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Intro & RE concerns

cupcake916cupcake916 member
edited June 2014 in Trouble TTC
So I've been lurking for a while and feel that 3T is where I belong.  My story is similar to many others on here.  I'm 30, DH is 29.  We've been together 8 years, married for 3.  I went off BCP in Sept 2013.  No period for 4 months. Ob/Gyn gave me a round of Provera to induce a period and ran some basic bloodwork.  Everything came back normal, but no period again for 4 months.  After talking about it with DH for a few weeks, I decided to call an RE, expecting it would be a few months before I could get an appointment.  They had a cancellation and I got in pretty quickly.

I had the usual testing and workup with the RE (ultrasound, CD3 b/w, HSG, SA, b/w to rule out PCOS).  Everything was normal - I'm just not ovulating.  The only mild concern was that my ovaries are enlarged and have numerous follicles on each (~25).  Bloodwork results did not indicate PCOS.

The RE first suggested clomid (CD3-7) + IUI.  But due to lack of insurance for infertility treatment, DH and I would like to try clomid + TI for a few months.  He agreed, gave me some informational papers and told me to call the nurse if I don't have a period by 7/9 to start Provera.  I'm concerned that they don't require ultrasound monitoring on clomid - I'm supposed to use OPK's starting on CD10 and call if I don't have a positive after 5 days.  I think this is partly because I don't have insurance coverage.  Also, the RE said I can try various approaches using clomid for up to a year before moving on to injectables.

After everything I've read on here, this doesn't seem quite right - but I have to assume that the RE knows what he's doing.  Should I be worried?  I plan to call and ask questions before I start the medicated cycle - what should I ask?  Any advice would be appreciated.  Thanks  :)
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Re: Intro & RE concerns

  • lupineauralupineaura member
    Welcome! I hope your stay is short. If you can, I would recommend a second opinion. There are a lot of risks to unmonitored Clomid, including undetected cysts and higher-order multiples (ever hear of Kate Goslin?).

    Good luck whatever you decide!
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  • bravegrace22bravegrace22 member
    hi! i have some questions on 'lingo' if you gals don't mind clarifying...
    What do mean by "TI"
    cupcake916 said:
     DH and I would like to try clomid + TI for a few months.   
     and rainbowbridge14, i didn't quite understand this..trigger??
    rainbowbridge14 said:
    one did limited ultrasound monitoring and relied on OPK's for timing rather than a trigger. He only did a baseline ultrasound CD3 and a mid cycle around CD12 just to make sure I was responding to the meds, then I waited for a positive OPK. I actually found it really stressful and was glad when I switched to an RE that does ultrasound monitoring and trigger for all cycles. 

    thanks!

    image
    Me:26 DH:27
    Married Oct 2011
    NTNP for about a year before actively 
    TTC since April 2013
    Currently testing for infertility cause and hormone imbalance.
    Infertility & ovarian cyst diagnosis: May '14
    B/W: 'good', more ordered to check antibodies & progesterone
    SA: Normal :)
    U/Ss for cyst: who the f knows
    DH's cat scan: showed encapsulated fatty growth; u/s: didn't really show much more
    Breast Specialist: Most likely a large fibroid, but keeping an eye on it, repeat u/s every 6mos 
    HSG: clear tubes, uterus is A-ok
    WHAT'S NEXT: DH's consult with surgeon to discuss next step for growth, either biopsy or surgery~Big discussion with Dr. before any possibility of starting Clomid, since I'll want another u/s before and to be monitored and he doesn't seem into that. I had to force his hand just to order the AMH test so may be looking for another OB
    ~All welcome :) ~
    Cycle 3 of OPK; Cycle 2 (this time around) of Temping

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  • lebradfordlebradford member
    bravegrace22 said:


    hi! i have some questions on 'lingo' if you gals don't mind clarifying...
    What do mean by "TI"
    cupcake916 said:

     DH and I would like to try clomid + TI for a few months.   
     and rainbowbridge14, i didn't quite understand this..trigger??

    rainbowbridge14 said:

    one did limited ultrasound monitoring and relied on OPK's for timing rather than a trigger. He only did a baseline ultrasound CD3 and a mid cycle around CD12 just to make sure I was responding to the meds, then I waited for a positive OPK. I actually found it really stressful and was glad when I switched to an RE that does ultrasound monitoring and trigger for all cycles. 

    thanks!


    TI stands for timed intercourse. It means having sex on specific days that your doctor tells you to either in relation to your follicle growth, your LH surge, or your trigger shot (if you're using one).


