TTC After a Loss

Clomid users - past & present - thin lining?

I'm feeling really conflicted. I live in Canada and 'normally' you don't see an OB until you've had 3 losses. I got to see one because I was referred prior to my BFP because of the length of time that had passed TTC.
The OB prescribed 6 months of Clomid (50mg CD5-9) as I was having short cycles and short LPs. He didn't do any testing and told me he didn't need to see me back until I got a BFP or the 6 months had passed. I'm told he's the best OB in the area and I should be lucky to see him so switching isn't an option.
I've completed 2 full cycles on Clomid so far and AF is getting shorter and lighter (only 3 days, then 2 days last cycle). The cycles except for the length of AF have been picture perfect. Nice BBT and length, definite O, no symptoms from Clomid.
I have a feeling that my lining must be getting thinner. I wish I could just have tests done. I do have an aptmt with my GP in 2 weeks and I will run it by him then.
In the meantime do you have any thoughts on skipping one cycle of Clomid? In the case where you had a thin lining what was recommended? I don't see any 'harm' in it but at the same time don't want to slow the process. It just seems like most people are only recommended 3 months of Clomid as it seems to have a bad effect on your body after a while. Any thoughts/experiences would be great. (Sorry for the long post)

Lilypie Angel and Memorial tickers

BFP#1 Oct/19/13, EDD June/27/14, MC began Dec/4/13 at 10w5d, sac measured 6w1d - blighted ovum, Misoprostol Dec/13/13 - nothing, bleeding, slow declining HCG, D&C Feb/6/14, HCG <1 Feb/18/14

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Re: Clomid users - past &amp; present - thin lining?

  • buggirl72buggirl72 member
    edited August 2014
    OP, I'm sorry for your losses.

    My understanding from the other Canadian ladies on this board is that the monitoring that is given in the US (multiple ultrasounds during a clomid cycle) just is not an option there (depending on where OP lives).

    My biggest concern is that your OB put you on clomid without doing any testing whatsoever.  Without any indication as to why you had your previous loss, Clomid is not necessarily the best treatment. For example, if your losses are being caused by a genetic issue that either you or your H has, clomid will not "fix" that. You have also had only one loss - odds are in your favor that this was a fluke.  Other issues that should be looked at before turning to fertility meds are making sure that your tubes are clear, your ute is fine, and that your H has had an S/A. 

    PP (and you) are correct that clomid can cause fertility issues.  Thinning of the uterine lining is one known side effect and, because of the length of clomid's half-life, it can get worse cycle after cycle.  I think taking a cycle off is a good idea for you to talk with your GP about your concerns and making sure you understand all of the risks. 

    @gscoville was faced with the same choice as you and I'm paging her to this thread so she can give you her input, what testing her GP/OB was willing to do pre-clomid and what they did while she was on clomid.

    ETA - to clarify

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  • I second wicked. I know of the three in my city all three you don't need referrals; I'm located in ontario. If your OB is concerned enough you need fertility medication I believe it's concern enough to see an RE for an opinion and proper testing.

    I understand how easy it is to agree to do anything to increase your chances but the risks are very real and if you head over to tttc there are many previous posts of pp who unfortunately had extreme side effects from Unmonitored clomid.

    ((Hugs)).

    EDD 5/2/14, NMC 9/11/13
    EDD 10/15/14, CP 2/8/14

    IF Diagnosis: PCOS, MFI 

    Current Cycle: 5 mg Femara/1000mg Metformin + TI = BFP, EDD 4/23/15 Please be our RAINBOW

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    **ALL AL/IF Welcome**
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  • Thanks for the thoughtful responses! I hate to go against Dr's orders but it just doesn't seem right. I've waited a long time already; a little longer to make sure I'm safe won't hurt a bit.
    @mlal78 & @TVLily I'm in ON too (Kingston), where are you (if you're comfortable)
    Thanks again ladies!

