I hope this isn't a stupid question...

amd1982 · May 2012

So in trying to remain realistic for this cycle, here's my question. What does someone with PCOS do (in terms of treatment course) after the following:

Clomid + trigger + IUI in January (BFN but responded very well with two mature follies)

Clomid only (50mg) no response in Feb

Clomid 100mg + trigger + TI this month (so far excellent response).

Let's say this results in nothing. Let's just say. It's not like I should move on to injectables, since the Clomid works well for me. DH doesn't have MFI, but I guess if we have a bfn we'd probably try another IUI? i guess i'm just wondering where we go from here....with good response to the Clomid, I'm feeling like injectables wouldn't be an appropriate option. plus at between 4-5k, would it be a waste of money? at what point does IVF become something we should discuss? Again i'm not trying to be negative or anything, just wondering because it doesn't seem like IUI actually increases your chances much (if MFI isn't an issue) so i would hate to waste money for crappy odds. i sort of feel like if this doesn't work, we're at a crossroads.

RE and nurse said "we'll just start over and try another Clomid cycle." But to me, if Clomid hasn't worked after 3 cycles I'm not sure I want to continue. Any ladies with PCOS who are going through IVF or struggling with the decision are welcome. TIA!

Blueyed228 · May 2012

I have PCOS but we have slight MFI (morph issues). We never did Clomid because my RE said it wouldnt work for us. I did 3 inject IUIs before we moved to IVF. I know our situations are not the same thought.

I would ask your RE what he thinks and why.

notquiteblushing · May 2012

That's a good question but I don't have an answer. My RE originally said to try three Clomid cycles and then 3-4 injectible cycles but I think I may ask for a hybrid Clomid + injectible cycle instead. I'm pretty sure that would be cheaper and there's less chance of overresponding.

MrsRedVelvet · May 2012

This was pretty much my question the other day as well. It seems every RE is different with regards to their treatment plan and ultimately it is up to you on what you feel is right to do. Also, insurance/cost is a huge factor, no denying that.

I did 3 rounds of Clomid and I felt like I gave it a real chance. So we're doing injectables now because of the med insurance coverage we have. Otherwise, I would have given some real thought to IVF and the cost/benefit factor.

My RE did say that Clomid+IUI jumps from a 8-10% success rate to 15-18% success rate for injectables though.

Good luck in your decision (hopefully you won't need to make one and positive thoughts for this round!

maggie2324 · May 2012

MrsRedVelvet:
My RE did say that Clomid+IUI jumps from a 8-10% success rate to 15-18% success rate for injectables though.

The success rates here are not really based on the drugs used, it's based on the response. The 8-10% is for one mature follie, the 15-18% is for 2+ follies. Most women only get one follie on Clomid and they will get multiple on injects.

If you're responding well to Clomid (2-3 follies and nice lining), there is no reason for injects yet. IUI will be a good idea because it increases your odds even without MFI, especially when Clomid can create CM issues. I would do at least 2 more Clomid + IUI cycles and then reevaluate.

amd1982 · May 2012

thanks for all the feedback - i guess it's something we'll have to discuss when the time comes. hopefully we don't have to! i guess it's just when i start comparing the cost of Clomid + trigger + IUI it adds up pretty quickly. it's hard to imagine IVF being the best option, but i guess i'll cross that bridge when i come to it.

Jezebell26 · May 2012

Just keep in mind your lifetime max of clomid is 6 cycles. Maybe you can ask about femara. I had no response to clomid at 100 and 150 mgs and my old RE said 200mgs is not worth it because even if you respond you dont get pregnant. I dont know how true that is. I would move to injects at least once before IVF to know how your body responds. You may also get more follies that way and have better odds. We only made teh decision for IVF because i do not respond safely to injects and it is not safe to trigger and do an IUI with how many follies I get. So before you make that decision I would at least suggest trying one injects cycle before IVF. And just so you know we did not chose to do IVF. I would have been happy doing some IUIs, but this is just how it worked out. Best of luck to you!

Ellie 08 · May 2012

I'm on my 5th medicated cycle (IUI #2) and if I get another BFFN this month, I'm going to move to IVF. RE seems to think if we continue with the meds, we're just playing with the same low odds, and since I have a set limit of coverage, we should do IVF while it is covered to increase our chances.

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I hope this isn't a stupid question...

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