Clomid Police!! ::users please pull over::

Mrs.Slick

Alrighty people, listen up please.

 There are certain steps that you and your doctor should follow if you're planning on taking Clomid or any other fertility drugs.

Step 1: You should have been trying at least a year or have an infertility diagnosis (or 6+ months if over 35)

Step 2: Testing - this includes no less than: CD3 b/w, SA for your dh or s/o, hsg

Step 3: Monitoring - this includes CD3 b/w & u/s, mid cycle monitoring and 7DPO b/w

 If you'd like more detailed information on these things you can see my blog - Infertility Basics page

• Why should you be tested?  Well because there would be no point in pumping up your follies if your tubes are blocked, or your H's sperm doesnt' swim or many many other things

 

• Why should you be monitored? With all IF meds there is a risk of OHSS (which trust me, it isn't pleasant), HOM (wanna be the next Kate+8?), most RE's will only do a LIFETIME limit of 6 Clomid cycles because of the risk of temporarily or perhaps even permanently damaging your uterine lining, cysts (trust me again, not fun - why risk your reproductive health or even your life with a ruptured cyst?) Oh and the Clo can severely impare cm making it impossible for sperm to make it where it needs to go.

 

Most obgyn's don't monitor like they should. Most are underqualified to treat infertility. Most will throw pills at you without diagnosing you. And no, your obgyn isn't likely to be one of the exceptions to this rule. If you're seeing a RE who hasn't done proper testing/monitoring - run. They're likely just making money off their patients without properly treating them.

 

Yes, most people don't have horrible reactions to fertility meds, but do you want to risk it?

KdgTeacher

::passes Slick a pen for writing tickets::

How are ya??

Mrs.Slick

KdgTeacher:

::passes Slick a pen for writing tickets::

How are ya??

Pretty good, you? Crampy though which is annoying.

KdgTeacher

Mrs.Slick:

KdgTeacher:

::passes Slick a pen for writing tickets::

How are ya??

Pretty good, you? Crampy though which is annoying.

Awesome--I'm on spring break  )  We just got back from a weekend at my in-laws condo at the lake. 

 

KLN1179

::passes the ticket pad::

Thanks for posting!!!  There seems to be a lot of unmonitored stuff going on around here!

Mrs.Slick

KdgTeacher:

Awesome--I'm on spring break  )  We just got back from a weekend at my in-laws condo at the lake. 

 

I go back to work tomorrow   Have a good spring break!

kleigh926

Question: what is the significance of CD3 bloodwork as part of the testing? I had lots of b/w done to diagnose my PCOS but none of it was on CD3 as part of the problem was I wasn't getting my period. Why does it matter when you have the bloodwork done? 

KdgTeacher

kleigh926:

Question: what is the significance of CD3 bloodwork as part of the testing? I had lots of b/w done to diagnose my PCOS but none of it was on CD3 as part of the problem was I wasn't getting my period. Why does it matter when you have the bloodwork done? 

Because "normal" levels are different at different points in your cycle.

A P4 of .69 on CD 3 is fine while a P4 of .69 on CD 22 with confirmed O is not ok

happilyeverafterxo

x 1,000,000

Mrs.Slick

kleigh926:

Question: what is the significance of CD3 bloodwork as part of the testing? I had lots of b/w done to diagnose my PCOS but none of it was on CD3 as part of the problem was I wasn't getting my period. Why does it matter when you have the bloodwork done? 

At some point you should have day 3 b/w done to test FSH levels and such. However with monitoring cycles it should be done day 2-5 (just day 3 is standard) to check E2 level as it should be nice and low at the beginning of a cycle. The accompanying u/s should check to make sure your lining is appropirately thin and there are no cysts. If there is one, then E2 levels will tell them if it's producing hormones, how much, etc. so they know if they should procede or cancel.

MonsterBean3815

Thanks for posting this!  My OBGYN wanted to do 4 cycles (4 CYCLES!!!!) of Clomid with no monitoring, no HSG, no SA!  Thanks to the knowledgable ladies on his board, I promptly refused and made an appointment with an RE for May 1! 

