What's after clomid?

buckeyebaby814 · January 2012

I realize that it will completely depend on Dx, but what is typically next? I don't have an official Dx other than recurrent pregnancy loss and short LPs (9 days long every time, except when on clomid).

Also, the only testing I've not had done is an endo biopsy (to Dx LPD) and antral follicle count. Should I be requesting either of these? I don't know that my treatment would change based on a LPD Dx (my RE has already said he believes THIS is the primary problem my body will not accept my pregnancies), but I wonder about having my AFC checked.

What do you ladies think? I feel like I've entered a new world, much like when I first started charting and posting on TTGP a year ago!

ETA: I know this is 'cart before horse' talk, I haven't even had my follie scan for this cycle Embarrassed

KdgTeacher · January 2012

I did 3 cycles of Clomid only.

My 4th cycle (this past one) I did Clomid + Follistim + IUI

buckeyebaby814 · January 2012

KdgTeacher:
I did 3 cycles of Clomid only.

My 4th cycle (this past one) I did Clomid + Follistim + IUI

This is my 3rd clomid cycle- which is why I was thinking about asking my RE about future treatment plans. My husband's SA was good, except his morph was 23% (normal=30%). I think I'm going to ask about IUI for next cycle. This is my first treatment cycle with my RE, the previous 2 clomid cycles were with my OBGYN (yes, monitored Smile ) so I'm not sure how it typically works, but when would you bring up future treatment plans? Schedule a separate consult appointment?

ellephunt · January 2012

The steps my RE generally takes are Femara+TI for 6 cycles, Clomid+IUI for 6 cycles, Injects+IUI 6 cycles, IVF. Now obviously things change from cycle to cycle and depending on dx you may respond differently. This is the general chart that my RE gives out before the first consult.

KdgTeacher · January 2012

buckeyebaby814:
KdgTeacher:

I did 3 cycles of Clomid only.

My 4th cycle (this past one) I did Clomid + Follistim + IUI

This is my 3rd clomid cycle- which is why I was thinking about asking my RE about future treatment plans. My husband's SA was good, except his morph was 23% (normal=30%). I think I'm going to ask about IUI for next cycle. This is my first treatment cycle with my RE, the previous 2 clomid cycles were with my OBGYN (yes, monitored ) so I'm not sure how it typically works, but when would you bring up future treatment plans? Schedule a separate consult appointment?

My RE really changes things up after 3 cycles (so I did 3 cycles of Clomid but the dosage was different each time) with TI. I did my highest dosage of Clomid (50mg) plus 25IU (lowest dose) of Follistim. I responded VERY VERY well (3 follies versus 1 follie each time on Clomid) to Clomid + injects. We did 1 IUI (my clinic usually does B2B) with MH's count of 20 million.

I imagine this cycle will be close to my last but we'll do B2B IUIs

ellephunt · January 2012

buckeyebaby814:
KdgTeacher:
I did 3 cycles of Clomid only.

My 4th cycle (this past one) I did Clomid + Follistim + IUI
This is my 3rd clomid cycle- which is why I was thinking about asking my RE about future treatment plans. My husband's SA was good, except his morph was 23% (normal=30%). I think I'm going to ask about IUI for next cycle. This is my first treatment cycle with my RE, the previous 2 clomid cycles were with my OBGYN (yes, monitored ) so I'm not sure how it typically works, but when would you bring up future treatment plans? Schedule a separate consult appointment?

It might be a good time to sit down and just consult with him. At our first consult I expressed that I would like to move on after 3 cycles of no success on the same plan. He agreed and we would come up with a new plan when needed.

ukcats27 · January 2012

Possibly injects? Whatever is next for you, I hope it is successful for you.

genmalone · January 2012

It depends on how well you responded to Clomid. Next step is usually Femara or a combination of Clomid + injects.

