TTC After a Loss

Clomid question from a thankful lurker

Hey Ladies! I get so much inspiration and support from you ladies even from the sidelines. I am going to start Clomid this cycle and am going to have a sit down with my OB tomorrow and just want to make sure that I am prepared and have the right questions to ask.

A little history on me. I am 31 and have only had on pregnancy in the almost two years that my husband and I have been trying. I had a pretty normal pregnancy until almost 16 weeks when I went in for a routine visit and found that my baby had no heartbeat.

I had an extensive myomectomy one year prior to my pregnancy to remove large uterine fibroids and during all the prep work for my surgery, an MRI revealed that I had a Bicornuate Uterus. I was told that this uterine anomoly was the best of all the anomolies to have because pregnancy outcomes are good. Once I had my miscarriage,  I went for further testing and found out that actually had a septate uterus instead of a bicornuate uterus and had a hysteroscopy to remove my septum in December of 2011. Folowing my surgery I had an HSG to determine whether the surgery was successful and thank goodness it was. No  more septum and MH and I were given the green light to TTC in February.

At my annual GYN visit a couple of weeks ago, my OB asked how things were going and I told him that my cycles prior to my surgery and after have been very irregular and I have been temping and using OPK's and have never had a temp shift or positve OPK. I had CD21 blood work to see if I had infact ovulated and my progesterone came back negative.

He said he would like to give me Provera to jump start my cycle and start me on Clomid to see if he can get a "better ovulation". I am aware that I should be closely monitered while taking Clomid and he is all for it but I just want to make sure that I have all my ducks in row....if you know what I mean.

I know that I need monitering U/S to check for cysts, uterine lining, and hyperstimulation. When did you have your first U/S and did you get more than one? I know that I should continue to temp and do my OPK's as well.

I am sorry this post got so long but I would appreciate any advice or information you can give me. I really appreciate it!!

 

Re: Clomid question from a thankful lurker

  • I am so sorry for your loss and for the hard road you have already traveled!

    They should do a baseline u/s to make sure you don't have any cysts and to look at your lining to see if you need estrogen as a thickener. I got them with my medicated IUI every couple of days along with bw to look at FSH and E2 levels, however, I have not used clomid specifically so I am not sure if this time line matches up to that drug, but I don't think there is such a thing as "over monitoring". I say the more the better!

    Welcome to the board and I wish you luck!

    Me: 37 DH: 40 TTC since 9/09
    #1 BFP 1/10/11; missed m/c discovered 7w5d
    IF Dx: Endo, hetero MTHFR mutation, poor morphology
    #1 IUI: 1/18/12 = BFN
    #1 IVF/ICSI 4/2/12 = 2 x 7-cell and 1 x 5-cell transferred (3dt) = BFP!!
    H was born at 41w2d on 12/29/12 - be still my heart!
    #2 IVF/ICSI 1/19/14 = 2 x 8 cells transferred (3dt) = BFP!! EDD 10/09/14
    M&W born at 37 weeks on 9/18/14 - I am the momma of 3 boys!!!

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  • I'm so sorry that you've had such a bumpy road on the way to having children.  I'm very sorry for your loss and am glad you've found comfort here. 

    Regarding Clomid, the most important is monitoring.  First is a baseline on CD2 or 3 to ensure there are no cysts.  Then, you should return on CD10 to monitor follicle development.  After that, you should expect an ultrasound every few days.  A mature follicle is between 18-22mm and you should be monitored until that point as well to monitor for too many follicles.  At each of these ultrasounds, they should also be measuring your uterine lining thickness.  Ideal is between 8 and 12. 

    I've taken Clomid CD3-7.  I've also always taken it at night to hopefully sleep through the side effects.  However, it affects each person differently.  For me, I have hot flashes and insomnia, but don't have any issues with mood swings, etc. 

    One last thing - you mentioned CD21 day bloodwork.  That bloodwork is only accurate if you ovulate on CD14.  It really should be 7dpo bloodwork, but if you're not ovulating, that's impossible anyway. 

    GL with the Clomid and I hope your rainbow baby will be in your life very soon!

    After 22 months TTC and the loss of our identical twins at 10w6d, we're excited about our rainbow baby!
    Stick, baby, Stick!
    Beta #1 (12dpo): 38.3; Beta #2 (15dpo): 202.7
    Baby Girl born 1/17/13
  • Thank you so much for the information! I feel more prepared now:)

     

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