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PCOS, taking Duphaston, second IVF cycle. Why are periods not starting? Advise on options.

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Practicing since : 1990
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Dear Doctor,
I am currently waiting to start my second IVF with ICSI . I have PCOS so my cycles are long (around 40 days)and my doctor gave me duphaston to take on days 16-26 of my cycle so that we could programme the dates to begin the injections. I took the duphaston as instructed but I am now on day 37 of my cycle and my period has not come. Although we have been having unprotected intercourse from day 7 through to day 27 of cycle I know there is no way I can be pregnant as my husband has only 20% mobile sperm (A grade) and a low count and combined with my PCOS they said it will be impossible to conceive naturally. I took the duphaston before my last IVF attempt in XXXXXXX and it worked perfectly so dont understand why it hasnt worked now. I am desperate to get started again and it is so frustrating waiting for my period. Please advise what are my options. Many thanks
Posted Fri, 4 May 2012 in Infertility Problem
Answered by Dr. Chetna Jain 4 hours later
Thanks for posting your query.

Pregnancy is always a first thing to rule out. so, I would suggest you to do a urine pregnancy test with first morning sample urgently. With less count and sperm motility also you may be pregnant.
If the test is negative repeat it after 3 days.

If still negative, you have 2 options one is to wait for another 1 week, second is to take a combination of estrogen and preogeserone pills under guidance of your treating Gynecologist for a week then stop and wait for withdrawl bleed to occur.

Its best to take a down regulation protocol for induction of ovulation. Egg pickup should be done when you get more follicles reaching 20-22 mm.

If you let few initial ones go for a better crop later will yield better results.

Since you have PCO, you are likely to have more egg formation and if so they can be stored for future use.

Hope, this answers your query. I will be available for follow up queries.

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