PCOS and Success with Clomid - Times Two

My story has a very happy ending. And I'll start with the ending first. My husband and I have a beautiful girl who will turn two in September and are pregnant with our second child who is due late this year. We feel that this would not have been possible without the expertise of a fertility specialist and, specifically, Dr. Givens. Four years ago my husband and I decided that we were finally ready to have children. We had been together for over ten years. When we decided to start to try to get pregnant and I stopped taking the pill, we anticipated it might take a few months for my period to start and my cycle to become regular. After many months, I had not had my period and was still not pregnant. Still, we optimistically had sex, thinking that I might get pregnant even without having my period. We had heard and read that it was possible. More months went by. I spoke to my gynecologist who said that it might take a while. Still more months went by. After almost a year, I went back to my gynecologist to try to uncover what was going on. She advised that I could start taking Clomid to assist with the pregnancy. My understanding was that I would not be able to take Clomid indefinitely until I got pregnant, and I wanted to understand the underlying problem and diagnose it before I started taking drugs. Luckily for us, I had a family member who was able to advise us to seek help from a fertility specialist and even found out the names of the top specialists in San Francisco. I then found out that before I could see one, I would need to jump through a series of hoops. The first one was to try to get my doctor to identify the right tests I would need to take to get the referral to the specialists. After many phone calls to my doctor's office and insurance company, I was finally able to identify and take the right tests. This took a couple of more months, after which I was diagnosed with polycystic ovarian syndrome. The diagnosis was frightening to me at first. As it turned out, I had a mild case, and it did not interfere with my ability to get pregnant. Rather, Dr. Givens identified a very simple but elegant way to help me. She prescribed Clomid and monitored my ovulation. I was not able to detect ovulation with a home test, but Dr. Givens could see the egg maturing with ultrasounds. At the critical point, when I was about to ovulate, Dr. Givens prescribed a shot of HCG and said that my husband and I could have intercourse in the next 48 hours. It worked. This same approach worked with both pregnancies on the first cycle. We are fortunate to have found an excellent doctor and cannot underestimate the power of the expertise of Dr. Givens. -- LK (name withheld upon author's request) Once women with polycystic ovarian syndrome are successfully induced to ovulate with medications such as Clomid, it is likely that pregnancy will follow, if all else is normal. Sometimes Clomid alone will not work and ultrasound monitoring and appropriate timing of hCG injections will complete the ovulatory process. My patient, LK, is young and she only needed a little extra help to ovulate. She was very fortunate to conceive on the first try with both of her pregnancies. It is more typical that it may take 3-6 cycles of ovulation induction to achieve a pregnancy. Nonetheless, we are delighted that LK was able to have her family with a relatively low-tech approach. -- Carolyn Givens, MD

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