Trouble TTC

Clomid again?!

At my RE office, there are 2 RE specialist doctors (one male and one female) and a nurse practioner.  I've mostly been seeing the NP because she has the most appointment slots available that have fit with my schedule.  She is OK ....she actually seems quite knowledgeable.  But she always seems to be in such a rush with me and has a very serious demeanor.  Today the female RE returned from maternity leave and I happened to have an appointment with her.  I LOVE her!!  She immediately cracked jokes with me when she came into the exam room.  Took the time to listen to me and sat down and took her time coming up with a plan for me.  I had a huge concern for this cycle because my husband will be going out of town next Fri morning (July 11th) through the weekend.  That is right when my IUI would be expected to happen.  She gave me some options of how we could get around that and assured me that it wasn't the end of the world.  Now I don't want to see anyone but her ....she made me feel so comfortable and I just immediately liked her a lot!  

I'm just frustrated because she's putting me on the same dose of Clomid (150mg) that I was on last cycle.  I want to trust that she is the RE and knows better than I do ....but I feel like it didn't work for me last cycle.  So why would it now?!  I told her my concerns that (from what I understand), the body becomes resistant to Clomid and requires higher doses for the same response.  So wouldn't it make more sense to move on to an injectable (Menopur is what my RE office standard is).  She said that Menopur is much stronger than Clomid and that there is a much higher risk of multiples.  She's treated many women in the past who she feels in retrospect they jumped too quickly to the Menopur ....and many of those women ended up with triplets.  She'd rather stick with Clomid for me for 1 more cycle as she feels that "I'm still relatively young" and she feels it may work this time.  :(  I don't want to be negative but I just feel like the Clomid is not gonna work for me!  I'm like "Give me my injectables!!"  Haha.  I'm just frustrated and venting!  For those of you who are on injectables, how many cycles of Clomid did you have to make it through before your RE started you on the injectables?
**Formerly EastBayBride508**

Me 34   Him 33

Me - Left salpingo-oophorectomy at 19 due to large cyst/torsion  and 2 large uterine fibroids found at age 30
Him - Borderline low sperm count (correcting through Fertility Blend supplement)

Married 8/20/2011
TTC #1 since Jan 2013
First appointment with RE 10/2013.  
April 2014 - Clomid 100mg CD3-7.  HCG shot CD10 IUI #1 done on 4/12/14 (CD12) ....BFN
May 2014 - Break cycle to repeat saline sonogram and re-group.  Travel to Kauai 5/7-5/12 (Yay!!)
June 2014 - Clomid 150mg CD4-8.  HCG shot CD14.  IUI#2 done on 6/9 and 6/10 (CD15-16) w/ Prometrium suppositories during TWW .... BFN
July 2014 - Clomid 150mg CD3-7.  Ultrasound CD12 - 4 mature follies! HCG trigger shot CD12 AM.  IUI#3 on CD13 w/ Prometrium suppositories during TWW ....BFN
July 2014 - Repeat ultrasound done to measure size of fibroid - 8x9cm (the size of a grapefruit!) Surgery referral made.
August 2014 - MRI done which revealed 2 fibroids: a 13x15cm fibroid as well as an 8x7cm one.  Super freak out mode over surgery plan.  OB-GYN/surgeon said surgery would most likely have to be a laparotomy (open abdominal surgery)
August 2014 - After a 2nd opinion, plan to take Lupron x 2 months to shrink fibroids then laparoscopic/robotic myomectomy.  Surgery date is set for Nov 21st!  
November 2014 - Robotic myomectomy done (2 large fibroids removed, mild endo found).  Benched x 3 months

PAIF/SAIF welcome

Re: Clomid again?!

  • @NariaDreaming - I had 2 follies last cycle that were very SLOW growing!!  When I came in on CD11 for the ultrasound (took 150mg Clomid CD4-8), I had 2 dominant follies - 1 that was 14 mm and 1 that was 15mm.  I came back again on CD14 and they were up to 16 and 17mm.  I triggered on CD15 evening and did the IUI on CD15 and 16.  She still seems to think that it could work this cycle.  I am just gonna try to let go, trust that she knows better than I do how to handle this and see how it goes  :)
    **Formerly EastBayBride508**

    Me 34   Him 33

    Me - Left salpingo-oophorectomy at 19 due to large cyst/torsion  and 2 large uterine fibroids found at age 30
    Him - Borderline low sperm count (correcting through Fertility Blend supplement)

