Infertility

::Waves hello:: Introduction

I guess I have been not wanting to introduce myself here although I have been checking in and stalking you all for the past few months. But now wanted to say hello and introduce myself. Hoping support from the board will make this whole process easier. I have been frequent on GP board (hi Gen!) and am needing a different support at this point.

I am 28 and DH is 29. Married in 2008 and went off pill in 3/09. First cycle of trying was 4/09. I was dx with PCOS and Hashimoto's disease summer of 09. Started Clomid 50 in end of 2009 and got first positive HPT then. M/c shortly afterwards due to high TPO levels from Hashimoto's. Clomid cycles since have been a bust and am now on my last Clomid cycle. Starting 150 mg tonight (CD 5) and then moving to injectibles or IVF next if no O with Clomid again.

I don't chart...I am a charting failure. Using CBEFM, OPKs, and monitoring with RE. Hoping this cycle with Clomid yields some signs of ovulation but am pestimistic at this point.

I am being seen at a single doctor RE office. He is older and I love the personalized care. However, he is a little old school in his thinking. When we talked recently about a more aggressive approach with meds, he said my next step would be IVF since he worries about injectibles being too risky for me? I have been researching other meds that can be taken prior to IVF and will discuss with him when I go in for my first follie check on Friday. Of course, I am hoping to keep this research in my purse and not have to mention it if I have some good follies this cycle.

Anyone else experienced this with RE...going from Clomid to IVF? From what I see online, there seem to be other "in between" options that I could try before the IVF. I am not against IVF but I want to try all avenues before committing to this procedure. Any insight, words of wisdom, or specific sites you ladies would suggest?

Thanks in advance and it's nice to be out of stalking mode :)

image image Baby Birthday Ticker Ticker Hashimoto's girl truckin' through BFAR! Working towards EBF but celebrating every ounce I can give right now! Follow my journey http://meatballsmommy.blogspot.com/

Re: ::Waves hello:: Introduction

  • In my honest opinion, and in my RE's opinion, it is quite a gamble to move from Clomid to IVF w/o doing an other inject cycles first. Everyone responds to the injectable meds so differently and with so much being invested in IVF (time, money, emotionally), its a good idea to have some type of idea of how YOU will respond to the meds. Is your RE checking for ovulation with b/w and u/s?
    TTC #1 since June 2008 *SAIFW*

    TI, IUIs, IVF = c/ps and BFNs

  • the risk in injectibles for someone with PCOS is hyperstimulation or overproduction and a cancelled cycle. With IVF it is more controlled as they can decide how many embryos to transfer. 

    We did 1 Clomid cycle, 1 Femara cycle, 1 Injectibles/IUI and then moved to IVF for insurance reasons. I wish we would have jumped to IVF first (honestly). My husband just wasn't ready. It is the only thing that has been successful for me in terms of treatments, and I really believe in the process.

    GL to you with whatever you decide. Welcome to the board, thanks for de-lurking :) 

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  • Welcome! 

    I have PCOS and have been using injectables without a problem (I didn't develop any follicles on Clomid). 

    The concern with injections is over-stimulation.  My RE (I'm at Shady Grove) started me off on a very low dose of injectable FSH and monitored me as he titrated me up.  The first couple of cycles were a bit frustrating because they seemed to drag on as we kept increasing the dose.  But, it was better than having a cycle canceled due to having too many follicles (or getting OHSS). 

    Best of luck!  

    image 30 y/o with PCOS HSG normal, SA essentially normal (slightly low morph but good # and motility) 50 mg Clomid...zip; 100 mg Clomid...nada; 150 mg Clomid...zilch 1/10 Injectable cycle with Gonal-F, Ovidrel, and TI.....Beta 2/22...BFN 2/10 Injectable cycle with Gonal-F and Follistim (long story), Ovidrel..BFN 4/10 Injectable cycle (see above). BFP but early m/c 5w5d. 5/10 Break cycle due to BFC (Big Fat Cyst)...darn it all 6/10 Injectable cycle +IUI...BFN 7/10 Injectable cycle + IUI.....BFP!!! Baby Birthday Ticker Ticker
  • Hey Kymberli! I've not got any advice as we went straight to IVF due to MFI issues.  BUT - I remember you from GP!  So wanted to say hi & welcome.  Sorry you're here, but I've found this board to be a great resource full of wonderful ladies (GP, too, but if you have ART questions nothing beats this group).

