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Infertility Cubby

Are Fertility Drugs Necessary?
By Sam Thatcher, MD, Ph.D.

Sam Thatcher, MD, Ph.D.Q. I have a preliminary diagnosis of PCOS. I have read so many contradictory things about it, and nothing cheerful. I am wondering...is it possible/likely to get pregnant with PCOS without taking fertility drugs? I do not believe in them, but it seems that all the women I encounter with PCOS wind up using something like Clomid (which some sources say works and others say doesn't really) to get pregnant. And if it is, what would be a reasonable time frame? One year? Three?

A. First, I recommend that you have a "sit down" with a physician familiar with both PCOS and infertility to discuss options. This is usually a reproductive endocrinologist. It is very difficult to obtain a foundation of information about either fertility therapy or PCOS from a collection of life experiences. None of these individuals are you. There are excellent studies form Australia that suggest that those with PCOS who are also overweight have an excellent chance of establishing normal menstruation and pregnancy by lifestyle alterations alone. As little of a 10% decrease in body weight associated with a modest increase in physical activity may be all that it takes. Clomiphene is a good drug, but not a great drug. Of course some with say that it works and others will not because that is the truth. It is about 30% effective in establishment of pregnancy. The drug is a good first line therapy. It is relatively easy, safe, and cheap. The chance of twins is about 5%. Over 70% of pregnancies established on clomiphene are in the first 4 cycles of use.

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