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What should I do for a follicle to achieve maturity ?

my question is for infertility . my pt have b/l pcos . marriage history 12 yrs. one time she conceived without medicine in 2nd year.2nd time she conceived about 5 yrs ago with hormonal therapy and clomifine. but both time she had miscarriage . after that she was on fertility drugs last year but not having any best size of follicle .she drop her treatment . from last august she was again on hormonal therapy for 3 months from me than 3 cycles on fertomid but having no result. periods are also not regular till now. this time i gave her letrozole from 3rd day with inj. FSH 75 iu on 7th means the 9 th day largest size of follicle in lt ovary is 9mm.i want to add this also that at 9th day this time only she reach upto 9 mm before this she only reached 6mm in 2 cycles. i also give 2nd inj. FSH 75 iu today. i m still confused.i call her the day after tomorrow for last inj.FSH and 2nd question is ,Is there any chance for follicle reach upto best size .?Should i increase the dose? and give it daily instead of alternate day? please send me ur opinion because i have only one day to take any decision. sorry i forgot that her test FSH,LF,S.PROLACTIN,S.INSULIN ARE NORMAL.and from august she is also taking metformin 500 mg tds.thanku
Asked On : Mon, 9 Apr 2012
Answers:  1 Views:  68
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OBGYN 's  Response
Hi Anita
Next time you can use clomiphene citrate 100 mg from day 2 of menses for 5 days with estrogen support and then start her on Inj.FSH 150 IU alternate day ( 3 times).Letrozole is banned nowadays.
Also start her on recent preparations containing myoinositol for better ovulation. if the size of follicle not increasing then consider surgical option like ovarian drilling.
best regards
Answered: Thu, 12 Apr 2012
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