    Lilypie Angel and Memorial tickers

    BFP#1 Oct/19/13, EDD June/27/14, MC began Dec/4/13 at 10w5d, sac measured 6w1d - blighted ovum, Misoprostol Dec/13/13 - nothing, bleeding, slow declining HCG, D&C Feb/6/14, HCG <1 Feb/18/14

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  • I am only going to tell you what happened to me....loss mentioned.


    I was on Clomid for 7 cycles which was wrong to begin with and was not monitored at all by my OB. My AF was on time but would only last for like a day. We got a BFP earlier this month that resulted in an ectopic pregnancy and I'm currently recovering from that surgery.

    I'm telling you this because my new doctor will be doing testing once I'm recovered to check for any permanent damage. You need to be monitored on it and/or get a referral to an RE. Take care of yourself and good luck!
  • First and foremost, I second, third, fourth, etc... everyone that says you are not being monitored properly and should have had some testing done to see if there is even a need for clomid. Outside of that, as to personal experience, I used clomid my first cycle with my previous RE and it thinned my lining enough that I had to use estrogen suppositories during my next cycle, which I insisted we switch to femara for. We conceived that cycle, which ended up being our loss, but the entire 9 weeks of pregnancy I had to use the suppositories because of my thinned lining. I personally, would never use it again, between the thinned lining and emotional wreck it made me, but I know that is not the case for everyone. Trust your gut on this one, if you are worried about the lining, take a break and seek a second opinion if possible. Good luck! 
    TTC #1: 3/2013
    02/2014: Clomid = BFN
    03/2014: Femara + Menopur + Ovidrel + IUI = BFP! - 3/17/14
    EDD: 11/29/14 - MMC @ 9 wks: 4/25/14 
    Misoprostol 4/28 & 4/29 - D&C after misoprostol failure 5/2/14
    07/2014: Spontaneous IUI, no meds = BFN
    08/2014: Spontaneous IUI, no meds = BFN
    08/2014 v2.0: Final spontaneous IUI, no meds = BFN
    09/2014: BCP cycle in prep for injectable cycle in Oct.
    10/2014: Gonal-F + Cetrotide + Ovidrel + IUI  = BFP!
    TWINS! 
    "Top Bunk" & "Bottom Bunk" due June/July 2015
  • I am 2 hours SW of Toronto.

    EDD 5/2/14, NMC 9/11/13
    EDD 10/15/14, CP 2/8/14

    IF Diagnosis: PCOS, MFI 

    Current Cycle: 5 mg Femara/1000mg Metformin + TI = BFP, EDD 4/23/15 Please be our RAINBOW

    image

    **ALL AL/IF Welcome**
    My Chart

  • I don't know the ways of the Canadian health care system, but I hope that you are able to maneuver it so that you get the proper monitoring. FX for a speedy resolution!
  • While my RE stopped my using clomid after three cycles - they were spread out. One in April 2011, another in Oct 2011 and one in Jan 2012..each time lining got worse. But I never noticed AF was lighter (my AF is super light and short already). The only way I *knew* my lining was thin was from mid cycle ultrasounds. Even in IVF and FET on lots of hormones with the thickest lining I've ever had, my af was still light. RE said my body reabsorbs the blood, just saying this because short/light af is not necessarily an indication of thin or thick lining. This is just one of ten reasons I can think of why monitoring is important if at all available in your area of Canada.

    TTC since July 2009. Dx MFI & LPD. 
    IUI#1&2&3 (2011 & 2012) BFN
    IUI#4 1/23/13 on 75iu x9 Follistim = BFP then chem preg m/c (Feb 2013)
    IUI#5 BFN (April 2013)
    IVF w/ICSI Oct. 2, 2012 - 13R, 11M, 7F, 1 frozen blast 4BB grade - - - FET Nov 15, 2013
    BFP! Beta 1:104 @ 10dp6dt, Beta 2:178 @ 12dp6dt,  beta 3:366 @ 14dp6dt
    Saw heartbeat twice before missed M/C at 8w3d on 12/27/13, missing my little angel boy
    JUNE 2014 IVF#2;  5R, 2M, 1F Three day transfer 6/7.  Beta 6/18 - BFN
    Child Free Now?
    S/PAIFW , S/PALW

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  • buggirl72 said:
    OP, I'm sorry for your losses.

