Lh Surge But No Ovulation Clomid

Mandy asks…

Clomid Sucess Rates and should I get my hopes up?

Just wondering my doctor is just about to start me on Clomid in a few months. I have ready all the books and I am losing weight, stopped drinking caffine, And also quite smoking. (Oh by the way I have PCOS) . The doctor is going to have me try for 2 more months to do it natraully and then if that does not work she is going to put me on clomid. I have done everything possible to do it natraully. I have used the ovualtion prediction kits and layed on my back after sex with my hips up. I am starting to get very frustrated becuase nothing seems to be working and I am worried that taking the clomid will not work either. Any more suggestions….. ?
I am 22 with PCOS. I have done everything that has bin asked by my doctor for someone that has PCOS. I just wanted to know if I have missed anything that I shouldbe doing.. Before I go to using Clomid..

Pregnancy Advisor’s answers:

First, ovulation predictor kits are VERY inaccurate for women with PCOS. It detects the LH surge which means you are going to be ovulating (however, women with PCOS have messed up LH levels).

Your best bet at getting pregnant is going to be treating the PCOS the correct way. To do this you should eat a low carb diet, exercise and be on an insulin sensitizing drug, such as metformin. Once you are on metformin, then you can start all the fertility treatments (such as Clomid, injecibles, IUI, IVF, etc). It might be possible to get pregnant with Clomid alone, but your chances will be much higher if you are on metformin.

I recommend seeing a reproductive endocrinologist to oversee your treatment.

The underlying cause of PCOS is insulin resistance (IR). The best treatment for PCOS is going on an insulin sensitizing drug such as metformin (1500-2550mg per day) combined with a low carb diet and exercise. There are a few important things to know:

1. Many women “pass” the test for IR, but still respond positively from the metformin. No one knows exactlly why..my thought is that the test is not a sure fire way of detecting the IR.

2. You must be on a high enough dose of metformin. I’ve heard women complain that their bodies dont start working even though they’ve been on metformin for awhile. Some doctors are hesitant to up the dose past 1500mg…but for some of us it takes more. I don’t respond until my dose is around 2000mg a day.

3. It can take a few months on the correct dose, before your body is regulated.

4. It is important to treat your PCOS even if you are not trying to get pregnant. There are higher risks for many things (high blood pressure, blood clots, diabetes, and many other things) when you have PCOS, but if it is treated properly, then those risks are lowered.

There are TONS of books about PCOS and dieting. There are two that I recommend. Here’s the links at amazon for those (if you’re interested):

http://www.amazon.com/o/asin/0809224275/…

Http://www.amazon.com/o/asin/0007131844/…

I also recommend a couple web sites:

http://pcos.itgo.com/

http://www.inciid.org/faq.php?cat=infert…

Http://messageboards.ivillage.com/iv-bhp… This one is a great message board where you can ask all your PCOS questions or just chat with the women who are also dealing with PCOS. Good luck.

Lizzie asks…

What is the the normal follicle size?

My Re gave me Clomid CD 5-9 and Metformin 1500mg. I went in today for my CD12 u/s and I only had one follicle that is 10mm. The dr said that I only have a very slim chance of ovulating this month. Can anyone tell me what the normal size should be? I’m a little down cause I really was hoping to ovulate this month. Thanks for any help.

Pregnancy Advisor’s answers:

I’m sorry…I know how frustrating it is to not ovulate!!!! I think the follicles are typically 22-24mm to stimulate the LH surge and cause ovulation. But follicles that are 14-15mm are also able to be considered “mature” when doing IVF so maybe some sort of stimulation could be used in future cycles? Here’s a good article that might help, http://www.medscape.com/viewarticle/501803, Good luck!!!

Carol asks…

What length cycle do you have when your on CLOMID? 28day 25days etc etc. . . .?

Does it give you a normal 28day cycle? & when on clomid do you ovulate on the 14th day!?

Thanks so much

Pregnancy Advisor’s answers:

Every woman is different.. And no it does not necessarily give you a 28 day cycle. I’ve been taking clomid for the past 4 months.. And my cycles are usually about 32 days. Every woman is also different to when they ovulate. You need to get yourself an Ovulation Predictor Kit (i recommend the Clear Blue Easy Digital) it is a little pricey.. But it is better than the others b/c it tells you for sure and your never guessing. This will tell you when you have ur LH surge, and when you get that + OPK test then you should ovulate withing 12-36 hours.. So… Baby dance every other day from day 10 on.. And ur covered… If you get ur AF then you know ur not prego.. If not.. Then take a HPT.. Good luck!!

Sharon asks…

getting 10 days of high readings on CBE fertility monitor?

I’m on my 3rd cycle using the Clear Blue Easy fertility monitor and have found it very easy to use. This month however, I’m already at 10 ‘high’ days. Last month was 8 and the first month was only 6. Why is this happening?

Pregnancy Advisor’s answers:

It sounds like your body is constantly gearing up for ovulation but your LH surge isn’t happening. I would speak to your doctor and ask him to check your progesterone and estrogen levels to make sure that you are actually ovulating and if not get some medication to help with ovulation like clomid or femara.

Betty asks…

What is a Mid-Cycle Ultrasound? Are they checking for follicles?

I have an appointment with my RE this friday for a mid-cycle ultrasound. I thought it was to check for follicles. I looked up mid-cycle ultrasound and it was saying it is for measuring the endometrial linning. Is that all that is being checked? Or are the follciles being checked then too?

Please let me know your experiences!!!!

Pregnancy Advisor’s answers:

Yes, they check the thickness of the lining and also to see that the lining has 3 layers.
They measure the number and size of the follicles as well. Basically, they want to see how well you are responding to clomid but they also want to make sure your ovaries are not being overstimulated. They also check your LH to see if you are surging. If you have enough mature follicles, they may advise you to use an hcg trigger shot, like ovidrel, to encourage ovulation and to give your early luteal progesterone a boost. They will also measure your estrogen levels to make sure you are not being hyperstimulated.

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