Infertility/Fertility/Fertility options



I am 24 (almost 25). I have 1 daughter, she is 4. She was a honey moon surprise baby. When I conceived her I was on birth control and had missed a pill or two. After her birth I had an IUD implanted and about a year later I had it removed. My husband and I have currently been trying to conceive for 3 years. My doctor has done a few blood tests and has told me that I have PCOS. I have tried metformin and clomid with any luck at all. I still have berry heavy irregular periods (before my IUD I had regular periods and they Weren't heavy at all). My husband and I can not afford IVF or adoption and we currently don't have any insurance and so medications haven't been readily available to me. I am beyond frustrated because all my life all I have ever wanted was to have a big family and now I can't. Is there anything else I can try other than just the old fashioned way? Iced tried taking ovulation tests and have never gotten one to come out positive (saying that I'm ovulating). I just don't know what to do. All I want is for my daughter to have a sibling and a play mate and I feel like I'm to young to give up but I also worry that my daughter is going to be a teenager before we can afford costly treatments or adoption. I just need some direction on what I could try or what to say at a doctors appointment to get some help?
Thanks for your time.
Whitney from Utah

Hello Whitney from the U.S. (Utah),

If the PCOS diagnosis is correct, that means that you have an ovarian dysfunction that is preventing ovulation.  Without ovulating, you cannot get pregnant.  I wish there were a "natural" way to fix this but there is not.  You will need to use medication (often referred to as "fertility" medication) to induce your ovaries to ovulate (that's what they do).  This is called "ovulation induction."  Clomid is one of those drugs but I will bet that your general Ob/Gyn doctor used it incorrectly and ineffectively.  I would recommend that you look up my BLOG where I describe how Clomid ovulation induction cycles are done.  Basically what you need to know about ovulation induction is that there are three types of medications that are used: Clomid, Femara and injectables (lots of different types).  Clomid can be used from 50-250 mg per day for 5 days and are taken either day#3-7 or 5-9.  Most PCOD patients will not respond to low dose Clomid (under 150 mg) and most will require 200-250 mg.  The second drug that some PCOD patients will respond to is Femara and it is given just like Clomid but in doses of 2.5-7.5 mg per day.  Most will need 7.5 mg.  If these two don't work, then you have to use the "injectable" fertility medications.  These are strong drugs that you have to take eery day until the follicle (which has the egg) is ready to ovulate.  You then take a "trigger" shot to induce ovulation.  These are very expensive medications and need to be closely monitored and administered by a doctor that knows exactly what they are doing otherwise you could produce too many eggs and end up like "octomom".  PCOD patients tend to be very sensitive to these medications and grow lots and lots of follicles.

I would strongly recommend that you see an infertility sub-specialist and NOT a general Ob/Gyn for your care.  Otherwise you will be wasting time and money.  The only "natural" thing you can do is if you are overweight or obese, sometimes reducing the weight to a normal weight will cause the ovaries to work normally.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate


All Answers

Answers by Expert:

Ask Experts


Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

©2017 All rights reserved.