Trigger shots?

CGoldman96 · December 2010

How far along in the fertility treatment process did you start these?

We've just finished round 2 of Clomid (unmonitored). I talked w/RE today and was told they don't normally do the mid-cycle ultrasound w/clomid, but they will since I asked for it this cycle. Guess I have to ask for this every cycle... I dunno. They also would not have done CD3 us this month if it weren't that they are going to now do mid-cycle us... not sure what to think about that.

I am thinking when I go in for CD3 us that I might ask if we can do a trigger shot at the mid-cycle us if my follicles are looking good. I don't want RE to think I am overbearing so I was curious if there is a certain length of time to go through this process before they typically start the trigger shots.

Your thoughts are appreciated.

brideonjuly8 · December 2010

I don't know about Clomid, but my doc always recommends doing a trigger shot on Femara. If I didn't want it, I don't think they would force it, but he and all his NP recommend getting it.

I started meds after only 6 months, but I had surgery back in Sept for what my doc thought was a cyst, but it was a tumor, he found stage 3 endo, adhesions, so he wanted my long cycles fixed and pregnant ASAP so my endo won't come back.

I find it extremely weird you had to ask your RE to be monitored. IMHO, not being monitored on meds is like flying blind. You have absolutely no clue if you're responding, don't really know if your dosage is correct, and not to mention the risk of having mulitple mature follicles at a time. And the overstimulation thing.

CGoldman96 · December 2010

I agree. I thought it was odd I had to ask them too. I found it even more strange they told me they don't normally do the mid-cycle monitoring. Unfortunately this is the only RE in my area, so I am going to try to build the relationship and keep myself as informed as possible about fertility treatments.

I honestly was afraid they'd be b*tchy today when I asked about the mid-cycle monitoring, because I transferred to them last month from an ob/gyn who became irate when I asked questions regarding fertility treatment. Fortunately they were nice about it, it just took a few phone calls to get the nurse to discuss with the doc and he agreed.

I don't think it would hurt for me to ask about the trigger shot this month, but I don't want them to get pissy w/me for asking for too much too soon.

UMichGirl · December 2010

CGoldman96:
I agree. I thought it was odd I had to ask them too. I found it even more strange they told me they don't normally do the mid-cycle monitoring. Unfortunately this is the only RE in my area, so I am going to try to build the relationship and keep myself as informed as possible about fertility treatments.

I honestly was afraid they'd be b*tchy today when I asked about the mid-cycle monitoring, because I transferred to them last month from an ob/gyn who became irate when I asked questions regarding fertility treatment. Fortunately they were nice about it, it just took a few phone calls to get the nurse to discuss with the doc and he agreed.

I don't think it would hurt for me to ask about the trigger shot this month, but I don't want them to get pissy w/me for asking for too much too soon.

You are paying them! (Well, or your insurance is paying them...) At any rate, they're making money because of you. Ask what you want! Personally if I'm putting my body through the meds and whatnot, I'd want to make sure that timing was as good as possible--meaning I'd want the trigger shot. Ever since I've done medicated cycles, starting with my first clomid cycle, I've done a trigger.

Good luck--I understand that with this being the only RE in the area that you feel you need to handle things carefully with them, but I also wouldn't be afraid to talk to them and ask them about what you want. There's a lot more at stake than possibly hurting the nurse and/or doctor's feelings or feeling like you're stepping on their toes, kwim?

orange1414 · December 2010

I've triggered on every medicated cycle I've done. I'm sorry you're having to push your RE on stuff that is just standard at a lot of other places. It's too bad there's not some competition in town!

brideonjuly8 · December 2010

CGoldman96:

I agree. I thought it was odd I had to ask them too. I found it even more strange they told me they don't normally do the mid-cycle monitoring. Unfortunately this is the only RE in my area, so I am going to try to build the relationship and keep myself as informed as possible about fertility treatments.

I honestly was afraid they'd be b*tchy today when I asked about the mid-cycle monitoring, because I transferred to them last month from an ob/gyn who became irate when I asked questions regarding fertility treatment. Fortunately they were nice about it, it just took a few phone calls to get the nurse to discuss with the doc and he agreed.

I don't think it would hurt for me to ask about the trigger shot this month, but I don't want them to get pissy w/me for asking for too much too soon.

