No O on max dose of clomid where/what to next?

I'm asking this on behalf of a friend. My dear friend has been ttc on/off for many years (she is 26) Several years ago she found out she had PCOS. Anyway for the last 6months she has been on clomid (starting on 50mgs and the last month she tried 200mgs) anyway she has not ovulated on any of these cycles.

Just wanting to hear some stories to show her tomorrow from other who have been through the same thing or know of others who have. Her next FS appointment is just over a week away and she has no idea what they are going to suggest. Already they are preparing for IVF but hoping there is another stimulation drug that may help her to ovulate before going down that path.

Any advise I can pass on would be greatly appreciated.

My friend has an 8yr old son from a previous marriage and her new husband has had a SA which showed a good result.

I had no response on clomid... From there we went to FSH injections to help ovulate unfortunately I got OHSS, so from there I had ovarian drilling no luck and then went to IVF as it was the safest way cause of my OHSS...

Hope this helps, if you would like to know anything else feel free to pm me xx

From Clomid I went to IUI (superovulation). So, you inject to get follies growing then once they are a certain size, you trigger to release the egg then they do the AI (insert the sperm) then wait to see if AF shows up or not....

Do you know if her partner has any issues/been tested. B/c depending on that they may go to ISCI or straight to IVF.

Thank you both for your replies. I'll be chatting to her tomorrow and will probably have more questions. Rhichichi her DH has had 1 sperm analysis which showed a normal result. At this stage it is assumed annovulation is the only problem as the clomid has not helped achieved ovulation. My friend did go a number of years without a period and has had AF induced for all her cycles this year.

They will probably do the sperm analysis again through the IVF clinic. I know my DH had one when we did IUI and we were going to do IVF & they made him do another one.....

They may send your friend for a laparoscopy prior to the referral to the IVF clinic - they did that with me. I was on Clomid for 6 cycles then had a lap & dye study (which was all clear) then got referred to a FS, who suggested IUI.

GL to your friend

Yep, my next step was a FSH drug called puregon. For me I was ovulating on clomid but I had some severe side effects which wasn't productive. They often do puregon with IUI but you can use it and do timed DTD. Yes, I ended up on IVF but they gave me good chances with FSH but luck didn't go my way and I think the FSH and trigger injection made IVF seem easier as I already had the injections down pat.

Wishing your friend heaps of luck.

i'm another that moved from clomid (no response) to IUI.

the injectibles were a bit hit and miss to start with - the first cycle/s are experimental while they work out how your body responds - it may be a case of not responding at all, or over responding. there is an aim to make you ovulate, but due to the risks associated with higher order multiple births, some clinics will cancel a cycle if more than 2 follicles develop (mine allowed me three because of the history of miscarriage). they need to find the type of cycle that is most appropriate for her

she may be asked to go on the pill for a while before kicking off, if this is what they want to do
she may be asked to take a drug called synarel (nasal spray) or lucrin (injections) to put her into a drug induced menopausal state and give the FS total hormone control
it's hard to say for sure what they will do given she hasn't had AF naturally for quite some time


i had the ovarian drilling and associated Lap and studies before starting the clomid - if she hasn't already had this, it may be something they look at too

Update: I am extemely excited my friend has just got a BFP. Woot woot. Bub or bubs (there were 2 dominant follies at her midcycle scan) was conceived on a high dose of puregon as previous doses didn't help get the golden egg. FX everything goes smoothly and she will be enjoying newborn cuddles in approx 8months

Just saw this post! All the best for your friend x

Yay that's great mildez!!!

fantastic news!