Posted by: Anonymous | 2009-04-21

Increased clomid but no follicles

Dear doc,

I produced one follicle in my right ovary in my last cycle with 50mg clomid. This time I took 100mg fertomid &  it hasn' t had much effect one me. My right ovary hasn' t any follicles. I did have one follicle in my left ovary that was small. Doc said it is a very slow response.

When I was on the 50mg clomid, my right ovary produced a follicle early and I had the ovidrel by cd13 as doc said I would ovulate by cd14. Why is it that a larger dose has had very little effect on me? Why has my right ovary not even responded this time?

Would my next treatment be injectables, if 100mg fertomid has had no effect on me? Please advise. I am hoping to do IUI again this cycle &  hopefully the one follicle my left ovary has produced, will develop. I have also read on the infertility forum that some women have produced multiple follicles and have not fallen pregnant. Is it even worth doing IUI if I only produce one follicle, when women who produce 5 or 6 follicles don' t fall pregnant with IUI. Wouldn' t my chances of falling pregnant be very very much lower?

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Our expert says:
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Dear Anonymous

Due to the disruption in workdays there has been a delay in response to your question. We do apologise of any convenience caused.

The issue really is whether the need for Clomid is based on poor ovarian function in the first instance. Often this is detected by baseline blood tests, which suggest that the ovaries and the receptors are not fully functional and require ovulation induction. In other couple were the ovarian response is expected to be normal and healthy the indication for IUI may be based on male factor problems and hence the difference in the numbers of follicles seen between the two types of situations. In the poor ovarian responder such as yourself, the underlying failure may be secondary to poor egg quality and therefore poor embryo quality as apposed to the other situation were egg quality is not a factor. It is important therefore to discuss this in detail with your fertility specialist and it may well be necessary to proceed to injectables to enhance ovarian response and receptor functionality.

Answered by: Dr M.I. Cassim

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