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Infertility/Fertility/Strange cycle on Femara

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Hi, I have a question about irregular bleeding I'm having while on femara to treat PCOS and trouble ovulating.

I had a long annovulatory cycle (56 days) following a miscarriage that had lots of brown spotting.  When I did finally start red bleeding it was very light, but I started my femara medication on cycle day 3 as I had been directed by my doctor.

I'm on day 9 now and still bleeding on and off.  Sometimes it's brown, sometimes it's red.  Sometimes thick like cervical mucous and sometimes thin and red like blood.  It even stopped for two days (Day 4-6) then restarted heavier.

My main question is if there is a still a chance for the endometrium to build up before I ovulate (usually around CD 15 when on femara).  I would ask my doctor about it but their answer is always to wait another cycle, and I'm getting frustrated as we've only been able to complete 3 cycles in the last 12 months because of delays.  If this is not going to be an issue I'd rather not bring it up.

Writing from Northern California!

Answer
Hello Jean from the U.S. (California),

I think that they main problem you hare having is that you are not using the Femara correctly.  If your doctor is doing nothing to monitor your response, such as ultrasounds, then you are just self-treating and guessing.  It is most likely the Femara dosage you are on is inadeauate and so you continue to have anovulatory cycles, which is leading to endometrial dysfunctional bleeding.  If the Femara is not stimulating the ovaries (hence ovulation), then the endometrial lining will not build up because there is inadquate estrogen production (which comes from the growing ovulatory follicle).  It sounds to me like maybe you need to seek out a doctor that knows what they are doing, will answer your questions and do more than "always wait another cycle".

Good Luck,

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

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com 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.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.

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Edward Joseph Ramirez, MD, FACOG

Expertise

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.

Experience

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.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

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

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

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