What I did today... Dr Phil Boyle Fertility Doctor
'TODAY I saw a woman in her late twenties, who presented with primary infertility, which means she has never conceived before. She and her husband have been trying to conceive since March 2009.
"She has been diagnosed with polycystic ovaries, a condition which can make it more difficult for women to conceive.
"In her case it caused long, irregular menstrual cycles -- she would get one bleed approximately every three months, which is just four menstrual periods a year.
"The woman had discontinued her contraception pill in March 2009 and tried a tablet called Glucophage, which is a diabetic tablet recommended for this condition. Unfortunately she could not tolerate its side-effects.
"I did an ultrasound examination which confirmed a classic case of polycystic ovaries, and recommended a natural progesterone called Cyclogest.
"I advised her to take this for 10 nights to boost her progesterone levels and induce a bleed.
"I also recommended a low-carbohydrate diet and supplements such as folic acid. I took blood samples to investigate the presence of food intolerance -- we find food intolerance can affect about 50pc of the patients we see with polycystic ovaries.
"The main hormone treatment is taken on the third day of the menstrual period -- we give the patient medication to stimulate ovulation.
"I told the woman that she would also need to attend one of our specialised teachers to learn how to track her fertility cycle -- this is critical to treatment. There is a lot of detail required for this charting. The patient will document her responses to treatment and record her bleeding patterns, mucus flow and the day of ovulation.
"Most importantly, she will get a blood sample seven days after ovulation. This blood sample will measure progesterone and oestrogen levels.
"She will call me with that blood result and if the bloods are within the normal range, it means she is ovulating well. Otherwise we will need to adjust her medication.
"Ultrasound follicle tracking will be carried out during the first cycle to get proof that all is happening as it should.
"That is the beauty of this system -- there are a lot of checks and balances: mucus flow, bleeding patterns, timing of ovulation, blood test results and ultrasound. All of these things come together to determine whether we have achieved optimum conditions for conception.
"The most important thing after that is that the couple don't 'try' to get pregnant -- they should take a light-hearted approach and not get stressed around conception, allowing it to happen rather than trying to make it happen.
"When people try too hard they often don't conceive. It can take up to 12 months for conception to occur.
"This treatment is particularly effective for patients like this woman who are young and who have not been trying for too long. We would expect a 70pc success rate with patients like this."
n Phil Boyle is director of Fertility Care in the Galway Clinic
Www.fertilitycare.net
- Ailin Quinlan
Irish Independent
