Q&A: Can I up my Clomid dosage if I have PCOS?

Does PCOS (polycystic ovarian syndrome) ever block the fallopian tubes and prevent the egg leaving the ovary to be fertilized? I'm trying to get pregnant and my fertility specialist mentioned that I have PCOS, something my OB-GYN never mentioned. I was shocked, but the fertility specialist said it was "no big deal." Wouldn't my other doctors have noticed this condition on my ultrasound? I have been on 100mg of Clomid for five cycles; I'm on day 54 of my cycle. Is there any reason (if I am not pregnant) I shouldn't up the dosage of Clomid to 150mg?

Polycystic ovarian syndrome (PCOS) is a common problem which results in the failure of eggs to develop and mature in the ovaries. Without egg maturation, ovulation does not occur. PCOS does not cause blockage of the fallopian tubes. In the United States, PCOS is the most common cause of ovulation problems. Since PCOS is a "syndrome" and not a disease, there is no specific test which will always allow your doctor to make a diagnosis. The more signs and symptoms you have, the more likely it is that you have PCOS.

Common symptoms of PCOS include irregular or absent menstrual cycles, acne, and unwanted hair growth. Common laboratory signs include elevated levels of certain hormones known as androgens and an elevated ratio of the pituitary hormones LH and FSH. On ultrasound, the ovaries may be enlarges with more than 10 tiny follicles just under the surface of the ovaries—this is known as a polycystic appearance. Not all women with polycystic appearing ovaries on ultrasound have PCOS and not all women with PCOS with have a polycystic appearance of the ovaries on ultrasound.

Ninety to 95 percent of pregnancies that occur on Clomid, occur within the first four ovulatory cycles. So if you have ovulated four times without pregnancy, it is time to move on to something else. If you have not been ovulating, which seems to be the case on this last cycle if you are not pregnant, then increasing the dose is reasonable.

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