missed my surge?? first month on clomid - need some advice!

staycb01 · January 2014

Hi ladies!

I was needing your help. I always ovulate each month with no problems, however in the past year of TTC I've had a couple early losses which totally messed up my cycles. I recently found out I have PCOS and was put on clomid. This was my first month of taking it CD 3-7. I'm on day CD14 today. i've used the digital ovulation tests each month and always have gotten a smiley face (except for last month but I quit testing after CD18). So far no smiley face, but on CD 11 (at night) &12 (morning) I noticed a bunch of EWCM and my cervix was high and open. My hubby and I dtd on the morning of CD 12. My boobs have been sore now for 2 days. I'm wondering if I ovulated on either CD 12 or 13 and missed my surge? I only test once in the AM. Has anyone ever had any experience with this? what was the outcome, if so?

KingLED · January 2014

staycb01 said:

Hi ladies!

I was needing your help. I always ovulate each month with no problems, however in the past year of TTC I've had a couple early losses which totally messed up my cycles. I recently found out I have PCOS and was put on clomid. This was my first month of taking it CD 3-7. I'm on day CD14 today. i've used the digital ovulation tests each month and always have gotten a smiley face (except for last month but I quit testing after CD18). So far no smiley face, but on CD 11 (at night) &12 (morning) I noticed a bunch of EWCM and my cervix was high and open. My hubby and I dtd on the morning of CD 12. My boobs have been sore now for 2 days. I'm wondering if I ovulated on either CD 12 or 13 and missed my surge? I only test once in the AM. Has anyone ever had any experience with this? what was the outcome, if so?

If you're on clomid you should be monitored. Have I had experience with ovulating on CD 12 or 13? Yes. The outcome was I ovulated. Not really sure what you're actually asking.

ky29 · January 2014

Were you being monitored by your doctor?

staycb01 · January 2014

No, I'm not being monitored. My dr hasn't said anything about it other than taking it 3-7 and coming in for day 21 blood draw. I didn't even know I needed to be monitored until a few of you mentioned it....

My husband did have an SA done and he's perfect. I started testing on CD 9 with OPK's - once per day in the AM.

Sorry - it's my first post on here and maybe I was not clear. I'm asking:

1 - has anyone ever missed their surge when testing with OPK's and ended up ovulating anyways?

2 - has anyone had EWCM and ovulated but did not get a positive OPK?

curlylocks3 · January 2014

staycb01 said:

No, I'm not being monitored. My dr hasn't said anything about it other than taking it 3-7 and coming in for day 21 blood draw.

Sorry - it's my first post on here and maybe I was not clear. I'm asking:

1 - has anyone ever missed their surge when testing with OPK's and ended up ovulating anyways?

2 - has anyone had EWCM and ovulated but did not get a positive OPK?

People that have been taking Clomid appropriately would not have been relying on OPKs to tell them when they ovulated so they likely won't be able to answer your question. For what its worth, I had TONS of EWCM starting 5-6 days before O while on Clomid. And my OPKs were worthless.
At this point all you can do is keep your fingers crossed and hope for the best. If you are not pregnant, find an RE and get properly tested and monitored before taking Clomid again. Do not pass go, do not collect $200.
Oh, and find a new OB.

angeltennis3 · January 2014

Similar to what PP's have said...if you were being properly monitored, you would know when and if you ovulated.

Clomid is dangerous to take without proper monitoring. First, you should be going through an RE, not an OB. Clomid can cause you to mature and potentially release multiple eggs. Typically, your RE will schedule a CD12 ultrasound to take a look at your ovaries to make sure they aren't being overstimulated...and to make sure the medication is actually working. This ultrasound also takes a look at your uterine lining, which Clomid is known to thin. If your uterine lining is thin, then your doctor can prescribe a supplement to take during your cycle to counteract the effects of the Clomid.

You should also have a blood test after ovulation to confirm ovulation.

After each cycle of Clomid, you should have a CD3 ultrasound to make sure that you don't have developing cysts on your ovaries, as Clomid tends to cause these.

Abusing Clomid and not being properly monitored can lead to hyperstimulation of your ovaries. This can result in further fertility problems than what you already have or cause severe trauma to your reproductive organs that could result in requiring surgery.

So, if I were you, I would not be so concerned IF you ovulated and be more concerned why your doctor is putting you at such a health risk.

EDIT: I should also add that being on Clomid can throw off OPKs & temping accuracy. Now I am on Clomid and still use OPKs & temp for my own knowledge, but I have all of the necessary appointments with my RE to monitor how my body is responding.

RayRay007 · January 2014

I love it when I read a thread title and think "oooh, this should be fun".

