Clomid help...

Rawr08 · October 2011

My OB mentioned he would prescribe me Clomid. That was our next step when DH had his first SA and the lab said agglutination was present, so the Clomid was put on hold. With DH's second SA the clinic (an actual fertility clinic, not his GP) did not find the agglutination, so I have been thinking about Clomid.

Here is where I am hesitant. I don't think my OB will monitor me while I am on it. I guess I would like to know what you would do. Considering the RE would not do any testing on me because of my weight, I don't think they would prescribe me Clomid or monitor me. I guess I feel like my only hope (right now) is going back to my OB.

Would you do a Clomid cycle without being monitored? Is it completely necessary? Should I make another appointment with my OB to see if he would monitor me, or maybe I could talk to the nurse? Tell me what you would do, please.

TIA!

BzeetyD · October 2011

I hope I can answer here, I think after this week I'd be "qualified" to be over here.

Would you be monitored at all? Would you have a mid-cycle ultrasound to check for follie development?

Personally, I wouldn't do it unless you were at least having this.

I would make an appointment to see if your OB would monitor you and to see how familiar they are with Clomid. Once you know that, then I would make your decision.

My clinic does a lot of RE type stuff including IUIs, so they are very familiar with Clomid and injectables and have different levels of monitoring for each. Even our RE told us to stick with our OB clinic. I know this is not the norm.

Good luck in your decision.

ChristinaCT · October 2011

Honestly I would call my OB & See if they would monitor me. I would explain your fears & the side affects you know of & just tell them that if you try it you would want to be closely monitored. If I have to go the Clomid route, I will be doing the exact same thing.

BzeetyD · October 2011

PetraStonegirl:
I am currently on my 3rd and final 'partially monitored' Clomid cycle.
My OB considers it to be an 'unmonitored' cycle because we aren't doing a trigger so we don't need the mid-cycle u/s to check for hyperstimulation, but he is still doing some things. A cycle looks like this:
CD1 -- call in and be referred for a follicle study on CD1 or CD2. They do count follies as a matter of course, but it is really a scan to make sure there are no cysts on the ovaries before I take Clomid. OB does not call in script until u/s is cleared.
CD2-6 -- take Clomid dose each night
1DPO -- begin 2x daily progesterone suppositories
9DPO -- progesterone draw to verify ovulation
14DPO -- HCG draw to determine if we continue progesterone or stop and wait for AF.
Each successive Clomid cycle always begins with follicle study.
Granted the progesterone isn't standard with the Clomid, that part is an extra precaution my OB is taking in case the issue is a fault with the development of my corpus lutem not related to poor ovulation.
So, I would call the absolute minimum for a non-trigger Clomid cycle as a CD1, 2, or 3 u/s to verify that there is not currently any ovarian cysts prior to taking Clomid, and to do that each and every Clomid cycle.
It may not be the most effective use of Clomid, in that you aren't examining the follicles just before trigger, releasing any/all mature eggs. This method relies on the dominate mature follicle to O on it's own, leaving any others to reduce and fade back as with any normal unmedicated cycle. But, it's what my OB recommended prior to going to an RE, because it keeps the risk of multiples low. Not that I would object to twins, but he's worried about the additional risks multiples carry.

Just wanted to say that my monitoring was very similar to Petra's except I did not have an early follicle study (always had a progesterone draw to check for ovulation in the luteal phase prior) but instead had one around the time of a +opk. This was also done to ensure we were only ever dealing with 2 follicles (not 3 or 4). This was the routine all 6 of my Clomid rounds.

johnnys june · October 2011

I guess it depends on why you want to take it. For me, based on my charts (from over a 6 month period) and based on previous signs and symptoms, my doctor and I discussed trying a low dose of Clomid to see if I would ovulate. The CD21 draw was optional, but she said it was unnecessary if I was getting positives with OPKs and temps. We're basically trying to jump start my body without me having to go on Clomid. However, I feel that if I was concerned at all she would take it seriously and do the testing/monitoring. I'm only on 50mg. Most women start out at 100mg. I expressed all my concerns as well as knowledge from some of the women's experiences on here and she assured me that her reason for putting me on Clomid was less serious than most. It was more of a trial to see if I can ovulate before proceeding with more intense tests and putting out more $$$. I was ok with this. If you've had more issues or have some fears, I would request they monitor you. Good luck, Lovey!

