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Success after IF
DaniGirl0517
member
PCOS Mama's: Gotta Q for ya (Long)
DaniGirl0517
member
Ladies, if you could help, I feel a little stupid today. I had a dr appt. and was prescribed Clomid 50 mg for the next cycle and to call if it didn't work so I could get a new higher dosage script for the 2nd cycle and so on. I will not be on monitoring. I know that's bad but 1) this is out of my regular gyno's office, I haven't seen an RE and 2) We're OOP and couldn't afford it right now anyway. I was told to use OPK's and continue charting to know when the window was and to "do it like rabbits during that window," So much was going on and I was pretty emotional that I didn't ask when to take a pg test. SO my questions are: When do you take a pg. test? and When do you go in for your first appt, after finding out you are pg? I was told that I'd probably have to continue taking progesterone supplements during the pregnancy so I'd assume I'd need to go in soon after finding out I was pg so they could make sure everything was okay even though it would be VERY early and so I could get a different progesterone than I'm taking now. I'm clearly confused. Sorry for the long post and being so stupid, today was kind of an upheaval so if you all just say to call and ask tomorrow I'll do that.
This discussion has been closed.
Re: PCOS Mama's: Gotta Q for ya (Long)
With my first three Clomid cycles I had a standing order for day 21 progesterone level(to see if I ovulated) & day 28 beta. With my BFP cycle I had my progesterone drawn & then had a positive HPT @ 11DPO. I already had a Clomid follow up for the next week so I didn't have the beta drawn. I just waited until the follow up & then they ordered two 48 hours apart. Hope this helps & the best of luck with the Clomid!
Also wanted to tell you I did the big NO NO & had 4 unmonitored Clomid cycles. We are also OOP so we wanted to try everything with my GYN first. The downside is the first three cycles were not pleasent. I had huge cysts each time & only ovulated once. The upside is I got pregnant(with the help of a lap too).
Okay...a few more questions... So should I ask for these tests to be run? I wasn't given any indication she planned to run tests or that she planned to see me again. She said she'd call in my script so I assume that means I wouldn't even have to pick up the slip of paper. I guess I'm doing a lot assuming...
As I understand what happened today, she wants me to: Continue taking the Prometrium on the 1st through 10th of the calendar month, cycle starts on the 10th of the month. On cycle day 5 (calendar day 15) I start taking the Clomid, one a day for 5 days. Start using OPK's and watch my temp. Then we hump like bunnies. Still just once a day and only in the morning? Then I suppose I take a HPT on the morning of the 1st of the next calendar month which would be cycle day 30/31 dep on month, and if negative call that day for a new script for higher dose Clomid and start over that night taking Prometrium. Would a HPT give an accurate result that early?
Thank you for the advice thus far agdudley08, and for the well wishes. Congrats on you BFP!!! That's definitely the kind of news I wanted to hear though I'm sorry it was rough until you got it. Last question for ya: What do you mean by help of a lap? Do you mean lap-band or am I misunderstanding an abbreviation?
I would ask about having that blood work done. That way you know if you ovulated. If you did, you may not need to increase the dose if you don't get pregnant.
We had sex every other day because of some sperm count issues. I was using CBEFM & I had big time ovulation pain so I knew when I ovulated.
A HPT should show up that early. Start with a line test first they are more sensitive.
I had a diagnostic laproscopy in July. I had some endometriosis removed from my uterus and right tube. Sorry about the abreviation, it's the nurse lingo coming out.
Did she do any tests prior to rxing Clomid? If it were me, I'd want to make sure the Clomid would work before taking it...it can have some bad side effects. It didn't work for me and I pretty much hated it.
I would want bloodwork drawn on CD3 and especially I'd look at LH, FSH, and thyroid levels. I'd get an hsg done (https://www.webmd.com/infertility-and-reproduction/guide/hysterosalpingogram-21590) to make sure the tubes/uterus are unobstructed. That would let you know whether you'd need a lap or not. I'd also get a semen analysis for DH. The bloodwork and hsg should be covered by your insurance if they are coded as for irregular/absent periods. The SA probably wouldn't be covered, but they aren't that expensive and I think it'd be worth it to find out if there's a problem on his end. Not saying there is, but all the Clomid in the world isn't going to help if there's no sperm.
Since you aren't being monitored and won't know the exact date of ovulation until it happens, and since you don't really know how DH's sperm looks, I would do the deed every OTHER day. That should help to keep his numbers higher. Just to confirm, your cycle will start when AF comes, which may or may not be on the 10th. Also, Clomid can cause a delayed ovulation, so don't be surprised if you haven't O'ed by CD14. I believe you can O all the way into the late 20's/early 30's.
If you use an early response test, you can generally test after 9dpo, though it may not be accurate that early. If you've ovulated and are still testing negative by 18dpo, but haven't started AF, I'd personally want a blood test. I think I'd hold out for ovulation until CD35 and if it hasn't happened by then, take the prometrium to induce AF. Like the pp said, if you've ovulated at 50mg, I wouldn't move up to a higher dose, at least not right away. Oh and you are only "allowed" 6 cycles with Clomid, if it hasn't worked in 6 cycles with the Clomid, it probably won't. If you are still looking for a cheaper treatment, you can try Femara.
Good luck!