    Hope you aren't around long, but welcome! Smile

    Our IVF Miracle Arrived 2.26.11! <a href="http://s790.photobucket.com/albums/yy188/KikiGee/?action=view
  • Hi! I agree and guess that's why I posted finally. B/w and u/s are being done every Clomid cycle. Never any ovulation from Clomid. The only cycle I had ovulation was when I got pg in December and that was unmonitored Clomid from ob. I left that office when she told me I did not o from b/w on CD 21 when I O'd on CD 21 according to CBEFM. Positive pg test on Xmas eve also proved it.

    When I mentioned DH and I wanted more agressive approach to meds since Clomid has not been successful, RE said his next step would be IVF likely since I did respond once to low dose of Clomid. In addition, I am a teacher and he said inject cycles would need much more frequent monitoring. I am ok with the frequent monitoring...it will be hard since it is a challenge to leave the classroom...but I would make it happen. I have seen some respond to Femera when no Clomid has not been effective and guess I am trying to find research that would encourage him to try other meds such as this before injectibles.

    At this point, I am searching for any and all IF med research before IVF would be considered. I really do not want to leave this RE but will if it is what is best for me. Just kinda at a loss as what to do right now. Research and persuade him to try other options or find new RE...

    image image Baby Birthday Ticker Ticker Hashimoto's girl truckin' through BFAR! Working towards EBF but celebrating every ounce I can give right now! Follow my journey http://meatballsmommy.blogspot.com/
  • First of all Welcome!  I have PCOS and I am guessing the reason your RE wants to jump to IVF is because of the risk for hyperstimulation like Niki said.  I did clomid alone at various doses with no response. Then we moved to IUI with clomid & the loswest dose of follistim. I ended up with a canceled cycle and OHSS. So we moved onto IVF.  I can't say that it's the right path for everyone but I understand the reasoning behind it.  The other thing to take into consideration is if your completely OOP.  I am and paying for follistim (which is expensive) for more canceled IUI's did not appeal to me, nor did the thought of getting OHSS again.  With IVF they were able to control things better. If you have any more questions feel free to ask.
    Lilypie Premature Baby tickers image
  • I don't really have any answers to your questions, but wanted to say welcome and GL!
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  • Welcome!! I hope your stay is short!!

    I don't have much advice about the Clomid straight to IVF, as I didn't do anything (medication wise) before IVF.

    GL!!!!

    Lilypie Second Birthday tickers

    imageimage
    TTC Since Dec 2006
    *IVF #1 cancelled at ET*
    *IVF #2 OHSS, transfer cancelled*
    *FET #1 2 frosties, c/p*
    *Lap April 2010, removed endometrioma/endo implants*
    *Surprise BFP June 2010*
    *Beautiful daughter born 2/14/11!!*
    Thoughts from an Overwrought Mind
    SAIFW
  • Thanks for all of the great responses already!! I have considered Shady Grove but have decided against it so many times because I love the personalized "service" with my current RE. I have several friends with success at Shady Grove but really keep hoping my current RE can get things moving. I have made 2 appts at SGF and cancelled because DH really likes how small my current RE's office is.

    I'm lucky that my insurance covers some IF treatments...I get 3 IVF cycles. However, I really only want to use them as a last resort I guess. That may not make any sense but I feel like I need to try other meds before going through IVF process.

    GP has been great and all but it's not what I need anymore. Some wonderful girls over there but I need support that many of them just cannot help with :)

     

    image image Baby Birthday Ticker Ticker Hashimoto's girl truckin' through BFAR! Working towards EBF but celebrating every ounce I can give right now! Follow my journey http://meatballsmommy.blogspot.com/
  • So this might be a completely stupid question...

    Once I can get O to happen, IUI is planned. I have been able to develop follies that are like 9 or 10 mm but no any higher. We thought we had success last 100 mg cycle with a 22 mm follie and went back two days later because I still had not gotten a positive OPK so could not schedule IUI. B/w following showed it must have been a cyst not a mature follie because it was gone when I went back in for monitoring.

    Question is...if I can get 9 or 10 mm follies, what can he give me to boost growth so IUI could happen after trigger? Once you develop follies is there a med or a way to encourage growth?

    image image Baby Birthday Ticker Ticker Hashimoto's girl truckin' through BFAR! Working towards EBF but celebrating every ounce I can give right now! Follow my journey http://meatballsmommy.blogspot.com/
  • They won't trigger you until your follies are mature.
    TTC #1 since June 2008 *SAIFW*

    TI, IUIs, IVF = c/ps and BFNs

  • Right but there's got to be a way to boost follie growth once they are there so trigger can happen! I mean there should be a med to do that at least! LOL...off to develop new IF drug :)
    image image Baby Birthday Ticker Ticker Hashimoto's girl truckin' through BFAR! Working towards EBF but celebrating every ounce I can give right now! Follow my journey http://meatballsmommy.blogspot.com/
  • It sounds like you're just not really responding to the Clomid.  I had tons of follies each time, but none of them ever grew above 10 mm.

