Q. I am having PCOS, and trying to conceive for eight months. What is the treatment?

Answered by Dr. Sameer Kumar and medically reviewed by Dr. Nithila A


Do you have a question on Pcos or Clomid? We have medical experts to help you right away. Ask a Doctor Now »

Hello doctor,

I am 33 years old. I have been trying to conceive for eight months from now. I have monthly periods and positive OPKs and BBT shifts, but periods are also very light, basically spotting. I had an Ultrasound which showed a few cysts, had mildly elevated testosterone, normal LH and FSH, normal estrogen, low progesterone. My PCP is not convinced. I have PCOS but I am wondering if that is still a possibility and what I should anticipate for treatment in the future (clomid vs. progesterone therapy, etc.)?

Related Questions:
Why are faint T lines appearing on urine pregnancy tests, while ultrasounds say I am not pregnant?
According to scan, the fetus growth is lagging. Kindly clarify it.
I want to get pregnant very soon. Can I take clomid for ovalution?

Dr. Sameer Kumar
Infertility, Obstetrics And Gynaecology


Welcome to icliniq.com.

The fact that you are getting positive OPKs each cycle indicates that you have an anovulatory cycle or in simple terms that you are ovulating regularly. PCOD (polycystic ovarian syndrome) cannot be diagnosed alone with just small cysts in ovaries, rather one should have around 10 to 12 multiple small subcenterimetric follicles lining the periphery of the ovary during midcycle scan, one should have featyres of clinical hyperandrogenism like acne, hirsutism (excessive facial and body hair), acanthosis and most importantly oligomenorrhoea or irregular menses.

Testosterone alone does not justify the diagnosis. However, if o e needs to be sure, then AMH (ante Mullerian hormone) test can be done, which is more than four indicates PCOD. As mentioned that you are on thyroid medications, I believe your TSH levels are less than five. Please share your ultrasound and hormonal profile reports for review.

Now, it would also be essential to check for your partner's semen analysis for quality and quantity of sperms. I am not sure if you have any kids before or not as you have not mentioned, but if you do not yet, then semen analysis of your partner would be mandatory, as your reports are relatively normal. Progesterone deficiency can be treated, and even Clomid can be contemplated only of the male infertility factor has been ruled out first.


Thank you doctor,

I have attached all of my results. I have been on the Synthroid for years since my thyroidectomy, and it has never seemed to be an issue. Admittedly, some of my tests were saliva tests (the progesterone, estrogen, testosterone). Not sure how valid that makes them. We also did a home sperm test, which seemed to show an adequate sperm count for my husband. One more question I had, the ultrasound says my uterine thickness was 4 mm, and it was done around the time of my ovulation. Is that thin?


Dr. Sameer Kumar
Infertility, Obstetrics And Gynaecology


Welcome back to icliniq.com.

I have gone through the reports (attachment removed to protect patient identity).

1. You have an early LH (luteinizing hormone) surge as on same day LH is high, and FSH is normal. This causes immature folliculogenesis and first ovulation, which are incapable of forming corpus luteum to secrete adequate progesterone and hence the thin endometrial ling as well.

2. Testosterone levels are high borderline.

3. Progesterone levels are low for day 21 of cycle indicates less production by corpus luteum of no ovulation at all.

4. Presence of small anterior wall fibroid which would not affect pregnancy at present or likely cause of infertility but is expected to increase with cycles.

5. Thin endometrium due to poor estrogenisation of the endometrium during the cycle.

Keeping all in mind, this does not indicate PCOD, but it does indicate a hormonal imbalance between early LH increase, low FSH, and low progesterone. Please get AMH levels done as well.

You can and should be treated for hormonal imbalance with low dose combined OC pills for three cycles first before planning pregnancy, which would be mandatory in your case, unless you wish to hurry up for pregnancy, then ovulation induction can opt again with estrogen and progesterone support during the cycle and possible recombinant FSH injections if required. Success rate universally remains 35 to 40 % only, even with assisted techniques.

Ask your health query to a doctor online?
Ask a Doctor Online »
* guaranteed answer within 4 hours.

Related Questions & Answers

Faint T Lines Appearing On Urine Pregnancy Tests,While Ultrasounds Say I Am Not Pregnant?
Query: Hi doctor, I have been trying to conceive for a few months, but every time the test comes back negative. My last periods was on the 25th of last month, and I started ovulating on the third of this month, and it ended on the 12th. My husband and I had sex on the fifth. Despite my history of irregular...  Read Full »
Dr. Vidya
Obstetrician And Gynaecologist

Answer: Hello, Welcome to icliniq.com. There are two possibilities here. One is a chemical pregnancy, where only the pregnancy test result come positive, and there is no evidence of sac on ultrasound. Second being a healthy pregnancy is a delayed conception or an ectopic. I suggest you do a serum beta hCG b...  Read Full »
For how many cycles can I take Clomid 50 mg?
Query: Hi doctor, I am 26 years old. I have been trying to conceive for the past seven months. I have regular 28 day cycle. Recently, I got a hormone test for FSH, LH and prolactin, uterus scan and my husband's semen analysis. Everything was normal. My doctor prescribed me Clomid 50 mg on day 4 to day 9 an...  Read Full »
Dr. Neha Singh Rathod
Obstetrician And Gynaecologist

Answer: Hi, Welcome to icliniq.com. First, relax. Anxiety and depression also cause delay in pregnancy. Continue with the same medications and start Folic acid supplements. Try every alternative day during your fertile period at least for two weeks. In this way you are giving rest to the body and also to i...  Read Full »
Can PCOS cause irregular periods?
Query: Hi doctor, I am a 28 year old unmarried woman. Last month my period was irregular. I got my periods on the 30th of last month and it was already 20 days later from the actual due. Initially, I had spotting for five days, then I bled for seven days and again, had spotting for three days. Now, I am bl...  Read Full »
Dr. Neha Singh Rathod
Obstetrician And Gynaecologist

Answer: Hi, Welcome to icliniq.com. Please do not worry. Irregular periods are not an alarming thing to worry about. Irregular periods are due to stress and strain anxiety work pressure change of place change in climate low blood count thyroid disorders or uterine or ovarian problems. Please...  Read Full »

Ask your health query to a doctor online?
Ask a Doctor Online »
* guaranteed answer within 4 hours.

Ask a Doctor Online

* guaranteed answer within 4 hours

Most Viewed

Sepsis - Causes|Symptoms|Risk Factors|Diagnoses|Treatments|Prevention
Sepsis is a medical emergency, as it causes multiple organ failure. When the body's response to infection in the blood s...  Read more »
I have on and off acid reflux as well as mild dysphagia. Is this esophageal cancer?
Hello doctor,I am a 26-year-old male. I have been experiencing on and off acid reflux for a few weeks as well as mild dy...  Read more »
There is a hard lump under the nipple. I am afraid of breast cancer. How to proceed further?
Hi doctor, I am a 25-year-old female. I found a quarter-sized hard nonmobile lump under my nipple a day ago. Is that an...  Read more »

Also Read Answers From