Dr. Sameer Kumar
Obstetrics and Gynecology
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Patient's Query
Hello doctor,
I am 28 years old. I had my last period before two weeks. I have PCOS, and the doctor asked me to take Letrozole (3 to 7) 2.5 mg, Clomid (5 to 9) 50 mg, Estradiol 6mg per day (8 to 12) and Metformin 1000 mg daily. I got a positive ovulation test on the 14th day of my cycle, and I went for an ultrasound, and my doctor said I am not ovulating now, so I wanted to know if I am going to ovulate in this cycle or not.
Hello,
Welcome to icliniq.com.
It would be helpful if you can share the pictures of the ultrasound you have undergone and also the report which mentions the endometrial thickness on day 14 of your scan.
Patient's Query
Thank you doctor,
I do not have the reports with me it is with my doctor.
Hello,
Welcome back to icliniq.com.
If you got your ovulation test positive with an ovulation kit positive on day 14 of this cycle, then ideally you would ovulate after 36 hours of the positive test. The ovulation test indicates the LH (Luteinizing) hormone surge, and ovulation occurs after 36 to 40 hours after the LH surge. So if you did the USG on day 14 itself, then for sure there would have been no ovulation as it would be expected only after 36 hours on day 15 to 16 of this cycle. If today you are on day 16 then you can have timed intercourse or an IUI (whichever is planned for you) after a repeat ultrasound today to check for ovulation, which would be indicated by fluid in POD and evidence of ruptured follicle.
Patient's Query
Thank you doctor,
Sorry I was not clear. The earlier doctor said my follicles are not big enough and that they should be of size 0.7 inch and she thought it was a false positive ovulation test.
Hello,
Welcome back to icliniq.com.
In that case, she is right, the follicle should reach a minimum growth of 18 mm plus before it can ovulate. If they were less than 18 mm, then likely that the ovulation induction with Letrozole and Clomid 50 that you received would have to be increased from the next cycle and regular day 7, 11, 13, 15 and 18 transvaginal USG (ultrasound) would have to be done to monitor follicular growth. And if required, FSH injection (follicle-stimulating hormone) may be added, but all in the next cycle now. There is another possibility that you may follow up with USG again in three days and monitor ovulation for another week (as there are chances for delayed ovulation) and if you do in next one week, then you can plan your timed intercourse even in this cycle or an IUI (intrauterine insemination) procedure, as would be advised by your gynecologist. If no ovulation in the next one week, then this is a failed cycle and another attempt should be made in the upcoming period with readjustment of dosages and regular follicular monitoring. I hope I have been able to answer your queries in detail,
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Obstetrics and Gynecology
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