    Married 8/20/2011
    TTC #1 since Jan 2013
    First appointment with RE 10/2013.  
    April 2014 - Clomid 100mg CD3-7.  HCG shot CD10 IUI #1 done on 4/12/14 (CD12) ....BFN
    May 2014 - Break cycle to repeat saline sonogram and re-group.  Travel to Kauai 5/7-5/12 (Yay!!)
    June 2014 - Clomid 150mg CD4-8.  HCG shot CD14.  IUI#2 done on 6/9 and 6/10 (CD15-16) w/ Prometrium suppositories during TWW .... BFN
    July 2014 - Clomid 150mg CD3-7.  Ultrasound CD12 - 4 mature follies! HCG trigger shot CD12 AM.  IUI#3 on CD13 w/ Prometrium suppositories during TWW ....BFN
    July 2014 - Repeat ultrasound done to measure size of fibroid - 8x9cm (the size of a grapefruit!) Surgery referral made.
    August 2014 - MRI done which revealed 2 fibroids: a 13x15cm fibroid as well as an 8x7cm one.  Super freak out mode over surgery plan.  OB-GYN/surgeon said surgery would most likely have to be a laparotomy (open abdominal surgery)
    August 2014 - After a 2nd opinion, plan to take Lupron x 2 months to shrink fibroids then laparoscopic/robotic myomectomy.  Surgery date is set for Nov 21st!  
    November 2014 - Robotic myomectomy done (2 large fibroids removed, mild endo found).  Benched x 3 months

    PAIF/SAIF welcome
  • I'm glad that you found an RE that you love working with! I'm not sure about the clomid but in reading on here 3 cycles seems about normal before switching to something else if you are still getting good follies. Good luck with your cycle!
    ***********siggy warning **********



    Me: 26 DH: 27
    TTC #1 Since Aug. 2013
    Cycle 1: O CD 25=bfn
    Cycle 2: O CD 48=bfn
    Cycle 3: Anovulatory/Provera =120 days!
    Cycle 4: Anovulatory/Prometrium=127 days! RE consult 6/16
    Me: Anov/poss. pcos?  HSG=normal/SA= Normal 
    July/Aug. 2014= Femara+trigger+TI=BFP!!
    Beta #1@ 16dpo=626!! Beta #2=1510
    Ultrasound @ 5w6d=heartbeat at 110!
    Ultrasound @ 6w6d =heartbeat at 131!


    Pregnancy Ticker

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  • What she is recommending sounds like the norm.  It is common to try a protocol 3 times before moving on, unless something isn't working (by not working, I don't mean a BFN, but follies don't grow or you have over-response).  And it is normal to have a cycle last longer and for the follies to take longer to grow with clomid.  So it sounds like you are responding right on track for your protocol.


    Me 33, DH 37 -- TTC since Jan'12 -- Low AMH (0.78) & endo, SA w/ low motility
    IUI's 1-3 = BFN, IVF converted to IUI 4/13 = BFN
    IVF 1.2: 8R 6M 4F -- 2 blastocysts frozen, FET 8/15 = BFP!!
    Beta #s = 445;1,098; 9,545  -- EDD 5/2 -- Team Pink!
    Camila Josephine arrived 4/30 :)
  • Thanks @gsancho!  I guess I am just really impatient with this process and I just assumed that injectables should be next for me.  But your responses made me feel better and more confident that my RE knows what she's doing.  
    **Formerly EastBayBride508**

    Me 34   Him 33

    Me - Left salpingo-oophorectomy at 19 due to large cyst/torsion  and 2 large uterine fibroids found at age 30
    Him - Borderline low sperm count (correcting through Fertility Blend supplement)

    Married 8/20/2011
    TTC #1 since Jan 2013
    First appointment with RE 10/2013.  
    April 2014 - Clomid 100mg CD3-7.  HCG shot CD10 IUI #1 done on 4/12/14 (CD12) ....BFN
    May 2014 - Break cycle to repeat saline sonogram and re-group.  Travel to Kauai 5/7-5/12 (Yay!!)
    June 2014 - Clomid 150mg CD4-8.  HCG shot CD14.  IUI#2 done on 6/9 and 6/10 (CD15-16) w/ Prometrium suppositories during TWW .... BFN
    July 2014 - Clomid 150mg CD3-7.  Ultrasound CD12 - 4 mature follies! HCG trigger shot CD12 AM.  IUI#3 on CD13 w/ Prometrium suppositories during TWW ....BFN
    July 2014 - Repeat ultrasound done to measure size of fibroid - 8x9cm (the size of a grapefruit!) Surgery referral made.
    August 2014 - MRI done which revealed 2 fibroids: a 13x15cm fibroid as well as an 8x7cm one.  Super freak out mode over surgery plan.  OB-GYN/surgeon said surgery would most likely have to be a laparotomy (open abdominal surgery)
    August 2014 - After a 2nd opinion, plan to take Lupron x 2 months to shrink fibroids then laparoscopic/robotic myomectomy.  Surgery date is set for Nov 21st!  
    November 2014 - Robotic myomectomy done (2 large fibroids removed, mild endo found).  Benched x 3 months

    PAIF/SAIF welcome
  • Honestly, it sounds like you had a pretty good response to Clomid. I think trying it at least one more time makes sense.

