Despite ovulation induction, I did not get pregnant. What to do now?

Hello,

Welcome to icliniq.com.

• The hormone reports (attachment removed to protect patient identity) submitted are normal and the ultrasound seems fine. But, as there is no detail about the sizes of follicles reached during both cycles of ovulation induction it is difficult to make a comment here.

• However, other hormone levels like serum testosterone, serum estradiol, DHEAS (dehydroepiandrosterone), 17-OHP (hydroxyprogesterone) levels also need to be done.

• If you have been forming adequate size follicles 222 x 22mm by midcycle then hCG (human chorionic gonadotropin) can help you ovulate but if hCG fails at this size then it is likely that your androgenic hormone levels are higher.

• I need to know the ultrasound pelvis report to assess the size of the ovaries as well.

• Also important would be anti-mullerian hormone levels for evaluation.

• Looking at the limited information provided, I feel that you can get pregnant with assistance.

• You may continue the medication for pcod (polycystic ovarian disease) which you are already on as they decrease the insulin resistance which hampers ovulation. Also you need to decrease your weight by 6-9 kg.

• Increased water intake and exercise is what I would advise for aiming weight loss. Paleo diet (diet chiefly with vegetables, fruits and meat excluding dairy products) is not recommended as it would add stress to your body.

For further information consult an infertility specialist online --> https://www.icliniq.com/ask-a-doctor-online/infertility-specialist

Hi,

Welcome back to icliniq.com.

• I have gone through both the follicular studies (attachment removed to protect patient identity) and in both you had follicle with adequate size which ruptured on time.

• I believe you were advised timed intercourse.

• The chances of fertilization cannot be guaranteed by any ovulation induction so you cannot say that you did not get pregnant in spite of ovulation induction.

• We can assist but cannot ensure fertilization which is a natural procedure after sperms are deposited. None can ensure as to whether sperms will fertilize or they will not.

• This is possible only in IVF (in vitro fertilization) when a fertilized embryo is placed inside the womb.

• So, I think the next step in your case should be an ovulation induction and IUI (intrauterine insemination) cycle where sperms can be directly deposited inside your uterus once the rupture of follicle occurs. This shall increase your chances of conception further.

For further information consult an infertility specialist online --> https://www.icliniq.com/ask-a-doctor-online/infertility-specialist