    OP- Monitoring on Clomid is essential, regardless of if you have insurance coverage or not. Please either seek a second opinion or push for proper monitoring. Unmonitored Clomid could land you with higher order multiples, cysts that you don't know about that could either delay future treatment or lose you an ovary or fallopian tube, or you might not respond at all, but your doctor won't know in time to do anything about it that cycle if you aren't being monitored.
    **siggy warning**  **everyone welcome**

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    DS- 11.07.02
    DSS- 6.26.04
    Married- 6.29.13
    TTC Again- Sept. 2013
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    Test Results/Diagnosis- HSG & SA totally normal
    DX: 3/2014 Prolactinoma/Hyperprolactinemia- Started cabergoline 2/2014
    5/2014 Possible mild PCOS in addition to hyperprolactinemia??
    7/2014 Adding probable tubal factor to the diagnosis list
    9/2014 And now adding hypothyroid to the list- Started synthroid 9/2014
    Cycles 1-4 - Sept.-March- All Anovulatory 
    IUI #1 March/April-  Clomid 50mg + Clomid 100mg +Trigger + IUI #1 = BFN
     IUI #2 April/May-Clomid 100mg + Clomid 150mg + Trigger + IUI #2 + Endometrin=BFN
    IUI #3- June- Follistim 75iu + Trigger + IUI #3  Benched due to a 40 mm cyst. :-(
    IUI #3- July- Follistim 75iu + Trigger + IUI #3 + Endometrin = BFP! on 7/25/14
    Slowly rising betas - Ectopic suspected on 8/8/14 & confirmed on 8/11/14
    Methotrexate on 8/12/14 -HCG negative on 9/2/14
    IVF #1- November- Antagonist protocol: 11/1: start stims, 200iu of Follistim; 11/12 ER 17R/14M/14F; 11/17 5 day transfer of two blasts, 2 blasts and 2 expanding morulas frozen; 11/22 BFP!! (On FRER at 5dp5dt)
    Betas: 9dp5dt 205, 11dp5dt 497, 14dp5dt 1,709
    u/s at 5w0d- 1 sac; u/s at 6w0d 1 baby with heartbeat, another sac without a heartbeat
    image


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  • cupcake916cupcake916 member
    Thanks for the second thoughts. I'm going to call next week and ask a lot more questions (and consider a second opinion) before beginning the clomid cycle. I was a little overwhelmed immediately after the HSG when we tried talking about a plan.
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  • bravegrace22bravegrace22 member
    thanks, lebradford, couldn't find TI (which is what we're doing based on surge, so good to know) in the list of abbreviations and some of the other terms are new to me.
    image
    Me:26 DH:27
    Married Oct 2011
    NTNP for about a year before actively 
    TTC since April 2013
    Currently testing for infertility cause and hormone imbalance.
    Infertility & ovarian cyst diagnosis: May '14
    B/W: 'good', more ordered to check antibodies & progesterone
    SA: Normal :)
    U/Ss for cyst: who the f knows
    DH's cat scan: showed encapsulated fatty growth; u/s: didn't really show much more
    Breast Specialist: Most likely a large fibroid, but keeping an eye on it, repeat u/s every 6mos 
    HSG: clear tubes, uterus is A-ok
    WHAT'S NEXT: DH's consult with surgeon to discuss next step for growth, either biopsy or surgery~Big discussion with Dr. before any possibility of starting Clomid, since I'll want another u/s before and to be monitored and he doesn't seem into that. I had to force his hand just to order the AMH test so may be looking for another OB
    ~All welcome :) ~
    Cycle 3 of OPK; Cycle 2 (this time around) of Temping

    Report Reply
  • nswain85nswain85 member
    Welcome! I'm sorry that you're here but think you'll find that there are a lot of experiences and information available to help :) I personally haven't used Clomid so I can't advise on that part but all that I have heard suggests monitoring is best to make sure that you're reacting ok to the meds. Could you request monitoring even though it's not initially offered?? Good luck!

    Trying to have baby #1 since April 2013

    DH SA March,May 2014 - Low motility and shape issues. On vitamins per RE to help

    Me testing April 3, 2014 - FSH and LH good, HSG showed blocked right tube

    April 29, 2014 - First RE appt., right tube needs to be removed and possibly left also if

    it's bad too. RE suggests going straight to IVF

    June 4, 2014 - LAP/HSC and unexpected endo. removed but tubes got to stay!

    June 13, 2014 - Post-Op appointment. We decide where to go next since main issue

    is MFI influenced. Trying naturally until decision... Repeat SA  in September. Aiming for IUI #1 November 2014.

    image

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