Low Response to Clomid - Questions

TTCBabyJ

I am so disappointed this morning. It seemed like this was the perfect iui cycle 4 promising follicles on cd 12 and better sperm count post wash. But when I got a positive opk on cd 16 I was wondering if that was enough time for those follicles to mature, and I guess it wasn't enough time. I got my 7dpo progestrone results this morning at it was an astonishing 5.75. I am shocked I took 100 mg of clomid from cd 3-7. Last month I took the same dosage and it was 13. I've had higher numbers on unmedicated cycles...so frustrating. So what is the next step injectibles? Could my RE add a trigger shot to the clomid drug regimen? I know the trigger will make ovulation more precise but how does the trigger stop you from ovulating prematurely which is what I think I'm doing. I'm just really getting so frustrated with this whole process, I'm definitely taking a cycle off next month.

TTCBabyJ

bump

masterofallcheese

Not sure what you should do but ((hugs)) and good luck! Have you talked to a nurse? Maybe they can provide some insight.

AnnaClaire256

What size were your follies CD12? Did they not do a repeat u/s?

TTCBabyJ

@annaclaire256 On CD 12 I had one leading follie at 15.7 mm, and three others that were around 12mm. My RE did not do another u/s on the day of u/s she said it wasn't necessary. I have an HMO and I'm starting to feel the lower class treatment.

Pintobean39

I've never taken clomid so I'm just guessing but I think the extra 4 days you had until you got a positive OPK would have been enough have at least the 15 be mature.

Are you on progesterone support? I would ask your RE if this cycle ends in a BFN if progesterone could be given for the 2WW and for a trigger. The trigger just makes timing better. I'm not sure if it stops you from premature ovulation. I only did injection with ganarelix to stop premature ovulation.

Good luck!

AnnaClaire256

I'm sorry she didn't follow up with you more. It must be incredibly frustrating to not get a full picture of what's going on. Your 15mm follie definitely had a shot but 5.75 sounds like a fairly weak ovulation.

My first u/s is usually CD10 and (if not ready to trigger) I go back CD12 and sometimes CD14 until they're fully mature. I wouldn't think moving on to injectables right away would be best if you're still responding to clomid.

Sorry I'm not more help. I hope your doctor can come up with a plan that will make you feel more comfortable.

TTCBabyJ

@annaclaire256 Thank you so much for the information. I am really not familiar with trigger shots so please excuse my ignorance in advance. So if you have an LH surge and then you wait to let the follicles mature and use a trigger, what stops the follicle from being released on its own? I guess I'm just confused on how a trigger shot works.

@pintobean39 unfortunately I'm not on progesterone support, my RE argued me down that I did not need it this cycle.....looks like she was wrong!

LindseyM2012

I don't have much input, but I'm sending good thoughts your way.

AnnaClaire256

@TTCBabyJ‌
Once your follies are mature (my RE ideally wants to see 22mm but will trigger at 18mm) you're given the HCG trigger shot and will ovulate 36-38 hrs later. I don't have to use OPKs to detect a surge because the u/s give me a clear timeline.

I did go in once on CD12 with a follie that wasn't quite ready and was told to come back CD14. When I went in, I had already ovulated on my own. Since we don't have any MFI issues, we just BD daily between scans to cover our bases!

ETA: clarity

TTCBabyJ

Thank you guys so much for the support and information. There is just sooooo much to learn in this 3T journey. I feel like I should write a book after this....but only if there is a happy ending.

brijen44

It will be a happy ending the journey is just taking a little longer

BunnyBerry

Do you think based on this experience, if you don't get a BFP, you can firmly request a day-of ultrasound to make sure? But I'd say there's no guarantee that the follie didn't mature or your progresterone won't increase this cycle.

I have heard that a trigger shot works by stimulating a burst of maturity in the egg. 

Glad you are taking a cycle off since you are feeling overwhelmed. Sounds like it would make sense to have an RE consult about injects if you are not feeling confident in the IUI protocol.

TTCBabyJ

@BunnyBerry‌ you are very right...first off if this cycle is a BFN I think this definitely proof that I need progestrone support and second I'm still trying to hold out hope to finish the rest of this cycle. But after 18 months of trying I need a break. As always ladies thank you for your knowledge and support.