To answer the questions, yes and yes. PPs have said the rest.

staycb01 · January 2014

Yeah, I must say I'm really shocked/disappointed. I've had my OB for years and she specializes in infertility and family planning as well. I'm def. going to call her and question/find a RE.

I went in b/c I had 3 chemical pregnancies within the last 6 months or so and fingured something is clearly wrong b/c I shouldn't be having all of those like that. She sent me in for an internal and external ultra sound of my uterus and ovaries. She did find a couple things that could be related to PCOS based on that and also did hormone testing (blood) and that came back with slightly high testosterone levels - which is common for PCOS - so that's how I was diagnosed. I was put in Metformin and Clomid. My hubby had an SA done before I was put on Clomid and he came back great.

curlylocks3 · January 2014

staycb01 said:

Yeah, I must say I'm really shocked/disappointed. I've had my OB for years and she specializes in infertility and family planning as well. I'm def. going to call her and question/find a RE.

I went in b/c I had 3 chemical pregnancies within the last 6 months or so and fingured something is clearly wrong b/c I shouldn't be having all of those like that. She sent me in for an internal and external ultra sound of my uterus and ovaries. She did find a couple things that could be related to PCOS based on that and also did hormone testing (blood) and that came back with slightly high testosterone levels - which is common for PCOS - so that's how I was diagnosed. I was put in Metformin and Clomid. My hubby had an SA done before I was put on Clomid and he came back great.

I'm sorry for your losses and that you were misled.

OBs do not specialize in infertility, however. Thats a separate 3 year fellowship. Its great that your H had a SA, but you also need an HSG and/or saline sonogram to insure your tubes are open (one can infer they likely are based on your BFPs but you need to be sure) and that your uterus is structurally normal. Additionally, after 3 losses I would be asking about repeat loss testing.
Good luck to you.

sister13 · January 2014

theresat858 said:

I am very confused as to why your doctor would prescribe Clomid when you are ovulating normally. Clomid does not help whatever might be causing your early losses. Clomid is usually given to women who have trouble *getting pregnant*, not trouble *staying pregnant*. And should be monitored, but I think that's been covered...

I would ask for an RPL panel to be run, and I would ask for progesterone testing. A supplement may help if a defect is causing your losses, but it may not help if that is not your issue. Many other things can cause early losses as well.

I would really question the logic of any doctor who prescribes clomid, (particularly without monitoring) to a woman is already ovulating.

As for OPKs- since the surge can be short, you should be testing at least twice a day. It's easy to miss your surge.

So, from what medical sources or studies can you state this with so much certainly?

I have definitely heard of Clomid or Femara being used for PCOS women who have suffered multiple losses.

Here is some randomly googled information from some IVF websites. To be clear, I am NOT claiming any scientific back-up or personal knowledge of this - but I have definitely heard of this and that some PCOS women have greater occurrence of miscarriages that can be treated with Clomid/Femara.

So, while her doc may be wrong for not monitoring - it does appear to be a medically sound course of treatment for some women with similar conditions as the OP has reported (PCOS, recurring losses). I do agree OP should have repeat loss testing done.

https://pcos.i8.com/custom4.html - snippet: Update:
A recent clinical trial in the USA comparing extended release Metformin (once a day) with Clomiphene or combined Metformin and Clomiphene showed that Metformin was not as effective as originally thought when used as first line treatment in women with PCOS trying to conceive. In the study of 626 infertile women, the live birth rates in women on extended release (once a day) Metformin was 7.2% compared to 22.5% in the Clomiphene group and 26.8% in women who were treated with a combination of Clomiphene and Metformin. (Reference: Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, Steinkampf MP, Coutifaris C, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Giudice LC, Leppert PC, Myers ER; Cooperative Multicenter Reproductive Medicine Network. Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med. 2007 Feb 8;356(6):551-66.)

https://www.jarrettfertility.com/pcds.html - discussed recurrent losses and treatment with Femara

https://www.ivf-indiana.com/education/recurrent-pregnancy-loss.html#ImmuneFactors (snippet below)

3. Endocrine factors

<snip>...Patients with Polycystic Ovarian Syndrome (PCOS) have an increased miscarriage rate (30%). This condition should be evaluated as well. A number of studies show that lowering insulin levels in PCOS with metformin (Glucophage) may reduce the risk of miscarriage. The treatments range from progesterone supplementation, clomid, to gonadotropin therapy. There therapies essentially involve production of multiple eggs in a given cycle and this improve the chances for conception and the likelihood to have quality embryos and uterine lining.

eta: snip

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missed my surge?? first month on clomid - need some advice!

Re: missed my surge?? first month on clomid - need some advice!

3. Endocrine factors

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