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DR PRABIR KUMAR DAS
DR PRABIR KUMAR DAS, CONSULTANT GYNAECOLOGIST
Category: OB GYN
Satisfied Customers: 1886
Experience:  MBBS(CAL)MD(G&O)
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I have PCOS and have been prescribed Clomid 100mg and Metformin.

Resolved Question:

Hi
I have PCOS and have been prescribed Clomid 100mg and Metformin. Despite long cycles (40+ days) I conceived in December 2014, which ended in miscarriage at 7 weeks. I was told to wait to see if i ovulate naturally. I waited for 5 weeks post miscarriage and hadn't ovulated so started to take Norethisterone 3 times a day as prescribed. After two days (Tues and Weds last week), i then had signs that i was ovulating (LH surge on ovulation test sticks). I stopped the Norethisterone (as advised) and tried to conceive. The LH surge lasted for three days (Thurs - saturday). On Monday, i started my period - which i gather is an induced bleed from the Norethisterone. I am now wondering if there is any chance that i could have conceived after stopping the Norethisterone? If not, i could take Clomid today, as prescribed - but i wouldn't want to take this if there is any chance that i could have conceived over the last few days.
Thanks!
Hazel
Submitted: 2 years ago.
Category: OB GYN
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Hello
I think you have misunderstood the treatment strategy.
Norethisterone (progesterone) was not given for ovulation. It is not ovulation induction drug.It was given to you for withdrawal bleeding.
When some one is having with amanorrhoea without being pregnant we start progesterone therapy for few days and after sudden withdrawn of the drug the endometrial lining support is lost and shedding occurred and bleeding starts.So you can understand there is no way ovulation during the course of norethisterone. It is give to start a new and fresh period. So you can start your clomid today.
Thank you
Customer: replied 2 years ago.

I am aware of this, however after taking the Norethisterone for 2 days it was apparent that I was ovulating. I was therefore advised to stop the Northethisterone (despite being prescribed to take it for 7 days) and try to conceive - which i did. It is my concern, therefore, that i could have conceived after stopping the Norethisterone as i would still potentially have the withdrawal bleed?

Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Thanks for your response.
As per you if you have conceived in any way after stopping norethisterone you will not start withdrawal bleeding.
I already mentioned it before that withdrawal bleeding is not possible by progesterone in a pregnant woman.
Am I clear?
Thanks
Customer: replied 2 years ago.

Is this the case despite ovulating on the Saturday and starting the period on the monday - as implantation of a fertilised egg would not have necessarily occurred prior to the bleed?

Can i assume that implantation cannot now occur since bleeding has commenced (despite it being progesterone-induced bleed)? Just want to be 100% sure that conception is not possible.

Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Thanks
It is just like a theoretical debate.
You want to say fertilization occurred but it has been terminated because of sudden progesterone withdrawn before implantation.YES it may happen.
DR PRABIR KUMAR DAS, CONSULTANT GYNAECOLOGIST
Category: OB GYN
Satisfied Customers: 1886
Experience: MBBS(CAL)MD(G&O)
DR PRABIR KUMAR DAS and other OB GYN Specialists are ready to help you
Customer: replied 2 years ago.

That's not what i want at all!

I want to make sure that it is not possible that i now have a fertilized egg that is about to implant and that could then be a viable pregnancy, despite being on my period??! If this is possible, then i would not want to take clomid, for obvious reasons.

Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
After your abortion you were not having with period for 5 weeks.but all of a sudden you ovulated after 5 weeks after the miscarry, It is mostly unlikely or never possible BUT possible because human body does not always follow the guide lines as per text book.So I said yes theoretically it is possible to ovulate after 5 weeks of abortion and after 2 days of ovulation (fertilization) another abortion (withdrawal bleeding) done by 2 days course of progesterone.This the concept for emergency contraception.But this withdrawal bleeding will be there if you were not pregnant or even pregnant.So how can one say whether you was conceived or not?

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