Hi
You have not mentioned about the day 21 serum
progesterone level ( suggests about ovulation)
It is reassuring to know that rest of your baseline subfertility investigations are normal.
What is your BMI? Do you have regular cycles? Usually women with PCO have irregular cycles as they do not have regular ovulation.
I suggest that you take clomid/tamoxifen +Inj HCG for six cycles along with
ultrasound follicular study. Ultrasound examination helps us to make sure that ovulation is occurring.
If conception does not occur with this treatment then I would discuss with you two options of management. Either to start induction of ovulation with hormones or
laparoscopy and ovarian diathermy for
polycystic ovaries.
Pregnancy rates between laparoscopic ovarian diathermy after 6 to 12 months follow up and six cycle of
ovulation induction with gonadotropins are the same. Laparoscopic ovarian diathermy carries the risk of surgery. However, the rate of multiple pregnancies is lower in women who conceive after ovarian diathermy.
Take one tablet of
folic acid daily.
To increases your chances of pregnancy, maintain normal BMI, quit smoking ( if you are a smoker) and have intercourse atleast three times in a week. For women with PCO maintaining normal BMI extremely important. Even reduction of just 5-10% of body weight corrects the hormonal imbalance and improves chances of conception.
I hope I have answered to your satisfaction.
If you have any further queries feel free to contact me through health care magic