Plumeria624

MonsterBean3815:

Thanks for posting this!  My OBGYN wanted to do 4 cycles (4 CYCLES!!!!) of Clomid with no monitoring, no HSG, no SA!  Thanks to the knowledgable ladies on his board, I promptly refused and made an appointment with an RE for May 1! 

Agreed.  Thank you for posting, as I am new and will be seeing my OB soon.

DoubleFlyaway

Do you recommend this for every cycle on Clomid?  My first cycle on Clomid, my RE monitored me by ultrasound (I don't remember any bloodwork during that cycle, but it was a couple years ago)-- he looked at the follicles, my uterine lining, etc.  But since everything looked good, he let me go without monitoring my second and third cycles (BFP on third).  He had given me a totaly of 4 cycles' worth.

I had testing done beforehand, and my husband had a semen analysis.  Everything looked good except that I wasn't ovulating-- I had several maturing follicles, but none that would mature all the way.  But combined they produced enough estrogen to trigger an LH surge, so, just using CBEFM and not temping, I didn't know I wasn't ovulating.  The first dose of Clomid my RE tried resulted in ovulation.

Now I'm TTC#2 (or will be this next cycle) and temping for the first time. This past cycle there was a clear temp shift, so I'm hoping no Clomid will be necessary, but if I'm not pregnant by late summer, I will probably seek it out.

 

KdgTeacher

DoubleFlyaway:

Do you recommend this for every cycle on Clomid?  My first cycle on Clomid, my RE monitored me by ultrasound (I don't remember any bloodwork during that cycle, but it was a couple years ago)-- he looked at the follicles, my uterine lining, etc.  But since everything looked good, he let me go without monitoring my second and third cycles (BFP on third).  He had given me a totaly of 4 cycles' worth.

I had testing done beforehand, and my husband had a semen analysis.  Everything looked good except that I wasn't ovulating-- I had several maturing follicles, but none that would mature all the way.  But combined they produced enough estrogen to trigger an LH surge, so, just using CBEFM and not temping, I didn't know I wasn't ovulating.  The first dose of Clomid my RE tried resulted in ovulation.

Now I'm TTC#2 (or will be this next cycle) and temping for the first time. This past cycle there was a clear temp shift, so I'm hoping no Clomid will be necessary, but if I'm not pregnant by late summer, I will probably seek it out.

 

Yes

Mrs.Slick

DoubleFlyaway:

Do you recommend this for every cycle on Clomid?  My first cycle on Clomid, my RE monitored me by ultrasound (I don't remember any bloodwork during that cycle, but it was a couple years ago)-- he looked at the follicles, my uterine lining, etc.  But since everything looked good, he let me go without monitoring my second and third cycles (BFP on third).  He had given me a totaly of 4 cycles' worth.

I had testing done beforehand, and my husband had a semen analysis.  Everything looked good except that I wasn't ovulating-- I had several maturing follicles, but none that would mature all the way.  But combined they produced enough estrogen to trigger an LH surge, so, just using CBEFM and not temping, I didn't know I wasn't ovulating.  The first dose of Clomid my RE tried resulted in ovulation.

Now I'm TTC#2 (or will be this next cycle) and temping for the first time. This past cycle there was a clear temp shift, so I'm hoping no Clomid will be necessary, but if I'm not pregnant by late summer, I will probably seek it out.

 

Yes, and a lot (if not all) of your IF testing may need to be updated/repeated also.

Kate504

I have a friend who told me she thought she was going to have to go on clomid b/c her metformin wasn't helping her. She wasn't taking her metformin AT ALL!  No wonder it wasn't working! 

 She is pregnant now on her own. She has really long cycles, had no period since August and thought that she O'd multiple times a cycle, just now getting a period. I had to explain to her that she was only O'ing once a cycle, she just had irregular cycles, that is why they weren't getting KU.  

Mrs.Slick

Kate504:

I have a friend who told me she thought she was going to have to go on clomid b/c her metformin wasn't helping her. She wasn't taking her metformin AT ALL!  No wonder it wasn't working! 

 She is pregnant now on her own. She has really long cycles, had no period since August and thought that she O'd multiple times a cycle, just now getting a period. I had to explain to her that she was only O'ing once a cycle, she just had irregular cycles, that is why they weren't getting KU.  

