Question 26. If I don’t have either PCOS or POF, then what is my problem and why am I not ovulating?

Some patients really do stick in your mind long after they have left the practice. A couple of years ago we had a patient who had absent periods and had failed to respond to clomid or gonadotropin injections. She had been told by another RE that she needed donor egg and there was no reason to think that she would ever respond to fertility drugs. Now it is pretty uncommon to find yourself in the position of talking a patient out of donor egg IVF...but that is exactly what Dr D had to do. The patient consented to a final go at fertility drugs. But...

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Question 25. I have PCOS and am still not having normal cycles with metformin. What comes next

PCOS is not at all an uncommon problem in our fertility practice. Although many OB GYN physicians advertise that they treat infertility, some really do not approach this common problem in a logical way. Instead, they give the patient a prescription for metformin or clomid and push the patient out the door. However, I still believe that having a logical plan is very important. My wife finds this hard to believe because according to her I am constantly flying by the seat of my pants. But that is my little secret and gets me off the hook for being...

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Question 24. If I have PCOS, why do I need to take metformin? Isn’t that a drug for diabetics?

I must admit that I am just running on fumes today. I was in Boston yesterday so that I could visit Mom and try to raise her spirits a bit. It is tough to get old but as my Grandmother always said "it beats the alternative." Unfortunately, her poor health over these past few months has prevented her from going on the internet and I hate to ask my Dad to download these posts as he tends to get very frustrated at times with the download/print/share sequence. That means that there are now only 3 people reading this blog....So what does any of this...

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Question 23. What is polycystic ovarian syndrome? Where does it come from and how is it treated?

So after a weekend off I found myself completely swamped this morning. How 48 hours can make such a difference is beyond me. Following two egg I rushed out to Reston and then back again. Traffic was so bad this morning that I canceled my Monday morning lecture to the residents and medical students. Too bad for them because it was supposed to be on PCOS. This is the one topic in RE that they should fully understand because it is so common. Yet, week after week I get blank stares and incomplete answers to my questions. At first I though that they...

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