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Dr. Andrew Rynne

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Have PCOD. Took clomid. IUI cycles failed. Should I go for IVF treatment?

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Dr. Aniruddha Malpani

Infertility Specialist

Practicing since :1982

Answered : 22 Questions

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Posted on Sat, 9 Feb 2013 in Infertility Problem
Question: Polycystic ovary syndrome and has irregular periods since early age (18 years old). She used to get period irregular periods in intervals of 1-3 months.


1. In this regard, we visited Fortis Mumbai and started the treatment there.
At Fortis Mumbai, we were suggested to take female contraceptives for 3-6 months with the hope that it might help to regularize periods and try naturally afterwards. We tried for 3 months after that but this did not help as there were muliple follicles and mature follicle/ egg formation.

2. Thereafter, we were suggested to go for Clomid to stimulate ovolution. We tried this method for another 6 months but this did not help inspite of increased dosage. The scans during this time still reflected multiple follicules and no single mature follicle (upto maximum 10 mm size).

3. After that, we shifted to Bangalore with the focus of getting results in this regard and visited Fortis Bangalore . We were suggested to undergo various tests like fallopian tube (HSG), tuberculosis, semen analysis etc. All the tests were normal and she confirmed that Polycystic ovary syndrome (PCO) is the only problem and that we should go for IUI as taking clomid for long duration may have side effects.

4. Since then my wife has undergone 3 IUIs and there has not been any positive results, with no explained reasons for failure. We have been suggested that we should try for 3-6 IUIs before thinking of IVF. During the 3 IUIs, genotropin injections was taken from Day 2 for 7-10 days and .The egg formation has been proper and size of mature follicule at the time time of doing IUI has been 18+mm. All this while, my wife is taking follic acid, metformin and CoQ tablets.
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Answered by Dr. Aniruddha Malpani 14 hours later
Dear XXXXXXX,

Thanks for writing to me.

I went through the details with diligence and I would like to help you.

1. You can read more about PCOD at WWW.WWWW.WW
2. If 3 IUI cycles have failed, I agree that IVF would be your best treatment option
as it would maximize your chances of conceiving quickly. You have an excellent chance of conceiving with IVF because you are young. IUI has a much lower pregnancy rate as compared to IVF (10% vs 45% per cycle) and doing more IUIs will just lead to more frustration. The chances of success with IUI after 3 IUI cycles have failed is slim.

3. At our centre we can also offer you a guaranteed pregnancy treatment option.
You can read more about this at WWW.WWWW.WW You pay for 4 cycles in advance.
If you do not get pregnant in these 4 cycles, we refund your money back to you.

4. IVF treatment takes about 20 days. Should I send you the treatment plan ?

We look forward to helping you to have a baby !

Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, XXXXXXX XXXXXXX SBS Road, Colaba
Bombay 400 005. India
Tel: 91-22-0000, 0000, 2218 3270
FAX ( India) 91-22-0000.
Helping couples build families !
PS Read our book, How to Have a Baby - A Guide for the Infertile Couple, online at WWW.WWWW.WW !

Read my blog about improving the doctor-patient
relationship at WWW.WWWW.WW
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Aniruddha Malpani 9 hours later
Dear Sir,

Many thanks for your response. Actually, I had read a lot about you before seeking your expert opinion and have gone thru most of the links shared by you already.

Actually my wife is not very keen for IVF and want to exhaust all options before that. Hence, wished to have your response on below factors:

1. We have read on internet that Laparoscopic ovarian drilling in PCOs can help in inducing ovulation. What are your thoughts on the success of this method? Also, since this is surgery, are there any risks associated with this treatment?

2. There is also some Ayurvedic treatment suggested which if tried can help in case of PCOs. I know it may not be your area of expertise but I guess since you would have treated many a cases of PCOs, you can share some light on that.

3. Since my wife has recently joined a new job, getting a 3 week leave might be difficult at this point. Hence, we wanted to seek your kind opinion regarding whom should we consult in Bangalore. Can you suggest as per you the best PCO/ Fertility specialist in Bangalore and a center with infrastructure & facilities required for the treatment?

Looking forward to you response,

Best Regards
XXXXXXX

doctor
Answered by Dr. Aniruddha Malpani 1 hour later
Dear XXXXXXX,

Thanks for the follow up.

1. Yes, one option for some PCO patients is to do an operative laparoscopy for ovarian drilling to normalise the ovaries. You can read about this at WWW.WWWW.WW This is useful for only for those PCO patients who have large ovaries ( as proven on ultrasound scanning ); increased ovarian stroma; and a high antral follicle count. For other patients, it can actually reduce fertility by reducing ovarian reserve

2. The results with Ayurvedic treatment are mixed. It is quite good for regularising the period, but whether it helps to improve fertility is uncertain.

3. I do not know much about Bangalore centers, sorry.

Hope I have answered all your queries. Let me know if you need any further clarifications.
Dr Malpani

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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