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Starting Back Fertility Therapy After Successful Pregnancy
By Sam Thatcher, MD, Ph.D.
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 Q. I have PCOS and we got pregnant using fertinex. My cycles seemed to become more stable after having our son, and we want to try again. Should we go right back to fertinex, or, since I seem to be have somewhat regular cycles, should we do something else? Time is an issue. I am 38 now.
A. I have two conflicting statements. The first is that I go back with what has worked in the past. Fertinex or Gonal-F would be a good place to start. The second is that with the new insulin altering drugs and possible some improvement in your ovarian function after pregnancy, you might take a less aggressive first step. Cycles tend to become more regular in PCOS between 35 and 45, but this is also a period of fertility decline. Your age is a concern and would cause me to be more aggressive. One of the first steps in your evaluation should be a FSH and Estradiol level on cycle day two or three.
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