    My understanding from the other Canadian ladies on this board is that the monitoring that is given in the US (multiple ultrasounds during a clomid cycle) just is not an option there (depending on where OP lives).

    My biggest concern is that your OB put you on clomid without doing any testing whatsoever.  Without any indication as to why you had your previous loss, Clomid is not necessarily the best treatment. For example, if your losses are being caused by a genetic issue that either you or your H has, clomid will not "fix" that. You have also had only one loss - odds are in your favor that this was a fluke.  Other issues that should be looked at before turning to fertility meds are making sure that your tubes are clear, your ute is fine, and that your H has had an S/A. 

    PP (and you) are correct that clomid can cause fertility issues.  Thinning of the uterine lining is one known side effect and, because of the length of clomid's half-life, it can get worse cycle after cycle.  I think taking a cycle off is a good idea for you to talk with your GP about your concerns and making sure you understand all of the risks. 

    @gscoville was faced with the same choice as you and I'm paging her to this thread so she can give you her input, what testing her GP/OB was willing to do pre-clomid and what they did while she was on clomid.

    ETA - to clarify
    Thanks Buggirl!  Yeah, my experience with OBs and clomid has been pretty much what you described here in terms of monitoring, meaning little to none.  My situation was a little different, as I had an ectopic pregnancy and the OB who did my surgery followed up with testing within four months of my loss given my AMA status, then he left the country and I was referred to another OB.  Between the two of them, though, I did have all the testing I should have had before starting clomid (HSG, U/S, hubby's SA), though, and I did have a standing order for CD21 bloodwork each clomid cycle I did, to check my progesterone level.  I agree with Buggirl, I'd be concerned that you haven't had any testing before just being given clomid.  

    Ultimately, my only reason for going along with an OB for fertility help was that OB help is all that's available to me in my area - I live 11 hours' drive from the nearest fertility clinic with actual fertility doctors.  My OB is the best around, but he is still just an OB and fertility work is not his specialty or his main focus.  OP, you should really look into getting a referral to a fertility clinic if you want to continue with treatment of any kind, OBs really aren't in the business of doing the proper monitoring and treatment related to getting women pregnant.  Especially here in Canada, where I know things work quite differently to the US, proper fertility treatment is hard to come by unless you're working through an actual clinic with actual fertility specialists.  


         

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    Married August 2012. Me: 41  DH: 42 
    Daughter from previous marriage: 20

    BFP 12/19/12: Ectopic discovered at 8 weeks, right tube removed 01/18/13
    June 2013 Testing Results: Progesterone: 31.7, LH: 5, FSH: 5, Estradiol: 161
    Clomid cycles Nov. 2013 and Jan, Feb, and March 2014

    TTC journey over as of the end of October 2014

    TTCAL BLOG

    All ALers welcome!

  • You have a few RE's around, there is one at Kingston Hospital, Whitby, Oshawa, or trek into Toronto.. I'm in the GTA, so when I had started with an RE, I have a few different choices.

    I started to look at what my options would be and apparently I am seeing the RE at KGH
    :-O (Dr Reid).

    I think I'm just going to have to push a little harder to get in again.

    Thanks again ladies! (How cool that so many of us live so close - we should all meet up in Toronto sometime!)

    Lilypie Angel and Memorial tickers

    BFP#1 Oct/19/13, EDD June/27/14, MC began Dec/4/13 at 10w5d, sac measured 6w1d - blighted ovum, Misoprostol Dec/13/13 - nothing, bleeding, slow declining HCG, D&C Feb/6/14, HCG <1 Feb/18/14

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