Not able to conceive. having PCOS history.

Patient

Q: I am 28 years old married woman trying to conceive for past 2 years. I am diagnosed with PCOS for past 5 years.
LH:9.9
FSH:4.85
AMH:11.18
TSH:2.83
Serum Analysis: OK but having some pus cells b/w 40-50 /hpf
HSG Test : Negative

Doctor is currently giving me Metformin 1750 mg, folvite, Fineova, Thyronorm 75 daily to conceive. I am doing ovulation study and ovulation is happening each month.Now I have regular periods and taken 1 cycle of Fertomid and 3 cycles of Fineova but not able to conceive. My doctor has also advised me to take My- DHEA but I am skeptical about it. She is not giving me any medicine to support the pregnancy , if this is happening.
Could you please guide me if I am going through correct treatment. Also need to know that pus cells detected in serum analysis will hamper in pregnancy probability. Also, can I take ovacare or oosure with the above medications.

Symptoms:  Infertillity ,PCOS
Doctor

A:   Hi,
Thanks for the query.

I understand your concern.
PCOS presents with irregular periods, anovulation, insulin resistance, excess androgen etc features.
Metformin helps in increasing insulin sensitivity.
Fertomid helps in ovulation induction. Fineova contains Tamoxifen, it said to help in release of the ovum.
According to studies, DHEA improves ovarian function, increases pregnancy chances in general.
But usually it is not recommended in PCOS, as one of the feature of PCOS is androgen excess, which may become worse with intake of DHEA.
Ovacare etc contains vitamins and minerals, which can help in infertility.
Infection leading pus cells in semen should be treated to increase the chances of pregnancy.

Hope this helps.
Take care.

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