EntropicEpona · October 2011

NO CLOMID WITHOUT MONITORING. No exceptions, sweetheart.

I'd check to see if your OB would at least do midcycle monitoring to check for overstimulation. No litters allowed!

Allie-Jo · October 2011

I am not over here yet, but I have been told the CD2/3 monitoring is NEEDED. If you start clomid and you have ANY cyst(not follicles) on your ovaries. they will grow dangerously big and really fast. They could rupture and you can internally hemmorage. Most OBs will skip it because its not very likely to happen. But for me, if I am on clomid two cycles in a row (sometimes it only takes one) I develop a cyst bigger then a mature follicle on CD3. If I had been unmonitored, by cycle 3 I would have had a huge cyst rupture by now. When I do have a cyst, we have to take a cycle off and put me on BCP to suppress thr cyst.

I never really thought it was a big deal but after hearing some horror stories and then a friend of mine winding up in the hospital for pains that was a cyst TWICE the size of a mature follicle(thank god it hadnt ruptured yet) I make sure I let anyone considering clomid know not monitoring CAN be really bad. and chancing it isnt smart.

buckeyebaby814 · October 2011

It really has to be a decision you ultimately make, but I would insist on being monitored. I know some OB/GYN's do not monitor, but some do (mine does.) I do not do all the monitoring a RE would do (I don't get CD 3 b/w- in fact I don't even know what it's for AND I do not get 7dpo b/w to confirm O, since I temp to confirm O) but I do get a CD 3 u/s to check my lining and for cysts and I go back about 8-10 days later for a follie count.

I think both u/s are important since the clomid could exponentially increase existing cysts at the beginning of a cycle (in that case they should probably cancel a clomid cycle) AND the 2nd u/s to make sure you do not overstimlate (OHSS, I think) which could be pretty serious. Also, if you have several mature follies, it will obviously increase your risk for multiples, which your doctor may at that point cancel your cycle as well.

I would just call and ask what their protocol is and if there's not monitoring, ask to leave a message for the doctor saying you'd at least like the u/s before and after.

Good luck sweety

Carolee · October 2011

Knowing what I know now about Clomid, I would not take it without being monitored. That said, I did 4 unmonitored Clomid cycles before I knew better, and nothing bad happened. I would ask the OB if they would do monitoring for you, because there is a small possibility of producing too many follicles, but there is also a possibility of it thinning your lining too much so that a pregnancy would not be successful. That way too, you would know if you respond well to it and you would know if you could continue on it if needed or if it would be better for you to switch to something like Femara.

cutebride73 · October 2011

This is how my RE's office handles clomid without a trigger. You go for your CD 3 basline b/w and u/s to make sure there are no cysts. Then take the clomid on the days prescribed. Since there is no trigger, use OPK's at home and when I got a + go in for a u/s. If everything looked good we did TI. Then if there are no issues with the cycle, they do the next one without monitoring. I only did the one cycle of clomid because I responded so poorly.

I would call your OB and see if they will at least do that much monitoring. I am not even sure you would need the CD 3 u/s and b/w since you have not been on meds and if cysts aren't an issue then you might be able just to have a u/s when you get a + OPK. That's what I would ask to do. Then see how you respond the first cycle and go from there.

Good luck hun, I know this is all so hard. I would def. ask for that much monitoring though.

CashewsMommy · October 2011

Give your OB a call and ask if they will do monitoring. At least an ultrasound to check for overstimulation!

MandaS08 · October 2011

I would make sure your OB will do monitoring-maybe they don't require it, but you should request it and I wouldn't take clomid without it.

Like PP have said you really need the CD3 ultrasound to check for any cysts, and at least a mid cycle check to make sure you don't have a million follices and might end up like John and Kate + 8.

Lastly, I would would to know if I was responding well to clomid before I continue to take it for multiple cycles. I wouldn't want to take a hormone like that (you are only supposed to take it for 6 cycles in your lifetime) if its not doing any good.

Clomid help...

Re: Clomid help...

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