Met with my RE... Now What?

runforcookies · January 2013

Here's a little background. My OBGYN works with a fertility clinic (there are none too close to me). I've all my testing done through my gyn and it all came back normal, and DH's SA came back great.

So today I met with the RE to go over everything and make a plan. So he basically gave me all my options and gave me the pros and cons of them all.

The 2 options he gave that me and DH are comfortable with at the moment are Clomid + IUI, and injectibles + IUI . The RE says he would do 3 cycles of Clomid + IUI before moving on to injectibles, or we could just go right into injectables.

Here are my questions. We discussed the monitoring on Clomid and he does monitor it very closely, but just wondering, what is the standard appropriate amount? I don't want to mess with Clomid unless I know I am getting the absolute best care.

If we decided to go ahead and go right into injectables, obviously our chances of conceiving are better, so why wouldn't we? There must be some downside or else, why would he have given Clomid as an option if we didn't want to jump right into them.

I also just wanted to thank everyone here, because even though I still have questions, I felt pretty prepared going into my appointment. I owe that to all the knowledge I've learned from this board.

mrsrichey11 · January 2013

The standard monitoring for Clomid is

CD3 ultrasound/blood work

CD11-12ish ultrasound/ blood work

7DPO p4 levels (progesterone)

I've only been on two rounds of Clomid and have not responded to either of them, our next step is one more round of 150mg of Clomid w/Ovidrel trigger shot. So I don't have any experience with injectables yet, but I wanted to wish you good luck!

Shortie24 · January 2013

I think the reason why most people choose Clomid/Femara + IUI is the cost factor. Injectables are crazy expensive if you have to pay out of pocket.

I choose to do 4 rounds of Clomid, and now I'm on round #2 of Femara but we did add injects to help push my ovaries since I'm a slow grower.

One 300iu Gonal-f pen set me back $278! (I did get 5 injects out of it.) I will get back $30 because they have a rebate right now.

I'm not sure if we'll be able to do an all inject cycle due to the cost since we are OOP.

I also feel that RE's would rather do the least invasive (and cheaper) protocols first, at least mine did, before jumping into something more expensive.

I hope this helps! And good luck!

Durham1008 · January 2013

Shortie24:
I think the reason why most people choose Clomid/Femara + IUI is the cost factor. Injectables are crazy expensive if you have to pay out of pocket.
I choose to do 4 rounds of Clomid, and now I'm on round #2 of Femara but we did add injects to help push my ovaries since I'm a slow grower.
One 300iu Gonal-f pen set me back $278! (I did get 5 injects out of it.) I will get back $30 because they have a rebate right now.
I'm not sure if we'll be able to do an all inject cycle due to the cost since we are OOP.
I also feel that RE's would rather do the least invasive (and cheaper) protocols first, at least mine did, before jumping into something more expensive.
I hope this helps! And good luck!

This. Also, I think it would be better to see how you react to the Clomid alone because if you have a good response to it, there's really no need for the injects. You could end up overstimulating.

DontBlink29 · January 2013

I just had my consultation to move on to injectables next cycle.

The medicine is more expensive and there is more monitoring, which is more expensive.

For clomid I go in on CD3, CD11, IUI, and 7DPO bloodwork.

The schedule they gave me for injectables was CD2 -- BW+US, CD4 -- BW, CD6--BW+US, then monitoring continuing every two-three days while stimming until we're ready to trigger. That's 4-6 check-ins or so before even having IUI.

I would definitely try Clomid first.

runforcookies · January 2013

This all makes a ton of sense, I'm glad I asked. I feel a lot better about going with clomid and IUI. I guess I just am scared of clomid because of all the side effects I hear, but obviously injectables come with there own laundry list as well.

NickiChick · January 2013

I am exactly where you are right now. I'm unexplained and our RE gave us the same choice. He mentioned the FASTT study that gave statistics for Clomid/IUI and injects/IUI. Here's a web page with a summary from the study. It's long but the details of the study are in the "Comparison of Different Treatments for Unexplained Infertility" section at the bottom.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505167/

I chose Clomid/IUI for the reasons PP mentioned. Looking at the study, injects didn't increase the chances in a drastic way to make me lean that direction. GL to you. I hope Clomid/IUI does the trick!

laurid75 · February 2013

We also just went through this and did Clomid + IUI. I didn't experience any side effects from Clomid, they usually start you on the lowest doseage to see how your body responds. I think I only had one mature follicle but it was a good size so they triggered me and I should know by Monday if it worked.

runforcookies · February 2013

laurid75:
We also just went through this and did Clomid IUI.nbsp; I didn't experience any side effects from Clomid, they usually start you on the lowest doseage to see how your body responds.nbsp; I think I only had one mature follicle but it was a good size so they triggered me and I should know by Monday if it worked.
nbsp;

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