Dear Midwife,
I just turned 30. I was diagnosed with PCOS approximately 1 1/2 yr ago. We have been trying for about a year to get pregnant but with no success.

What are my options for fertility drugs? And what is my next step? My next doctor's apt is not until June.


I couldn't say in your particular case. I usually try metformin first, and then add clomiphene before I refer for the heavy-duty fertility drugs.

Losing as little as 10 pounds (never mind 20) can also improve your chances. You should also check to make sure your partner's sperm count is normal. So a candid talk with your doctor is in order.

-- Cynthia, CNM. PhD.

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Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.