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I took Clomid after I had routine blood work and my DH had an SA done up by my family doctor (wasn't seeing an RE yet). That blood work showed I was hypothyroid, so he first put me on Synthroid to see if my cycles would appear (This was during my 140 day long cycle). After 3 months they hadn't, so he prescribed Clomid. After my first Clomid cycle (where I actually did O and get a period) I started seeing my RE who did much more indepth tests (HSG, Uterine Biopsy, AMH and ultrasounds. He eventually diagnosed PCOS).

I never actually did a medicated cycle for my PCOS, but the plan with my RE was monitoring + Clomid + timed intercourse. After a few cycles of that we would have started IUIs. I don't know if there really is another treatment "directly" for PCOS besides diet and Metformin.

I guess it wouldn't hurt to get an HSG and an SA done at least. That'll rule out any problems with your tubes or your partner's swimmers.

My ob did blood testing to check for indicators of pcos (which i don't have) and dh had a SA done. Since i wasn't ovulating my ob prescribed clomid. I was on month 10 of ttc. The first round did cause me to ovulate, so we kept the dose the same. I got pregnant on my 3rd clomid cycle on the lowest dose. If the clomid hadn't been successful at causing me to ovulate she would have referred me to an RE and we would have gone from there.

@MrsBrewer: I had diagnostic testing to determine the cause of our infertility. For me that meant an HSG, blood work, and a glucose test.

@MrsBrewer: I'm in the same boat. Diagnosed in July. How long have you been on Metformin?

My OB wants CD3 bloodwork (done and normal), an ultrasound (also done), and SA before Clomid. She said she'd start as soon as we're ready (if we want to go that route). I was more like you and was skeptical as Clomid is not really the answer. But apparently after Metformin and diet/exercise, Clomid is the first line treatment as there's no other "cure" to get the hormones working right/together. DH and I decided to give the Metformin 6 months, go low glycemic, and add structured exercise in before moving to Clomid just so we felt like we had done our part.

@MrsBrewer: Monitoring is really important for women who already ovulate regularly and who are using drugs to induce "superovulation" to make sure that clomiphene (or letrazole) doesn't result in hyperstimulation or in too many mature follicles (and unacceptable risk for a triplet or more multiple pregnancy).

For women who don't ovulate at all or only do so rarely on their own, some OBs and REs still really like to do monitoring, many don't. Basically, you'll find out that it worked to induce ovulation because either you'll get pregnant (woot!), or, you'll menstruate on your own (no provera needed!) within 35 days of the start of your last period. If neither of those things happens, you still didn't ovulate, and they may bump you up to a higher dose of clomid.

For women who don't ovulate on their own there's minimal risk of clomid resulting in more than a couple mature follicles unless your provider does something really whacky like starting you at the highest dose rather than the lowest dose. So, minimal gains from monitoring from the standpoint of preventing higher order multiples.

@lilyofthewest: this makes so much sense! I had been worried about going on clomid again since my ob doesnt do ultrasound monitoring (only day 21 bloodwork to confirm ovulation). We ended up not needing it for baby 2, but i feel better about it now anyway!

I have PCOS too. I had CD3 blood work, DH had SA and I had an HSG. FX this works for you!!!

@MrsBrewer: I definitely don't think it hurts to at least mention it, and get your OB's opinion. It's a hard decision, especially when you have a doctor that you know and trust. One thing I have learned through this 3 year process is that I have really had to step up and be my own advocate. That scares me a lot, but I've learned the hard way that it needs to happen. FX that Clomid works well for you!!!

@MrsBrewer: I was in your boat. Knew before meeting my DH that I had ovulation issues. Started TTC in January 2012, spoke to my OB in April because I hadn't ovulated, she wanted to do Clomid with no monitoring and no IUIs on the weekends. Met with my RE in May 2012 and he diagnosed me as "on the cusp" of PCOS. Clomid cycle in July with two IUIs but got a . RE recommended IVF due to husband's low washed numbers. IVF in September 2012. LO born in June 2013. I'm so glad I didn't wait to see my RE.

ETA - I was 28 when we first saw the RE. 29 during IVF. Turned 30 less a month after giving birth.

@MrsBrewer: Wow! You've gotten lots of feedback already! I don't have anything to add, except that I did (and would recommend to) have an HSG before starting any meds. You don't want to waste your time, money, energy, etc if your tubes are blocked. As an added bonus, you may increase your chances of conception for the first few cycles after HSG! And I second monitoring with the Clomid...some people tolerate it poorly...and it is possible to develop cysts, thinning of the uterine lining, etc. Good luck!

I would just tell your doctor you're concerned about taking Clomid without monitoring. Educating yourself on how Clomid is typically administered is nothing to be ashamed of.

But I would strongly encourage you to seek out an RE and not bother with an OB. Most OBs are not equipped to do the type of monitoring that is needed, nor are the educated in the way an RE is. I have PCOS and it turns out I am also Clomid resistant. Due to that my first BFP was a chemical pregnancy (took so long to respond the egg quality was bad), and then I stopped responding all together the 2nd cycle. Without monitoring I probably would've wasted months of my time.

Ok so, my doctor gave me Clomid before testing a whole lot, but her point was: we KNOW you're not ovulating, so let's fix that first.
The only thing she gave me was a HSG. I wanna say she checked my egg count too but I can't be 100%.
I was already on metformin.
We later found out about my semi-misshapened uterus and my thyroid levels. DH has since has his SA as well (all clear).

@MrsBrewer: honestly? I kind of regret it because it gave me false hope. Yes, I started ovulating, but my thyroid levels were still so insanely out of whack, that I would've (and didn't) have gotten pregnant anyway. So, I do wish she would have done it all at once, but oh well. Life goes on. I'm with a RE now and he does things very thoroughly.