Good luck!

kellygksu · January 2012

For me it was injects after Clomid. I always ask my RE what's next at my iui, in case it doesn't work. I guess it's a little pessimistic to ask what's next as he's injecting DH's sperm into my ute, but otherwise, I think I'd drive myself crazy trying to imagine what he'll tell us to do next! If this cycle didn't work and we move on to IVF, I'm sure we'll have to have an official consult. (Adios, $300.) Good luck, whatever you decide!

KdgTeacher · January 2012

kellygksu:
For me it was injects after Clomid. I always ask my RE what's next at my iui, in case it doesn't work. I guess it's a little pessimistic to ask what's next as he's injecting DH's sperm into my ute, but otherwise, I think I'd drive myself crazy trying to imagine what he'll tell us to do next! If this cycle didn't work and we move on to IVF, I'm sure we'll have to have an official consult. (Adios, $300.) Good luck, whatever you decide!

You pay a consult fee every time you meet with the RE to discuss something? Even after your an established patient?!?!?!?1

buckeyebaby814 · January 2012

KdgTeacher:
buckeyebaby814:
KdgTeacher:

I did 3 cycles of Clomid only.

My 4th cycle (this past one) I did Clomid + Follistim + IUI

This is my 3rd clomid cycle- which is why I was thinking about asking my RE about future treatment plans. My husband's SA was good, except his morph was 23% (normal=30%). I think I'm going to ask about IUI for next cycle. This is my first treatment cycle with my RE, the previous 2 clomid cycles were with my OBGYN (yes, monitored ) so I'm not sure how it typically works, but when would you bring up future treatment plans? Schedule a separate consult appointment?

My RE really changes things up after 3 cycles (so I did 3 cycles of Clomid but the dosage was different each time) with TI. I did my highest dosage of Clomid (50mg) plus 25IU (lowest dose) of Follistim. I responded VERY VERY well (3 follies versus 1 follie each time on Clomid) to Clomid + injects. We did 1 IUI (my clinic usually does B2B) with MH's count of 20 million.

I imagine this cycle will be close to my last but we'll do B2B IUIs

That sounds good! My last clomid cycle I only had one mature follie, first cycle I had two. I feel with MH's borderline morph that IUI may be a good route to go.

Good luck with this cycle!

buckeyebaby814 · January 2012

ellephunt:
buckeyebaby814:
KdgTeacher:
I did 3 cycles of Clomid only.

My 4th cycle (this past one) I did Clomid + Follistim + IUI
This is my 3rd clomid cycle- which is why I was thinking about asking my RE about future treatment plans. My husband's SA was good, except his morph was 23% (normal=30%). I think I'm going to ask about IUI for next cycle. This is my first treatment cycle with my RE, the previous 2 clomid cycles were with my OBGYN (yes, monitored ) so I'm not sure how it typically works, but when would you bring up future treatment plans? Schedule a separate consult appointment?
It might be a good time to sit down and just consult with him. At our first consult I expressed that I would like to move on after 3 cycles of no success on the same plan. He agreed and we would come up with a new plan when needed.

I will ask about scheduling an appointment while I'm there on Saturday then. While my s/e's on clomid diminish with each cycle, they're still not desirable and I've hear femara is not as bad.

buckeyebaby814 · January 2012

ukcats27:
Possibly injects? Whatever is next for you, I hope it is successful for you.

Thank you! How are you feeling? I really hope this is YOUR cycle! Smile

buckeyebaby814 · January 2012

genmalone:
It depends on how well you responded to Clomid. Next step is usually Femara or a combination of Clomid + injects.

Good luck!

My first cycle I had two mature follies and the second I only had one (that resulted in my ectopic pregnancy). My RE upped the dose from 50mg to 100mg because he want's me to have more than one. I will definitely have to ask- thank you!

kellygksu · January 2012

KdgTeacher:

kellygksu:
For me it was injects after Clomid. I always ask my RE what's next at my iui, in case it doesn't work. I guess it's a little pessimistic to ask what's next as he's injecting DH's sperm into my ute, but otherwise, I think I'd drive myself crazy trying to imagine what he'll tell us to do next! If this cycle didn't work and we move on to IVF, I'm sure we'll have to have an official consult. (Adios, $300.) Good luck, whatever you decide!

