Success after IF

Question about injectable fertility meds. Please help an infertile-myrtle out...

Hi ladies, I'm hoping someone can help me out here or just share their experience about this.?We're dealing w/ 2ndary IF right now; DS is 3 y/o and we've been TTC for 1.5 years. ?We started seeing an RE last month, did 100mg of clomid and and IUI. ?I had 2 follicles, but only one matured for the IUI, and I got a BFN from it. ?This month the RE wants to go straight to injectables, which obviously boosts my chance of multiples significantly. ?I'm really afraid of hyper-stimulation and higher order multiples--I have an incompetent cervix and high blood pressure and spend 4 months of my first pregnancy on bedrest (good news with the bedrest is that my bp had never been better). ?So my fear is not with being a mom to multiples, but in carrying them successfully.?Has anyone here had similar high-risk complications, used the injectables and had twins/triplets? ?Any words of wisdom and/or caution? ?thanks so much!?

Re: Question about injectable fertility meds. Please help an infertile-myrtle out...

  • Really, in my mind, there's no difference in clomid & injectibles - it's just a different medication that's administered a different way.  They have the same hopeful result - controlled ovulation.  Your RE should monitor you closely and only trigger you when you have one / maybe two follicles if your problem is that you don't produce them on your own.

    Your doc should understand your worry, and be able to control it.  Take a deep breath.  If you produce too many follicles, you skip the cycle, you don't HAVE to take the risk.

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  • Are you unexplained?

    If you produced two follicles with Clomid, I'd just try Clomid again and maybe see about upping the dose a little bit or something to try to get two mature ones instead of just one mature one. ?It sounds like the pregnancy complications you've experienced would be serious enough to really, really want to avoid multiples.

    I've never really understood the logic of going to injectible IUIs if oral meds are "working." ?We tried Clomid and IUIs and had it "work" several times, and our old RE wanted us to try injectibles next, but our new, better RE thought that would be a waste and suggested IVF, and he was right.

    Also, you might want to try taking wheatgrass pills leading up to your ovulation. ?That helps with egg quality. ?

  • I would talk to your RE about a low and slow protocol...granted I ended up with twins from my low and slow protocol, BUT they were very unexpected as at my time of trigger I only had one follicle that was mature.(They did a low and slow protocol on me b/c I had hyperstimulated on my first inj cycle and it had to be cancelled or We could have run the risk of having our own TLC show b/c I had so many mature follicles)...I did 75ius of gonal-f for 12 days before I triggered.

    I didn't know before I got pg, but I too have an IC...my girls were born at 30 weeks, but I had a ton of other complications...rescue cerclage...PTL, PROM, high blood pressure (but the PTL meds he had me on fixed that really fast) and all that fun stuff.

    I'd also talk to your OB about a cerclage...my MFM told me that next time (if that happens), I'd have a cerclage between weeks 11-13 of my pregnancy and that I more than likely (even if I was pg with twins) wouldn't have to do BR again.

  • I never produced more then 3 follicles in an injectable cycle. My doctor was very against HOM and was sure to start me on a low dose and monitor my progress. I think when you are speaking of ANY infertility treatment, including clomid there is a chance of multiples.

    Injectables have benefits over clomid as it does not effect CM and have very few side effects.

    A lot of years and a million tears finally led me to you.
    After 7 years trying to concieve, 3 failed IUIs and 2 failed IVFs, my third IVF was a success!
    My Christmas baby turned into a turkey bird! Dillon Richard was born at 34 weeks, 5 days on November 28, 2009 after 10 weeks on bedrest for preeclampsia.
    <a href="http://smg.photobucket.com/albums/v705/arriinthere/PJ/?action=view
  • clomid didn't work well for me. I never got very good/many follies and it thinned my lining so we did injectables. I triggered with up to 4 mature follies and got all bfn's. I'd say that above poster is right that you have the same (maybe slightly lower) risk of mult on clomid. Talk to your re about how carefully you'll be monitored and about when he'll trigger to try to avoid having too many mature. Unfortunately with fert meds there is just that inherent risk of mults (twins/trips)
  • Assumign clomid is working with your body, the risks of multiples are similar.

    I'd just discuss with your doctor and with very careful monitoring, the risk of higher order multiples is very controlled.

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  • Ditto the other girls, if you end up with more follicles than you are comfortable with, it is your right to cancel the cycle. DH and I were planning to cancel with anything over 2 follicles, since his SA came back really great. Lo and behold, I ended up with about 10 mature follies and we were cancelled and put on bcp, but I ended up ovulating one anyway and I'm now about halfway through my pregnancy. So I guess the moral of the story is that if you do decide to go with an injects cycle and are worried about HOMs, do not have sex until you are triggered. We got pg from sex we'd had the night before our cancellation.
  • You could also ask to be put on Femara to see if you get a better result than clomid. Femara doesn't thin your lining like clomid so it might up your chances on the implantation side.

    Injectables can be monitored so the chance of multiples are less, but if you only want to have 2-3 follicles anyway, I wouldn't waste the money on injectables (unless insurance covers them) since you could get the same result from an $60-80 supply of Femara or a $20 supply of clomid. Another part of the decision is if you already have somewhat of a regular cycle and are only using the drugs as an ovulation support and not ovulation induction so to speak. There is not really a point to go to injectables unless the Dr wants you to o sooner for better egg quality or something.

    I was on a low and slow dose of gonal-f and paid 525 bucks for the one box I used. I got maybe one more follie (3) than I did on Femara(2). Good Luck!

    WAY 2 Cool 4 School


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