Sucks that there is only one in your area. I'm not seeing an RE, my OB is a Fertility Specialist as well as an OBGYN. Maybe you could call around to see if there are any OBs in your area that do treatements as well?

mmttc · December 2010

I would definitly ask to be monitored on clomid. How else do you know if it is working or if you'd developed a cyst? I'd also ask for a trigger shot. My understanding is that if clomid produces multiple follicles it's possible your body will only release the most dominate one. The tigger shot will help you release all the dominate follies and increase your chances. Are you seeing an RE or an OB that also does IF treatments? How long has he/she been in practice? The reason I wonder is if they have been doing this a long time as a solo practitioner it's possible they are not up to date with current protocols. Being the sole provider in town they don't have much competition. Maybe find a few articles listing protocols from some high successful clinics and tell the doc you want to try the next cycle like those. Have you had the HSG test? Sperm analysis?

CGoldman96 · December 2010

The only tests I've been made aware of (these may not be the only ones as their communication is lacking) are prolactin and progesterone bloodwork and then HCG tests at end of cycle. DH has has the SA completed last week and we are awaiting the results.

I am seeing a RE. He has been in the business I believe since the 80s from what I remember at the consult. I found out yesterday from another girl my sister knows who went there that she did clomid treatments with him for 3 years before she finally told him she was done and wanted an iui. He didn't even offer it as an option. Maybe he's overly cautious or something I don't know. But I'm glad I learned this now so I can start speaking up and hopefully help to progress my treatment.

I am already at the point where I feel like if this clomid cycle doesn't work and DH's SA is OK, then I'm ready to move forward and check my tubes and then see if we can do iui. I know I'm going to have to wait on that for at least another month though because the RE has already told me if this cycle doesn't work he wants me to cease all medication including glumetza (metformin) for 30 days and do baseline testing before we go forward.

heathercara · December 2010

As soon as I saw an RE he started me on testing as well as medicated/trigger cycles (this is my second and last before I start IVF if unsuccessful). But I am old asss and he did not want to waste any time as my window is quickly shutting.

jiffy-pop · December 2010

CGoldman96:

The only tests I've been made aware of (these may not be the only ones as their communication is lacking) are prolactin and progesterone bloodwork and then HCG tests at end of cycle. DH has has the SA completed last week and we are awaiting the results.

I am seeing a RE. He has been in the business I believe since the 80s from what I remember at the consult. I found out yesterday from another girl my sister knows who went there that she did clomid treatments with him for 3 years before she finally told him she was done and wanted an iui. He didn't even offer it as an option. Maybe he's overly cautious or something I don't know. But I'm glad I learned this now so I can start speaking up and hopefully help to progress my treatment.

I am already at the point where I feel like if this clomid cycle doesn't work and DH's SA is OK, then I'm ready to move forward and check my tubes and then see if we can do iui. I know I'm going to have to wait on that for at least another month though because the RE has already told me if this cycle doesn't work he wants me to cease all medication including glumetza (metformin) for 30 days and do baseline testing before we go forward.

Wow, looks like you're gonna have to take matters into your own hands with this doc...Good luck sweetie!

Jewlz018 · December 2010

jiffy-pop:
CGoldman96:

The only tests I've been made aware of (these may not be the only ones as their communication is lacking) are prolactin and progesterone bloodwork and then HCG tests at end of cycle. DH has has the SA completed last week and we are awaiting the results.
I am seeing a RE. He has been in the business I believe since the 80s from what I remember at the consult. I found out yesterday from another girl my sister knows who went there that she did clomid treatments with him for 3 years before she finally told him she was done and wanted an iui. He didn't even offer it as an option. Maybe he's overly cautious or something I don't know. But I'm glad I learned this now so I can start speaking up and hopefully help to progress my treatment.
I am already at the point where I feel like if this clomid cycle doesn't work and DH's SA is OK, then I'm ready to move forward and check my tubes and then see if we can do iui. I know I'm going to have to wait on that for at least another month though because the RE has already told me if this cycle doesn't work he wants me to cease all medication including glumetza (metformin) for 30 days and do baseline testing before we go forward.
Wow, looks like you're gonna have to take matters into your own hands with this doc...Good luck sweetie!

I agree. I'm afraid on can't offer any advice on specifics, but I think in general that you need to be your own health advocate. It is your fertility and your life.

You can be firm and direct without be a Biotch. Nobody can blame you for that, but if they do they will get over it. JMO

andrea817 · December 2010

I was triggered on my first medicated cycle, however it was with an iui. I also had the mid cycle monitoring. The way my doc explained it to me was, "when we get to this level, I really like to be able to see what's going in there, so we can be as accurate as possible with timing." I am a worrier, so I personally would ask for the mid cycle u/s.

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