You pay a consult fee every time you meet with the RE to discuss something? Even after your an established patient?!?!?!?1

For an official appointment, you do. That's why I always just work the conversation into my monitoring or IUI appointments. I am seriously hoping that if you are moving on to IVF, and about shell out thousands....they cut you a break!! I think I'm just cranky because I have spent sooooo much money there in the past two weeks, it's insane.

MrsZ816 · January 2012

I did Clomid/trigger/TI for 2 cycles, then I did Clomid/trigger/IUI for one cycle, and then moved on to injects/IUI.

kellyrn9956 · January 2012

If you've had a CD3 ultrasound at any time, you've most likely had an AFC - they just didn't disclose the results to you. I would call to ask what your AFC was at your last CD3 baseline ultrasound.

We moved to injects after 3 cycles of Clomid.

KdgTeacher · January 2012

kellygksu:
KdgTeacher:

kellygksu:
For me it was injects after Clomid. I always ask my RE what's next at my iui, in case it doesn't work. I guess it's a little pessimistic to ask what's next as he's injecting DH's sperm into my ute, but otherwise, I think I'd drive myself crazy trying to imagine what he'll tell us to do next! If this cycle didn't work and we move on to IVF, I'm sure we'll have to have an official consult. (Adios, $300.) Good luck, whatever you decide!

You pay a consult fee every time you meet with the RE to discuss something? Even after your an established patient?!?!?!?1

For an official appointment, you do. That's why I always just work the conversation into my monitoring or IUI appointments. I am seriously hoping that if you are moving on to IVF, and about shell out thousands....they cut you a break!! I think I'm just cranky because I have spent sooooo much money there in the past two weeks, it's insane.

That BLOWS my mind!

kellyrn9956 · January 2012

KdgTeacher:
kellygksu:
KdgTeacher:

kellygksu:
For me it was injects after Clomid. I always ask my RE what's next at my iui, in case it doesn't work. I guess it's a little pessimistic to ask what's next as he's injecting DH's sperm into my ute, but otherwise, I think I'd drive myself crazy trying to imagine what he'll tell us to do next! If this cycle didn't work and we move on to IVF, I'm sure we'll have to have an official consult. (Adios, $300.) Good luck, whatever you decide!

You pay a consult fee every time you meet with the RE to discuss something? Even after your an established patient?!?!?!?1

For an official appointment, you do. That's why I always just work the conversation into my monitoring or IUI appointments. I am seriously hoping that if you are moving on to IVF, and about shell out thousands....they cut you a break!! I think I'm just cranky because I have spent sooooo much money there in the past two weeks, it's insane.

That BLOWS my mind!

That's the same with me. If I schedule 1/2 hour of the doctor's time (not during a regular monitoring appt), I pay the consult fee. It's def less than $300, but I still pay it. We do a lot of our discussions over the phone unless we are getting ready to move to another type of treatment.

KdgTeacher · January 2012

kellyrn9956:
KdgTeacher:
kellygksu:
KdgTeacher:

kellygksu:
For me it was injects after Clomid. I always ask my RE what's next at my iui, in case it doesn't work. I guess it's a little pessimistic to ask what's next as he's injecting DH's sperm into my ute, but otherwise, I think I'd drive myself crazy trying to imagine what he'll tell us to do next! If this cycle didn't work and we move on to IVF, I'm sure we'll have to have an official consult. (Adios, $300.) Good luck, whatever you decide!

You pay a consult fee every time you meet with the RE to discuss something? Even after your an established patient?!?!?!?1

For an official appointment, you do. That's why I always just work the conversation into my monitoring or IUI appointments. I am seriously hoping that if you are moving on to IVF, and about shell out thousands....they cut you a break!! I think I'm just cranky because I have spent sooooo much money there in the past two weeks, it's insane.

That BLOWS my mind!

