To clomid or not to clomid?

GoaliesWife123 · January 2014

Happy New Year, Friends!

While I am waiting for the winter classic to start on TV, I decided to start getting things in order for this upcoming cycle. Along with figuring out referrals (now that I am insured, woo!), I am also going back and forth on whether or not I will start Clomid this cycle. As you all know, I have been seeing an acupuncturist for quite some time and she has discovered that I am kidney yang deficient. She is not sure that Clomid will actually benefit me, and neither am I, but there is no way to know...

At this point, I'm not sure whether we should try another unmedicated cycle, or if we should go ahead and start Clomid and with it, a fully monitored cycle. I have PCOS, which is why my RE wanted me to try it in the first place, but there are months where it is pretty obvious that my body ovulated on its own. This month was a very long cycle (and still going), but, I did have the CM changes as well as the increase in temps to indicate ovulation (finally).

If you took clomid, what is your opinion on it? Would you do it again?

Thank you!

ATXmommas · January 2014

I never used Clomid, but I used the alternative Femara (also called Letrozole) due to slightly irregular cycles (occasionally would not ovulate). My RE prefers Femara due to less side effects than Clomid. In fact, I didn't have any side effects from it. While I did ovulate each time I used Femara, I was happy that I didn't produce more than one dominant follicle each cycle. Personally, I did not want any increased chance of multiples.

I was happy I used Femara, but since I never had an unmedicated cycle, I can't say if it really made a difference for me. When we try for #2, I plan on using the same protocol.

Since you have irregular cycles sometimes, you might want to give it shot (fully monitored, of course) since the financial and emotional investment of TTC is so high and it may increase your odds.

Also, are you planning on moving to IUI? I noticed you did several ICIs each cycle and I think I recall you are using donor sperm, which is quite pricey. YOu may get more bang for you buck by using just one (or at max 2) vials per cycle with an IUI.

Just my two cents. So glad the insurance thing worked out and best wishes for your BFP this year!

trisholiosboi · January 2014

I would recommend Clomid. I think any time you can give your body a boost its a good thing.

GoaliesWife123 · January 2014

@atxmommas thank you! Femara was something that was discussed, but is the one medication my acupuncturist was really against. It was mentioned in my RE appointment, but we opted for Clomid first. I'm not too worried about the side effects, but I don't want to take anything that is given as a "routine" kind of thing, as opposed to something that will help ME. At this point, we are just so excited to not be benched anymore and really just ready for this cycle to be over so we can try again. If we decide to go forward with it, my cycle will be fully monitored with the first ultrasound on CD 13 after taking it. I'm also supposed to get the sonohysterogram completed this cycle.

IUI's are not covered by insurance, so we are sticking with the at-home ICI's for now. We are fortunate that my new insurance covers pretty much everything else for us, so the financial aspect of things is much less than had we continued without insurance.

Thanks for the encouragement, both of you!

trisholio · January 2014

I was on Clomid and I think the only side effect I had was increased appetite. That could have been in my head though :-) I would say to use it and be monitored, especially since your cycles are not consistent. I also liked doing the HCG trigger shot because we were able to get the timing down better. There is a chance of multiples, but it wasn't high enough for us to worry. I say that now, we could go to our ultra sound next week and find out we are having twins or triplets, lol. But the RE will let you know how many follies are mature before doing the insemination.

Good luck and I hope this next cycle is the lucky one!

ball.and.chain · January 2014

It's really a decision you have to make for yourself. I really wanted to conceive as naturally as possible, and held off on fertility meds for a long time (we didn't use Clomid until the 9th IUI). I ovulated every cycle on my own; I probably would have started meds earlier if I had PCOS or any other ovulatory issue. In retrospect, I do wish we'd move to meds earlier. But I also know someone who used Clomid right off the bat and ended up with twins; she wished they'd waited a bit since they didn't really have any reason to need it and singletons would have been easier and safer.

The bottom line is that Clomid is going to increase your chances of conceiving; that could save you money on donor sperm and time/stress. On the other hand, it will also increase your odds of multiples, cysts and a thin lining. You need to decide which you feel more comfortable with, and how important it is to you to get pregnant more quickly versus naturally.

Personally, I did not have any issues with side effects with Clomid, but I didn't respond well to it (despite ovulating normally on my own, it made me not ovulate -- that is an unusual response, but it happens). That is why we moved on to IVF after my Clomid cycle (like herbabymama, I wasn't interested in injectables IUIs).

Good luck!

laynesmomma · January 2014

My situation has ended way different than I ever thought but I do wish I would have been more aggressive earlier. With all the cost of ttc, I would have done more earlier. With that said, I struggled with major mood symptoms on Clomid... Mostly depression. I did acupuncture which helped. Good luck!

