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Q. There is no ovulation in spite of raising the dosage of Clomid. What to do?

Answered by Dr. R Balakrishnan Menon.


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Hello doctor,

I have been taking Clomid since early this year. I started with 50 mg and there was no ovulation. So, then I took 100 mg and again no ovulation. Now, I am on 150 mg and according to the OPK, I ovulated on the 17th. I know this sounds crazy, but I feel different. I have a pulling pain in my groin, cramps in my back, and boobs are sore. I am not the kind of person to look for signs because I live by 'it is what it is' I have never been pregnant. I am supposed to go on this weekend to get lab work done to see if I truly ovulated but I know I did this time. I know it is too early to test. And I have read that some people just know they are pregnant. I have thought about going to get a blood test. I do not know what to do.


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Dr. R Balakrishnan Menon
MBBS., DGO., DNB- OBG., MNAMS
Infertility, Obstetrics And Gynaecology

Hello,

Welcome to icliniq.com.

How are you doing?

  • As you mentioned, it is too early to diagnose pregnancy even in the blood. Had you ovulated on the 17th as you say, it would have reached the tube on that day. Let us say, the sperm too had reached at the same time and formed an embryo, it would stay in the tube for four to five days. So, on the fifth or sixth day, it would be a morula, which means on the 21st to 22nd of this month, it would have reached the uterus. Then it has to burrow into the endometrium and gain access to your blood flow and then release the hormone into your blood for detection. So, until 13 to 14 days after ovulation, it cannot be detected in the blood.
  • So maybe around the 30th to the 1st, have a serum beta hCG. This test can detect the smallest sign of pregnancy anywhere in the body.
  • If I may advise, instead of just raising the medicine dose by dose, try to find the cause you are not ovulating. You are trying to cure the symptom, not the cause. There is some hormonal imbalance blocking the normal growth of the follicle and ovulation. Is it not true this imbalance can also disturb the proper implantation of the fetus and cause an abortion?
  • The possible causes of ovulation failure are:
  1. Maternal age of more than  35 to 40 years.
  2. If the BMI is more than 24 kg/m^2.
  3. Thyroid or prolactin abnormality.
  4. Any significant physical or mental stress.

Hope I have been of help to you. Do write back if any more queries. All the best.

For further queries consult an obstetrician and gynaecologist online --> https://icliniq.com./ask-a-doctor-online/obstetrician-and-gynaecologist

 
 
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