What next if clomid does not work for PCOS?

[squirrelish]

I have PCOS and was referred to a fertility clinic. I am taking clomid, but I was only given 6 cycles worth. I usually seem to ovulate, but so far I am not pregnant and I only have a couple of cycles of clomid left.

The fertility clinic won't see me again until I have finished the 6 cycles, but I'm not really clear on what comes after clomid. So anyone out there with PCOS, where did you go next? Is it straight to IVF, or did you try other treatments?

There is another drug similar to clomid, it's letrazole(sp?).

The six cycle restriction on clomid is because there's very little research on what it does to the body after this period.
Each clinic and doctor is different.

I had mine on the nhs. I had 6 cycles of clomid (3 m/c) then tried letrazole but the side effect were horrific for me so when I saw the consultant again I was given another 3 rounds of clomid but off licence, simply at my own risk.

After those 3 the only option was ivf but I have a living child so my nhs restrictions were higher. I feel pregnant again in those extra cycles and I'm currently 11 weeks pregnant.

Thanks prickles.

The NHS website talks about injectables and ovarian drilling, but these have not been mentioned to me and plenty of people seem to be moved straight to IVF. It is good to know that there are other hormone pill treatments I can try if clomid does not work out.

Congrats on the pregnancy!

I could be completely wrong but I think they only do ovarian drilling if you don't ovulate.
There is an injectable, I don't know the name or much about it but I do know it very intensive.
If clomid is making you ovulate they will more than likely try other hormone options first.
What dose are you taking? Are you being monitored?

Just 50mg. I was monitored for a couple of cycles, but it seemed to be working, so I am no longer monitored. I am pretty sure that the clomid is still working, because I have regular cycles and positive OPKs, which I have never had before.

Thanks for telling me about drilling, that is exactly the sort of thing I am trying to find out.

The fact that 50mg is working is a good thing because it is a low dose.
I always found I ovulated late in the cycle though

You should actually be monitored by the clinic for all your clomid cycles as it is quite powerful stuff. To only monitor you for a couple of cycles is poor practice.

I would not use OPKs at all whilst on clomid as this drug can increase levels of LH. The OPK may well be reading that so giving you a false reading.

Treatment options like injectable drugs and ovarian diathermy can be tried if clomid is unsuccessful. IVF should be tried only after all other treatment options have failed; it is not the next treatment of choice for PCOSers due to the very real risk of there being ovarian hyperstimulation.

Second Atilla. I was monitored on all my clomid cycles, and then had a lap and drilling after failed clomid. Didn't work, so went to ivf 8 months later. Developed "mild" OHSS (it was HORRIBLE) so had a freeze all cycle. Self funded the lot so it's been an expensive couple of years tbh.

Also makes no sense to not monitor clomid for two reasons

1. you can't monitor for over response. I know someone who had twins due to un monitored clomid. She got one follicle on her first cycle that was monitored, then they didn't monitor her the rest. She had a higher response the third month and fell pregnant with twins. So you don't know about the risk of multiples

2. there's no way to monitor the impact on your lining. Clomid - especially prolonged use over 3 months - can thin the lining. It can stimulate ovulation but counterintuitively make it impossible to conceive if it thins your lining so nothing can implant. No way to know without scanning.

Yeah, I realise that there are risks when cycles are not monitored. But it is an NHS clinic, so I don't get any choice in where I am referred to, or how many cycles of monitoring I get.

Good to know that IVF is not the default plan B for PCOS though.

Hi i have pcos and chlomid or metformin didnt work for me but ive just started taking inositol, vitex and macca,
Trying the natural route before i have to save for IVF worth looking into