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Diagnosed with PCOD. Took birth control pills and menstruation became normal. Given APCOD. What is the use of this medicine?

Mar 2013
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Practicing since : 1998
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Hi, I was diagnosed with PCOD 2 years back when I was not married. With doctor's advice I took birth control pills and thus my menstruation became normal. I got married 18 months ago. I have not conceived yet but my cycles are normal for the last 8 months without any pills. Today I visited the same doctor and she said that I can never be able to become pregnant normally because of the PCOD. According to her some injections and long term monitoring will be required for successful ovulation. My weight is 58 kg, BP is low, age 27. I don't have thyroid problems and my prolactin is normal. On 12th day, my egg size is 7. Kindly suggest the future course of action for me. I have been given APCOD for three months from today. Kindly let me know the use of this medicine. Thanks
Posted Tue, 5 Nov 2013 in Women's Health
Answered by Dr. Aarti Abraham 15 minutes later
Brief Answer:

Detailed Answer:
Thanks for your query.
As you have not conceived yet for 18 months, you should please consult an Infertility Specialist now.
Am sure the basic problem in conception is PCOD.
In this condition, due to unknown reasons, a widespread hormonal imbalance exists in the body.
The ovary gets studded with multiple eggs, none of which mature to form a follicle which ovulates every month.
First go for the following workup -
FSH and LH on day 2 of cycle
DHEAS and free testosterone levels
Oral glucose tolerance test
TSH and prolactin ( if not within last 6 months, then repeat )
Fasting serum insulin.
Next, you might be given treatment like Metformin to control PCOD.
You have not mentioned your height, so I cannot calculate your BMI.
If overweight, please aim at gradual weight loss as it will help PCOD.
APCOD contains Myoinositol , folic acid and vitamin D 3.
Its use is supposed to help to control the symptoms of PCOD, however PCOD has no absolute cure as such.
Most women with PCOD do conceive successfully, but often require external aid to induce proper ovulation.
NOrmally, ovulation occurs on day 14, and then the egg size should be between 18 - 21 mm, so on day 12, your egg size is not optimum.
However, in PCOD, often ovulation is delayed , so the egg might grow to desired size later on.
Mostly you would need help of ovulation inducing agents ( can be tablets and can be injections ) and monitoring to help you conceive.
Let me tell you the plan of action for you, which I would suggest to a patient of mine -
1. Get the investigations for PCOD done as suggested.
2. get your husband's semen analysis done.
3. Get one cycle of plain follicular monitoring ( ultrasound throughout the menstrual cycle at regular intervals to check if you are ovulating naturally ).
4. If you ARE ovulating by yourself, then try naturally for 3 months, with follicular monitoring continued to allow you to pinpoint probable days of ovulation, around which you should be sexually active.
5. If you are NOT ovulating naturally, try ovulation induction first with clomiphene citrate tablets for 3 - 6 months ( injections of gonadotropins can be added if you do not respond to clomiphene also, most women with PCOD do respond well to clomiphene alone ). You can combine cycles of ovulation induction with IUI ( intra uterine insemination ) to increase pregnancy chances.
6. If this fails, please go for hysteroscopy and laparoscopy to check if your fallopian tubes are open.
7. If tubes are blocked / if multiple cycles of ovulation induction fail to yield pregnancy, you can go for IVF ( in vitro fertilization ).

Continue taking APCOD meanwhile.
Do not stress out, you are young, and am sure in due time, you will see positive results.
All the best.
Please feel free to ask for further clarifications.
Take care.
Above answer was peer-reviewed by
Follow-up: Diagnosed with PCOD. Took birth control pills and menstruation became normal. Given APCOD. What is the use of this medicine? 22 minutes later
Hi, thanks for your reply. It was a nice and detailed answer. My height is 5ft. Am I overweight? I have been prescribed APCOD twice daily for 3 months. Should I take one daily instead of two? In the meantime, I am taking folic acid tablets for the last one month. Should I continue it. I take Sinarest and Cetrizin for allergy regularly. Should I stop it?
Answered by Dr. Aarti Abraham 8 hours later
Brief Answer:

Detailed Answer:
Hi,Thank you for appreciating !
Your BMI comes to 25, which is alright, I would not call you overweight, however losing a couple of kilograms would do you good.
Please take APCOD in the dosage prescribed to you.
YOu do not need to take folic acid separately, it is already included in APCOD.
Sinarest and Cetirizine will not affect fertility, but I do not see any reason for taking it regularly, you should take it only seasonally or periodically for allergy, not on a routine daily basis.
All the best.
Above answer was peer-reviewed by
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