<s>[INST] Hello Dr good afternoon,we are planning for pregnanacy, MY Wife is havig pcod and completed metformin regimen then we go for ovulation induction ,our doc prescribe inj fsh on 7,9,11&13 th day of cycle from seventh day onwards we are taking for usg for follicular study but  till 13 th day there is no dominent follicle and endometrial is about 6.6 mm ,but now doc advised to take tab alivher for 5 days.we are so confused what we can do? [/INST] HelloThanks for your query.Alivher contains sildanefil.It is given to increase blood flow to the uterus , in order to try and increase the thickness of the lining of the uterus.It is common for women with PCOD to have anovulation .However, if there is no response to gonadotropin injections, that is a troublesome concern.The next step would be a few more cycles of ovulation induction, and if there is no response to stimulation then, then consider IVF .Reduce stress levels and keep weight in check.Take care. </s>