Hi,
My partner and I each have a child from a previously relationship ( both took no trouble conceiving )
However we have been TTC for 3 years nearly with only one missed miscarriage 18 months ago to show for it. A year ago I was diagnosed with PCOS, and then in March we were told he had low sperm, 76% were non motile.
I've just finished 3 rounds of clomid, each higher than the last dose and they have failed to make me ovulate.
I don't ovulate on my own. They have called us back in next week rather than after 6 months and I am worried about what comes next.
I know that we are not entitled to IVF on the NHS, but what else can we be offered, and at what point will they say " No you have to go and pay for IVF we can't help you anymore"?
I am overweight, BMI of 29, but struggle to lose any weight unless I eat less than 800 calories a day, if I eat 1000 calories a day I stabilize?! What can I do to help me lose weight? I've heard of metformin but don't know if it will be an option for us.
Feeling very desperate, what are our chances of having a baby with all this and also low progesterone, within the next 1-2years? I'm feeling very depressed and upset about it all.
Many thanks for sharing your case with us. I will try to address all the points and questions raised in your email.
The main problem related to the fertility of those women diagnosed with PCO is the lack of ovulation. Since without ovulation no conception can occur, the treatment is aimed at trying to make ovulation happen.
Sometimes weight loss is enough to restart spontaneous ovulation, although we are fully aware of how difficult it can be. I encourage you to seek specialized medical attention from an expert in the field of weight loss.
In spite of the fact that METFORMIN may be useful, please note that this is only true for those cases in which there is resistance to insulin. This resistance can be screened for by means of a blood test.
If no ovulation takes place after the use of CLOMIFEN and METFORMIN (in the case that it has been proven the existence of resistance to insulin), the next step for you would be to try to prompt ovulation with GONADOTROPINS. This treatment should be done under the supervision of an expert in Assisted Reproduction.
Nevertheless, we cannot forget about the presence of low mobility in the sperm sample. If this result is due to a single sample, I’d recommend you partner to repeat the sperm test so that another seminogram can be carried out. Please note that in order to reach a diagnosis two sperm assessments are required.
I shall also point out that it is highly recommended that when he does the new seminogram a total mobile sperm count (MSC) is also carried out. Otherwise, if a minimum number of sperm is not found, the chances of attaining a spontaneous pregnancy would be low and in that case it would be advised to resort to an In Vitro Fertilization Treatment.
I hope to have answered all your doubts.
Kind regards,
Dr.Marta Trullenque