Wednesday, July 6, 2011

Jamaican Woman Doing 1st IVF Confused About Meds: Possible PCOS Misdiagnosis


I am about to do my first ivf with a clinic and I got a lsit of medications that I will have to use/purchase. I am a litte uncertain about one of them - menopur. The list has over 40 vials of 75iu. I am certain that this is a mistake.

I will of course be asking the clinic but I wanted to be certain. I have had two iui - failed previously. one on clomid with three follicles gretaer than 10mm and one with menopur 150 with about 4 or 5 follicles. This is why I am uncertain about the quantity of menopur on the list.This medication represents the most expensive item on the list and I wouldn't want to order this many at once.

Again, I will be clarifying but I needed additional research/opinion. I have pcos and was diagnosed with endo, had a laporoscopy, ovarian drilling, suppression after lap etc etc

Thank you. KL from Jamaica


Hello KL from Jamaica,

I cannot tell you if this is the right dose or not because it depends on the protocol your doctor has you on. But I can make the following comments:

1. PCOS patients tend to be very sensitive to medication and therefore require less medication to stimulate. For that reason alone, I would be skeptical, as you are, of the amount of medication ordered.

2. Menopur is NOT a good medication for PCO patients (if that is a correct diagnosis) because PCO patients already tend to have an increase LH level and the additional LH in Menopur is not needed and will lead to the risk of ovarian hyperstimulation syndrome (OHSS). I will usually either use only Follistim or will use a very low dose of Menopur less than or equal to 75IU. However, given that you only had 4-5 follicles with Menopur 150IU before, I wonder if maybe the PCO diagnosis is not correct?

You definitely need to ask your doctor regarding these concerns.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.


  1. i had one failed ivf procedure i am diabetic and age 40 planning to try again, i planted 2 embryos but on day 10 i started to bleed do you think i should have bed rest after the transfer

  2. Hello,

    I generally do not recommend bedrest but do recommend sedate activity, which means very light activity. I call it "couch potato" rest, which is an american term for just sit on the couch and watch tv. Studies have shown that bedrest is of no benefit. Bleeding is very common in early pregnancy and after IVF so it may or may not be bad. Look at my blog post on "Bleeding after Embryo Transfer" and you will see just how common it is.

    Good Luck

  3. I have infertility probs what drug may increase my chance of being fertile.?

    1. There is a host of medications that are used in patients with PCOS. The main medications are ones that are used to get the ovary to function correctly and ovulate such as Clomid, Femara, Follistim, Gonal-f, etc. Others, that are used in some, but not all, PCOS patients include Metformin. You must consult a doctor that knows how to treat PCOS patients to obtaine the best and proper care.



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