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Is Clomid the last resort to get pregnant?

Q: I have PCOS. I have been taking Metformin and Clomid for 3 months now. I started with a progesterone level of 11.7, the next month it was 7.9, and last month it was 1.1. Last month, I took 2 Clomid pills for the 5-9 day cycle. This month the doctor is increasing my doses to 3 pills per day. My question is, if Clomid doesn't work, what are my chances of getting pregnant after Clomid? I have read that if Clomid doesn't work, then most drugs will not. Does this mean I will never be able to get pregnant?

A:Serum progesterone levels are different on different days. During the luteal phase the level can be 16-112 nmol/L while in the follicular phase the figures are below 16nmol/L. You have neither given the details of when the blood was taken nor the reference normal values which depends on the reagent used. Hence I am unable to comment on this part of your question. Clomid is the brand name; the name of medicine that it contains is called clomiphene citrate. Its use in PCOS is quite appropriate. The usual dose of clomphene is 50mg daily for 5 days beginning on the 5th day of the menstrual cycle for a maximum of 3 cycles. If ovulation does not occur after 1st course of 3 cycles, then the dose has to be increased to 100 mg daily for the 2nd course. There is no cause for getting worried at this stage. It is too early to write off clomiphene therapy. Your age is very much in your favour. There are other options available. It is not correct to say that if clomiphene does not yield results, then nothing else will do.

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