That's the same with me. If I schedule 1/2 hour of the doctor's time (not during a regular monitoring appt), I pay the consult fee. It's def less than $300, but I still pay it. We do a lot of our discussions over the phone unless we are getting ready to move to another type of treatment.

WOW! My insurance doesn't cover a ton, but GEEZE LOUISE will I say a prayer that I don't have to do that!

buckeyebaby814 · January 2012

kellygksu:
KdgTeacher:

kellygksu:
For me it was injects after Clomid. I always ask my RE what's next at my iui, in case it doesn't work. I guess it's a little pessimistic to ask what's next as he's injecting DH's sperm into my ute, but otherwise, I think I'd drive myself crazy trying to imagine what he'll tell us to do next! If this cycle didn't work and we move on to IVF, I'm sure we'll have to have an official consult. (Adios, $300.) Good luck, whatever you decide!

You pay a consult fee every time you meet with the RE to discuss something? Even after your an established patient?!?!?!?1

For an official appointment, you do. That's why I always just work the conversation into my monitoring or IUI appointments. I am seriously hoping that if you are moving on to IVF, and about shell out thousands....they cut you a break!! I think I'm just cranky because I have spent sooooo much money there in the past two weeks, it's insane.

Yuck! I would try and fit it into monitoring appointments too!

buckeyebaby814 · January 2012

kellyrn9956:
If you've had a CD3 ultrasound at any time, you've most likely had an AFC - they just didn't disclose the results to you. I would call to ask what your AFC was at your last CD3 baseline ultrasound.

We moved to injects after 3 cycles of Clomid.

That's what I thought! I hadn't thought that it was something much more complex than checking available eggs early on in the cycle, but I want to cover all my bases before shelling out more money if we're planning on more than just clomid! I will ask him about it when I am there Saturday!

maggie2324 · January 2012

kellygksu:
KdgTeacher:

kellygksu:
For me it was injects after Clomid. I always ask my RE what's next at my iui, in case it doesn't work. I guess it's a little pessimistic to ask what's next as he's injecting DH's sperm into my ute, but otherwise, I think I'd drive myself crazy trying to imagine what he'll tell us to do next! If this cycle didn't work and we move on to IVF, I'm sure we'll have to have an official consult. (Adios, $300.) Good luck, whatever you decide!

You pay a consult fee every time you meet with the RE to discuss something? Even after your an established patient?!?!?!?1

For an official appointment, you do. That's why I always just work the conversation into my monitoring or IUI appointments. I am seriously hoping that if you are moving on to IVF, and about shell out thousands....they cut you a break!! I think I'm just cranky because I have spent sooooo much money there in the past two weeks, it's insane.

For IVF, at least at my clinic, you pay the base cost upfront on the day of your appt ($7310) and that includes the consultation. That doesn't make it any better, I know.

As for what's after Clomid. With our MFI, we won't do any other drugs. After a max of 3 Clomid + IUI cycles, we will be onto IVF. That's because it doesn't make sense to pay $3000 for injects + IUI when we have much better odds with IVF. It has to make sense with the odds of success and cost.

dimples128 · January 2012

buckeyebaby814:
KdgTeacher:

I did 3 cycles of Clomid only.

My 4th cycle (this past one) I did Clomid + Follistim + IUI

This is my 3rd clomid cycle- which is why I was thinking about asking my RE about future treatment plans. My husband's SA was good, except his morph was 23% (normal=30%). I think I'm going to ask about IUI for next cycle. This is my first treatment cycle with my RE, the previous 2 clomid cycles were with my OBGYN (yes, monitored ) so I'm not sure how it typically works, but when would you bring up future treatment plans? Schedule a separate consult appointment?

We have similar DX. I have LPD and DH has low morph. My RE suggested only 1 cycle with TI before moving into an IUI. He said with our dx, we are great candidates for IUIs to work. Granted, the first one didn't work but we've changed it up a bit on this cycle by adding Bravelle to help with my lining. If this cycle doesn't work, I would schedule an appointment then for a "next steps" meeting. Hopefully you won't have to have that discussion!

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