StacyLH24 · January 2014

I used Femara for my first three cycles. Clomid wasn't presented as an option by my RE. I had very little side effects with Femara. As it shows in my signature, I used 5 mg for CD 3-7. I only ever had one dominant follicle for each cycle. If you absolutely do not want multiples and you respond (too) well to Clomid, you can always cancel your cycle. My RE's office told us that with Femara, they only ever expect 1-2 follicles per cycle. I would guess it might be the same for Clomid.

GoaliesWife123 · January 2014

Thank you!

KH826 · January 2014

I never took clomid, but I took Femara. The only side effects that I ever experienced were headaches and mild hot flashes. The medicated and monitored cycles made me feel much more in control of the process, and made me feel like we were doing all we could to optimize our chances each cycle. We paid out of pocket for everything (since my insurance does not cover fertility treatments), so every attempt was about $1800 when you factor in the cost of the sperm. Based on this, we wanted to be as aggressive as possible. I have no regrets for being as aggressive as we were, because in the end we got pregnant and that was the goal. The emotional and physical toll that TTC took was not something that I was prepared for, so for me "throwing the kitchen sink at it" (to use a 2mamaz phrase!) was the best approach.

Whatever you decide, best of luck and keep us posted!

GoaliesWife123 · January 2014

Thanks @KH! I'm currently trying to get a referral lined up for the RE because I'm thinking CD 1 is right around the corner. I don't want any delays once it arrives. We decided to adopt the mentality that "throwing the kitchen sink" is a good thing and we are going to try the clomid for this upcoming cycle. I'm excited and nervous, but regardless of what the outcome is, I have my DW and you all and that is all that matters.

Now, if only I could reach my PCP and get that referral lined up...

2MamazInSeattle · January 2014

Hey GW!
I'm so happy to hear you're going to move forward with a medicated cycle. I think as humans we tend to do the same thing over and over and expect a different result - and while I do think TTC is a numbers game, there is a time to step it up and I think you're making a good decision! I know you love your acupuncturist (as I also love mine!) and she has worked on a lot with you, I think significant systemic changes from acupuncture take a long, long time - whereas I know my blood pressure drops 20 points in a session sometimes so some things like circulation, relaxation, etc. I think is very in the moment too. I guess I'm kind of echoing @herbabymama - your RE will get you KU'd, while your acupuncturist supports the process.

My RE as well presented fermera back when we thought we were going to do IUIs. I'd ask your acupuncturist why exactly she is so against it as that may be what your RE suggests. It is seen as the 'better' drug but is often not prescribed because it costs more. It has less side effects and less chance of producing multiple follicles. Just saying I'd wait to decide which drug until you meet with the RE. Clomid is the one widely prescribed; it may be fermara is the right drug for you.

My only clomid friend was unmonitored (duh!) at home ICI. She ended up pregnant with triplets. She selectively reduced and ended up having full-term healthy twins, however, she carries a very, very heavy heart knowing there was one more who will never be born (but balances that with the her belief that she may have had none if she hadn't reduced).

My youngest sister is going to the same RE practice and they recommended femera to avoid the "clomid crazies" (my sister has a VERY sensitive body to everything). She also has mild PCOS, has gone gluten-free and sugar free as well and says it's made a huge difference overall in how she feels. She is essentially doing what you're doing - monitored medicated cycle followed by at home "insemination" (though she has a male partner so they have unlimited tries the old-fashioned way). Her bloodwork showed no immunity to chicken pox (!) so she had to get the booster and wait 2 months before cycling, but I'll let you know how she does when the time comes.

Last thought - I know you are trying to minimize cost - but you might ask how much the actual IUI procedure costs. I know places that the OOP price was $250, and also had a friend go to a regular OB for the insem b/c it was way cheaper than the RE doing it and paid OOP - in the scheme of the cost of sperm, etc. it may be worth looking into to get the 'direct deposit' added in the mix. Just a thought since insurance will cover all the ancillary costs that tend to make the cycles overall cost a lot (ultrasounds, meds, etc.). Maybe not now but perhaps this is the next step in a few cycles if you aren't pregnant yet.

Good luck and congrats on taking the next step!

laynesmomma · January 2014

One more thought... You mentioned that you weren't sure Clomid was necessary bc you ovulate on your own. The secondary gain of Clomid is the production of more follicles/eggs released thus more opportunity for sperm to meet egg. That's a big bonus!

GoaliesWife123 · January 2014

Thank you all so much for your replies. Your insights were incredibly helpful!

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