are ovulating, you should stay at the same dose of clomid until you conceive.  if you go above the minimum dose of clomid needed for ovulation, fertility actually can decline, and rate of miscarriage can increase.  if you don't get pregnant after the first, second or third cycle of an ovulatory dose of clomid, don't despair.  the chances of getting pregnant each ovulatory cycle on clomid are about 15%, which is slightly below the normal rate of fertility each month for women who have no infertility.  so keep trying.  if you don't get pregnant after four to six cycles on an ovulatory dose of clomid, seek referral to a fertility specialist, who will discuss treatment either with shots of FSH or with IVF.  adding estrogen and/or progesterone in the latter part of the cycle after taking clomid also can help, and may be a reasonable alternative to moving on to more advanced therapy. clomid can be a double edged sword- it helps you ovulate, but also may disrupt your uterine lining.  estrogen and progesterone may overcome some of the detrimental effects of clomid on the uterus.  though less expensive and easier to take, the success rate of such modified clomid treatment is lower than FSH or IVF.  don't give up, because at the age of 23, you have an excellent chance of eventually becoming pregnant. david