Oh and to answer these earlier questions - if you're just working with an OB/GYN, they probably wouldn't want to see you until around 12 weeks. Of course it varies, but that's how most are. Why were you told you'd need progesterone supplements? And actually...the prometrium pills? Are they kind of soft and like egg-shaped? If so, you can take those orally or as a suppository. I've taken them orally to induce AF and I was also supposed to use them as a suppository when I got pg, but we didn't find out about the baby until I was like 5.5 weeks and by then it was too late to bother. But I do think you'd have to ask them specifically about that. They may want you to come in early for a blood test when you get your bfp, then they can decide on the prog numbers that come back whether or not you'd need the supps.
Ok, I keep finding more. I am taking the Prometrium because my progesterone is way low, but she said it's SO low that I'll likely still have to take some kind of progesterone while pregnant to help sustain the pregnancy. She didn't specify and that was back in August when I was still just talking to the NP and not the actual Dr.
She said she would only do 5 cycles with me going up by 50mg each time till I maxed out at 250. She said at that point I'd have to go down the street to the infertility clinic for any other treatment. She said she wouldn't prescribe Femara that it would be something that the IF Clinic would have to prescribe
I would NOT just increase dose of clomid every month simply because you aren't pg. I would get the metformin in you and get that established for a month or two and see what that plus the low dose of clomid does. You may not ovulate on day 14....with DD I didn't conceive until somewhere around day 32 of that cycle! So the pg test won't show up until 9-11 days after you ovulate....go off your temps and not just the calendar there.
Plus if you are ovulating there isn't a need to keep boosting the clomid dose up.
This will probably be flamed.
But, if you can't afford monitoring for a clomid cycle how the hell are you planning to afford kids?
I think the pps covered everything pretty well so I don't have too much advice for you but I wish you the best of luck
) I will tell you that Clomid is a wonderful but funky drug. I didn't respond to it the way I had hoped but it really made my hormones go crazy. Be kind to yourself while you are on it and don't be afraid to call your OBGYN if you feel strange or have a question. Also since your going through an OBGYN make sure you have your LMP date if they don't already have it on file. My BFF got pg and forgot her LMP date and they never did a beta on her and made her wait until she was 10 weeks along to do an ultrasound and confirm she was pg.
Good luck!
I have to agree with the previous posters - if it works at 50mg there is no need to increase the dose. All that does is increase the probability of side effect and of high order multiples a la Jon & Kate plus 8. And incidentally that is a major concern with unmonitored cycles. I'd really step back and consider what you'd do if you responded very well to clomid and ovulated and became pregnant with 2 or 3 or 4 or more babies. All the OPKs in the world will not tell you how many eggs are mature.
And for what it's worth I never responded to Clomid, and because I was being monitored we knew that after my second cycle on it. So instead of wasting 3-4 additional months taking a drug that had the potential to thin my lining permanently, cause cysts and/or making my womb otherwise inhospitable for any pregnancy I moved onto an RE and did an injectible cycle and now have my daughter. I really don't see the point in taking any fertility drug unmonitored - you have zero idea what the effect of it is on your body so no baseline response information to provide your RE should you get to that point. If you get pregnant great, but if you don't all you know is that you didn't get pregnant, not whether you responded or not, over-responded, whatever.
Super excellent point -- PCOS makes it very difficult to detect ovulation on OPKs and the OTC fertility monitor thing, the electronic one with the sticks? Flat out tells you in the package insert that it will not work with Clomid. So ya, how are you going to even know if you ovulated?
I have PCOS, and I had a REALLY hard time with the sticks because my baseline was so high. I did finally see a slight difference, but I only knew I had ovulated because of the temperature shift. I didn't ovulate until CD24, and my E2 was very low that same day - so low that the RE didn't think it was possible that I ovulated. I got a positive HPT on day 10 after ovulation on day 24.
I took Femara, and if I had to do it again, I would have done u/s monitoring - it was stressful not knowing if the Femara was working and I had to buy a whole extra pack of OPKs because I ovulated so late. I almost missed ovulation, and then I wouldn't have my daughter.
ETA: I also think that CBEFM says that it may not work well with PCOS either.
Thank you for all the replies, even the ones where you think you might be criticizing me, I came here for the truth! As far as how will we afford a child, we were unaware she would just up and start us out so soon on Clomid and everything, we thought the whole process would take longer. Our money is currently tied up in building a big @ss garage and until we get the next installment check on last years rice (maybe a month or two away) we won't have much to spend. We usually are fine with money and have plenty saved, we just have a current project in the works.
As for what would we do if we had multiples even HOM, due to our beliefs we would only intensely pray. I'm sure some see that as irresponsible but "reduction" is not an option for us. I do understand that multiples can make the whole process incredibly difficult even before labor, and that it severely increases the risks. I don't want to risk my own life or that of future children, but we will not be "reducing."
Based on your replies I am going to call on Monday when she's back in the office and ask if I can have monitoring during my cycle. As far as the OPKs not working for PCOS women, I didn't know that, I just bought them because she told me to. After this post I'm starting to lose faith in this dr. that she knows the right decisions to make. As for upping the Clomid each cycle, again, she just said, "if it doesn't work" so if that means, it didn't work and we didn't get pregnant or it didn't work and we didn't ovulate I don't know.
I guess the biggest issues here is even after my appointment yesterday there are still too many "I don't knows" that need to be remedied, thank you for helping me see that!