polycystic ovary syndrome (PCOS) do not
ovulate regularly and often have difficulty becoming
pregnant. Although the medicine clomiphene (such as Clomid) is commonly used to
stimulate ovulation, it doesn't work for some women who have PCOS. This is because
PCOS ovulation problems are linked to an imbalance of multiple body systems.
Often other treatment measures can restore balance to the body's metabolism and
hormone system, making ovulation medicine unnecessary (or more effective if it
Before considering medicine to stimulate
ovulation, overweight women with polycystic ovary syndrome are advised to lower
body mass index (BMI) with diet and exercise. Even a
modest weight reduction may trigger ovulation in women who have PCOS.
If weight loss does not help start ovulation,
clomiphene is usually tried first, sometimes combined with a steroid.
If clomiphene does not start
ovulation, it may be combined with another medicine, such as metformin, to
start ovulation. Combining the two treatments may make it more likely that clomiphene will trigger ovulation in women who have PCOS.
Women who do
not ovulate with a combination of medicines are sometimes treated with
gonadotropins, which are similar to the hormones the body produces to start
ovulation. During this type of treatment, a woman must have daily monitoring of
egg follicle development, using blood tests and ultrasound, to prevent
ovarian hyperstimulation syndrome.
clomiphene does not work, your doctor may try a medicine called letrozole.
Letrozole is thought to harm the fetus if it is used during pregnancy. Talk to
your doctor about being sure you are not pregnant before taking this
Laparoscopic ovarian surgery such as ovarian drilling
(partial destruction of an ovary, which can trigger ovulation) or in vitro
fertilization (IVF) are sometimes used for women with PCOS who have tried
weight loss and fertility medicine, but still are not ovulating.1
For more information, see the topic Polycystic Ovary Syndrome (PCOS).
Before you take the next step in your journey to become pregnant, it's worth seeking out a good fertility clinic.
Let's say you've been getting advice from your gynecologist, who's run a blood test for hormones or had you record your basal body temperature for a couple of months. At the same time, your husband has had his plumbing checked out by a urologist. When it comes time to diagnose where the problem may be and suggest solutions, you may wish there were a single doctor you both could see....