Failure of Clomiphen citrate or Letrozole to achieve pregancy -The couples mental reactions and disappointment

·         Some dilemmas pertaining to CC induction. :-

·         Problem 1:-Tell us, doc , why?? Why this time too there was no pregancy after  CC cycle / letrozole cycle as was suggested by you :  : If CC fails in a cycle,  before the doctor plans for  next cycle the couple will keep questioning.  What was the problem in  the previous cycle , doctor -They will keep questioning?? – What is the way out then to avoid such an unpleasant situation at your clinic ,particularly if it happens in presence of your staffer other patients. Ans:-Our commitment is to counsel the couple about probable cause/ causes of CC resistance or failure.  Admittedly almost all of us are facing daily CC failure cases or say CC resistance cases. The couple demands and expects we should personally face and explain the couple about the cause of CC  failure or resistance . We are answerable to them and advice and counsel (though U arte hungry by that time to next course of action. They like to listen from you only not from your counselor or secretary. They become disappointed irrespective of female partner’s age or yrs of tine and cause of anovulation .They now through internet are aware of Types of Anovulation but them what they don’t understand diff kinds of WHO Type II anovulation and how difficult it is to establish the cause of anovulation. . We know this type of anovulation come under the broad heading of HPO dysfunction which may be due to diff kind’s minor hormonal abnormalities.

·         It is my observation they chase the clinician  when clinician  is tired and when you are very hungry at the end of clinic hours  .They won’t leave your clinic unless U personally explain the etiology of failure in that  induction cycle, however low cost induction  it may be. They come with great hopes in each month of treatment cycle when they are prescribed fertility enhancing drugs more so if the  said cycle was monitored by Foll monitoring(TVS-3/4 times per cycle) pr and rarely day 9 LH etc also. We can’t run away by the back door of clinic when challenged by the couple!!

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