    For comparison, I did 150mg of Clomid and had 1 17mm follicle and thin lining, and I wasn't ready for my IUI until CD 21. Because of this, I did decide to move on after 2 cycles instead of trying 3. With your response I would try 3-4 cycles before moving onto injects though.
    **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


  • I'm so glad you love your RE! Hope you can always work with her now.

    That sounds like exactly what is hoped for on a Clomid cycle, honestly. On Letrozole 5mg I got one follie that O'd on its own CD18, and they're cool with that - I'm doing the same thing this time around and the CD10 U/S is just happening on CD14 instead.

    My RE gave me a 5-month prescription for Letrozole, and I think his plan is to continue that many times (ouch!) as long as I'm O'ing. Not sure if we are up to that, but we'll just take it a cycle at a time.
    January 3T Siggy Challenge - New Year's Resolutions
    image
    imageimage

    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
  • I completely understand the frustration. I had a similar experience this month, I called the nurse and asked about what we would do this month and she said just up the med. I didn't like that idea so I called back and made an appointment with the doctor, told her that I wanted to be more aggressive and we came up with a compromise plan. 
    We have to be our own advocates, if you don't agree with the treatment plan say something. If you feel like the doctor is rushing mention it to them. We are paying a crap ton of money and emotional havoc, yes the doctor "knows best" but it is your body. I work in healthcare and I am not saying go in and tell the doctor we are doing this, this or this but come in with an idea of what you want and then give the reasons why you want it, the worse they can say is no. 

    Me: 32  DH:34

    Married: 7.6.13

    TTC: 1 year

    DX- Me: Endometriosis diagnosed in 2002

    BBT: 12/2012

    7/2013 to 12/2013-TTC

    1/2014-Laparoscopy, dx Stage 3 Endometriosis

    1/2014 to 5/2014- Natural TTC

    5/2014- First appointment with RE

    6/2104- Femera + Ovidrel+ 1 follice 18mm +TI= BFN

    7/2014 - Femera + Follistim + Ovidrel + IUI = ???


    image

  • First, glad you love your RE!

    **warning, preg/child mentioned**





    How many rounds of Clomid have you done? I got preg with my daughter on my "last chance" round of Clomid, at the same dose I had before. I hope you get the same success!
    Baby Birthday Ticker Ticker


    Pregnancy Ticker
  • Thanks everyone! It's good to know that this treatment protocol isn't unusual. I'm gonna stick with it and push harder for injectables next cycle if I need to.

    And @lupineaura‌ - that is reassuring! I hope I get the same outcome.

    **Formerly EastBayBride508**

    Me 34   Him 33

    Me - Left salpingo-oophorectomy at 19 due to large cyst/torsion  and 2 large uterine fibroids found at age 30
    Him - Borderline low sperm count (correcting through Fertility Blend supplement)

    Married 8/20/2011
    TTC #1 since Jan 2013
    First appointment with RE 10/2013.  
    April 2014 - Clomid 100mg CD3-7.  HCG shot CD10 IUI #1 done on 4/12/14 (CD12) ....BFN
    May 2014 - Break cycle to repeat saline sonogram and re-group.  Travel to Kauai 5/7-5/12 (Yay!!)
    June 2014 - Clomid 150mg CD4-8.  HCG shot CD14.  IUI#2 done on 6/9 and 6/10 (CD15-16) w/ Prometrium suppositories during TWW .... BFN
    July 2014 - Clomid 150mg CD3-7.  Ultrasound CD12 - 4 mature follies! HCG trigger shot CD12 AM.  IUI#3 on CD13 w/ Prometrium suppositories during TWW ....BFN
    July 2014 - Repeat ultrasound done to measure size of fibroid - 8x9cm (the size of a grapefruit!) Surgery referral made.
    August 2014 - MRI done which revealed 2 fibroids: a 13x15cm fibroid as well as an 8x7cm one.  Super freak out mode over surgery plan.  OB-GYN/surgeon said surgery would most likely have to be a laparotomy (open abdominal surgery)
    August 2014 - After a 2nd opinion, plan to take Lupron x 2 months to shrink fibroids then laparoscopic/robotic myomectomy.  Surgery date is set for Nov 21st!  
    November 2014 - Robotic myomectomy done (2 large fibroids removed, mild endo found).  Benched x 3 months

    PAIF/SAIF welcome
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