Holy moly, I don't understand how some people can think stuff like that. Good thing you were there to help her understand a little!

Kate504

Yeah. I don't know much about it  but I told her that if she wasn't taking one medication correctly I didn't think she should move to another because she really didn't know if it was working. Then I tried to explain that you can gear up to ovulate but not actually do it. 

 

I thinks she just googled and looked for answers. I hope because we go to the same OBGYN.  

rinascita

This is a great post - thanks!

My OB/GYN gave me the choice, you know since I went to med school?  Anyways, I did have a post a few months asking if I should have an HSG or take up to 3 rounds Clomid before having an HSG due to anolvuatory cycles.

I went with the HSG and am now moving on to an RE that I researched to find to make sure I am working with someone that is well known, with a great rep, and safe.

Its amazing how most OB's just throw 4 -5 cycles of Clomid at their patients and just tell them to come back in for CD21 (not 7DPO) b/w.  I even got my Rx over the phone from my OB's nurse... Scary!! 

Mrs.Slick

rinascita:

 I even got my Rx over the phone from my OB's nurse... Scary!! 

It's scary, indeed! It's also scary how common that is. It's the easy thing for them to do and gets patients out of their hair so to speak, too bad it's irresponsible and dangerous. I almost wish there were more strict guidelines for IF medications.

Shayliz

Can I save this and copy and paste it? I feel like I type out Clomid monitoring info every week.

I get that people want to trust doctor's know what they are doing, but if I had a bunch of people on here tell me my doc was doing something wrong - I wouldn't brush it off as "the internetz don't kno my lyfe!!" 

Mrs.Slick

Shayliz:

Can I save this and copy and paste it? I feel like I type out Clomid monitoring info every week.

I get that people want to trust doctor's know what they are doing, but if I had a bunch of people on here tell me my doc was doing something wrong - I wouldn't brush it off as "the internetz don't kno my lyfe!!" 

C&P away! I don't mind at all. I used to try to post this info around once a week but I don't come around here nearly as often as I used to.

mrsjollybrown

Thank you for this. I did my first round of clomid this month with my OB who us an IF specialist. EVERYTHING she said to me I asked about on this board and the 3T board. Now I am in my two week wait praying for my BFP.  

To the newbies these ladies on this board don't give out bad info they are trying to help optimize your chances of getting pregnant without unnecessary obstacles. It never hurts to ask you doctor the things they point out to you.

You need to be able to advocate for yourselves. Research what your doc tells you. Don't take a medication blindly. Or be willing to suffer the consequences. 

Just my two cents! 

siple1am

Thank you! I keep seeing people saying that they are going on Clomid, but I usually don't see the reason why..

 

You are awesome Slick!

mrsjollybrown

Yeah I had outpatient surgery to remove a polyp from my uterus. They sent me home with enough meds for a month when recovery was supposed to be 2-3 days. Needless to say I didn't take the meds unless I was literally shaking. Over the counter meds worked fine for me.

Some docs are just script happy. Hence why we have a large population of people addicted to prescription meds. 

Kate504

GhostMonkey:

mrsjollybrown:

Thank you for this. I did my first round of clomid this month with my OB who us an IF specialist. EVERYTHING she said to me I asked about on this board and the 3T board. Now I am in my two week wait praying for my BFP.  

To the newbies these ladies on this board don't give out bad info they are trying to help optimize your chances of getting pregnant without unnecessary obstacles. It never hurts to ask you doctor the things they point out to you.

You need to be able to advocate for yourselves. Research what your doc tells you. Don't take a medication blindly. Or be willing to suffer the consequences. 

Just my two cents! 

The sad fact is this applies to ALL medications, not just fertility meds. Some doctors are very pill happy and others aren't the brightest crayons. I was in the ER once for chest pains that ended up being an anxiety attack. The ER doc gave me narcotic pain killers to help with the pain. Um, what? Fortunately I went home and looked up what he gave me and never took it. 

 

Once I went to the Ed in severe pain and the dr said I had a kidney infection. It was ovarian cysts! My OBGYN was like "who was that dr. I want to know his name." 

minicheezburg

Hello I usually post on TTCAL and this was shared over there, I just wanted to say thank you for all the wonderful info.