Confirmed this morning that my second Clomid+IUI cycle was a bust and I went in for a regroup appointment (which I so endearingly call WTF appointment.) As background I only produced one follie with each cycle of 50mg Clomid. I was fully prepared to ask for and be switched to injectibles for the next 2-3 cycles. My RE recommended that I try 1-2 cycles at 100mg Clomid and then if that doesn't work, move on to IVF.
said he used to recommend injectables + IUI if Clomid didn't work
within 3 cycles, but that was when IVF success rates were only around
35%. Now that IVF success rates are at 60% he moves on more quickly.
Reason being that injectables are expensive and the success rates of
injectables + IUI are only 20%. (He quotes 10-15% success rates with
Clomid + IUI). He cited a study called the Fastt Trial that found in 508
couples, patients got pregnant quicker and with less expense when
bypassing injectables/IUI cycles. Here are a couple of links to the
study that I found interesting. Have you guys heard of this study
as previously mentioned from other Bumpies, some doctors don't correlate
higher doses of Clomid with increase follies. The only way we could
cycle in August would be to use Clomid since injectables require more
monitoring and we'll be out of town for 10 days. He gave me the option
to increase and I took it. I figure it couldn't hurt as I already know
how I respond to 50 mg.
Of course at the end of the day he leaves the decision entirely to us. If we want to do another Clomid, and then three injectibles before IVF, we could choose to do that and he would support it. In my mind right now, I think I'd do one cycle of 100mg Clomid and one cycle of injectables before IVF. But I'm nervous nelly about the IVF. Unfortunately we are 100% OOP for this but thankfully we both have good jobs and I'm way ahead of my number so far this year. Better go sell something! lolSorry that was so long and rambling. Lots to process right now!