Hi, and thanks for your medical question on eHealth forum
Chances of ectopics are very high when one takes Clomid. Hence if you have lower abdomen pain, and feel nauseated then an ultrasound should be repeated to rule out ectopics (though chances are less as you had an ultrasound the day earlier). Despite this Clomid should be stopped and PCOS treated first.
There are various approaches to treat a polycystic ovary. First of all insulin resistance has to be checked and corrected by a dose of metformin. Then regular check ups have to be scheduled and your wife put on low dose birth control pills to regularize her cycles first. Once this is corrected, regular ultrasounds will be done to assess the status of the ovum and accordingly drugs prescribed. At times laproscopy is done and cysts punctured.
Also the cysts can sometimes be painful and can get ruptured or twisted. They can also initiate an inflammatory process in the bowel. Hence it is difficult to say what exactly is the cause behind this pain.
However all this can be done only under a senior gynecologist or an infertility specialist.
It is difficult to comment beyond this at this stage. Take care!
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