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Infertility and clomiphene induction.

Resolved Question:

i am 25
my period day 2 results
fsh 4.9 mlu/ml
lh 4.2 mlu/ml
e2 14 ng/ml
tsh 1.8
amh 7.65 ng/ml

i have endometriosis and removed by lap / leaser
pcos / ovarian drilling

this month dr gave me
clomid 100 day 3 to 7
estradiol day 7 to 10
day 11 ultrasound shows 2 large cysts as my dr told me

my husband last semen analysis
sperm conc. 86 mil/ ml
vol 3 ml
sperm/ eja 259500000 mil
GII motility 0%
GIII motility 40%
normal morphology 23%

1/ why i got cysts after clomid ?
2/ what type these cysts ?
3/ what do you think afout my husband semen



Category: Infertility Specialist

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Category: Infertility Specialist
Dr. Aarti Vazirani is online now

Expert:  Dr. Aarti Vazirani replied 4 Days.

Hello,

Thanks for your consult at DoctorSpring.com.

Clomiphene ( clomid ) is given to induce the growth of the egg follicles in the ovary ( to artificially induce ovulation ).
It is common for clomiphene to cause hyperstimulation and enlargement of 1 - 2 follicles as a side effect, this might be the cause of the cysts.
Also, it could be a recurrence of your endometriotic cysts.

I need to know details, size and nature of the cysts as seen on ultrasound scan.
Only then can the exact type be known.

Your husband's semen analysis is fine, although the motility is a bit poor, however it is not a contraindication for pregnancy.
He can opt for IUI ( intra uterine insemination ) for best results, once you succeed in ovulating.
Next month should be a rest cycle for you till the cysts are managed.
Clomiphene induced cysts will subside, and endometriotic cysts might require removal.

Your husband should be assessed by an Andrologist for the cause for poor semen analysis - genetic, infections, blockages or hormone deficiencies.
Ask him to avoid smoking / drinking, to maintain an ideal weight , avoid exposure to hot tubs or baths, avoid tight undergarments and exercise regularly and eat healthy.

PS - The image is inconclusive.
Please upload the report of this scan please. That will be more helpful to me.

Hope this helps, would be glad to help you with any follow-ups.
Take care.


Patient replied :

my husband dr said , all hormones tests good for him , he is not smoking or drinking ,
,
,
for me there is no report about this scan ,
can you tell me type of my cyst ? i didnt have any endometriotic cyst before ?
how can i remove it ?


Expert:  Dr. Aarti Vazirani replied 3 Days.

Hello again,

The image seems to point towards cysts caused by ovarian hyperstimulation, most probably due to clomiphene use.
These are a known side effect, and not a cause for concern.
A month of oral contraceptive pills will help in resolving these cysts.

Hope this helps, please feel free to discuss further.


Patient replied :

i was on decapeptyl 11.25 mg after my lap , which stop my ovulation for 6 months , and this is my first period after decapeptyl which i use clomid ,
so this month there is no chance for pregnancy ?


Expert:  Dr. Aarti Vazirani replied 2 Days.

There are always chances of delayed ovulation even with clomiphene.
So please continue to remain sexually active.


Patient replied :

i mean is presence of cysts mean problem ?


Expert:  Dr. Aarti Vazirani replied 1 Day.

Yes, presence of cysts means that atleast right now, there is less chance of a follicle growing normally, and rupturing ( ovulation ).


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
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