    I hear what you're saying about the personalized care from the one RE, but one of the benefits of SG is that you could go in for monitoring early in the morning (first appts are 6:45.  So you may not have to miss much time in the classroom.  Also, I have never felt that I wasn't important.  I might see different REs for procedures or monitoring since they rotate, but my RE has always reviewed the results, calls after my beta, and my nurse is great.  One weekend I went in for monitoring and the doc on duty told me to increase my dose to a certain level.  My RE called and gave me different directions after reviewing my results...so even though he wasn't there he was thinking of his patients.  

    That all said....if you get a great gut feeling from your current RE and you're comfortable with him....than that means an awful lot.  

    Whatever you decide, I hope it all works out for you soon!

    image 30 y/o with PCOS HSG normal, SA essentially normal (slightly low morph but good # and motility) 50 mg Clomid...zip; 100 mg Clomid...nada; 150 mg Clomid...zilch 1/10 Injectable cycle with Gonal-F, Ovidrel, and TI.....Beta 2/22...BFN 2/10 Injectable cycle with Gonal-F and Follistim (long story), Ovidrel..BFN 4/10 Injectable cycle (see above). BFP but early m/c 5w5d. 5/10 Break cycle due to BFC (Big Fat Cyst)...darn it all 6/10 Injectable cycle +IUI...BFN 7/10 Injectable cycle + IUI.....BFP!!! Baby Birthday Ticker Ticker
  • Hey Kymberli!  Glad you de-lurked, you will get lots of info over here and find a different kind of "specialized" support that you can't get on GP. 

    It sounds like you are just not comfortable moving straight to IVF and that is ok.  Just tell your RE that you want to try other options first.  It is your decision to make and if you are just not ready to go there yet you can try other things (femara, inject IUI).  

    Hope your stay here is short!

    image
    After 2+ years and multiple treatment cycles,
    including an IVF vacation in Costa Rica/Panama,
    IVF #2 brought us our miracle baby!
    Baby Birthday Ticker Ticker

    Surprise!  Baby Boy is on the way!

    image

     

  • Thanks for all of the support already ladies :) It's nice to see so many familiar names. I will chat with RE on Friday about what's next and I am sure I will have thousands of questions for you all!
    image image Baby Birthday Ticker Ticker Hashimoto's girl truckin' through BFAR! Working towards EBF but celebrating every ounce I can give right now! Follow my journey http://meatballsmommy.blogspot.com/
  • Hi and welcome :)

    I really think there are two schools of thought on going from Clomid to IVF.

    Some think that having at least one injectable cycle before IVF will be a good indicator of how you will respond to the meds and give you a chance to get used to the injections. On the other hand, with PCOS you're likely to produce many follies so you would need to be closely monitored. (Any RE worth a grain of salt would monitor closely anyway, but with injectable IUIs it is harder to control the number of follies and therefor the risk of multiples.) Maybe that's what your RE is thinking.

    There are ladies on this board who did go from Clomid to IVF. I did three injectable IUI cycles, and I m glad I did. For us it was the right decision because I did get used to the injections, the RE learned that I am a quick responder, and it also gave us a chance to get used to the idea of IVF mentally and emotionally.

    You just have to choose what is right for you. In the end, you and your dh are the ones who have to be happy with the treatment plan. 

    image
    Unexplained Infertility

    After two Clomid cycles, three injectable IUI cycles, two IVFs, two miscarriages, and one lap surgery, IVF #2 has brought us our little boy!

    Baby Birthday Ticker Ticker

    TTC #2
    After months of being postponed or cancelled, FET #1.3 (Natural FET) brought us twin girls!

    Baby Birthday Ticker Ticker


    Surprise! Baby #4 is due in March!
  • imagekymberli00:
    Right but there's got to be a way to boost follie growth once they are there so trigger can happen! I mean there should be a med to do that at least! LOL...off to develop new IF drug :)

    That's what the purpose of stimming is...to develop and mature the follies. You'll take your Follistim (or whatever you are on) daily until your follies are mature. Then, once they are mature, you'll trigger. 

    That's where injects are better than Clomid--Clomid you for 5 days and then you are done..while on injects you are monitored and if your follies are mature after 5 days, great, trigger. But if they aren't, you stim longer until they are mature...6, 7, 8+ days..however long it takes. 

    TTC #1 since June 2008 *SAIFW*

    TI, IUIs, IVF = c/ps and BFNs

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