Our expert says:
The ovulation testing kits depend on elevated LH levels and in some patients with severe PCOS, baseline LH levels may be indeed significantly elevated intermittently to give a positive pseudo-ovulation test. The approach to the problem may be to confirm a mid-luteal progesterone level in this particular instance i.e. 7 to 8 days after a positive ovulation test has been detected, a serum progesterone level should be done and if this level is in excess of 25 then one can assume adequate ovulation. Should levels be below that then the initial discussion holds. The approach to the treatment would be a phase of down-regulation using either oral contraceptives or progestins before commencing on an ovulation induction protocol together with follicular tracking by ultrasound scanning. Follicle tracking is by far the more superior method of monitoring ovarian response and ovulatory changes.
Answered by: Dr.M.I. Cassim
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