Hello, I would be happy to help you with your question.

I have a couple of questions for you first:
1. Were your cycles irregular before May, or is this a new problem?
2. Are you doing anything to track whether or not you are ovulating?
3. How long have you been trying to get pregnant?

Thank you.

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Thank you for the followup information!

Based on what you are describing, you do not ovulate regularly. This is typical of patients with PCOS. This is a condition associated with insulin resistance, elevated androgen hormone levels, and irregular cycles. Patients often come to the doctor with abnormal bleeding, infertility, and coarse hair growth on their face and belly. If you perform an ultrasound, the ovaries have a polycystic appearance because of the lack of ovulation.

Typically, the strategy for someone like you would be:
1. Make sure there is not some other cause of non-ovulation - you testing for thyroid disease, diabetes, and prolactin levels
2. Most women with PCOS benefit from a medication called Clomid + metformin for induction of ovulation
3. Finally, you can buy an over-the-counter kit for tracking ovulation - it is a simple urine test.

Finally, it is not unusual for couples to take up to a year to conceive. So the fact that you have been trying for only 4 months is more reassuring than it is discouraging.

Let me know if this helps!

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Talk with your doctor, but the typical doses would be:

1. Clomid 50 mg per day for 5 days, on cycle days 5-9
2. Metformin 500mg twice daily

These are considered safe medications while attempting pregnancy. Once you are pregnant, your doctor will likely have you stop the metformin. The other medication that you are mentioning would not be appropriate while you are trying to get pregnant.

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If you count the first day of your period (of normal flow) as cycle day #1, then you would take the clomid starting on the evening of cycle day #5. You would take it the same time every night for 5 days - i.e. cycle days 5-9.

You would start this medication on day 5 even if your period had not ended.

I hope that this answers your questions.

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Yes, the metformin is taken daily regardless of what day of your cycle it is - i.e. it is taken continuously. The Clomid is JUST taken on days 5-9 of your cycle.

Thank you.

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Typically in patients who are trying to get pregnant, they would take the metformin until they are pregnant, and then stop. The clomid should be used for 3 cycles and if unsuccessful in getting pregnant, you should then seek the help of an infertility specialist.

Good luck!

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