Medicated vs. Non-medicated cycles

cdubs85 · July 2014

Hi all,

I've stayed away from the boards to concentrate on myself and my weight loss. I've lost 10 lbs so far!! Now that I've actually seen progress in terms of weight loss, my husband and I have started discussing resuming our TTC journey. I think an additional 15-20 lb weight loss and we'll officially be TTC again! Our RE gave us two treatment options moving forward: Both options I will take BA and progesterone following O but these are my options--> 1.) No fertility drugs or 2.) Clomid+Ovidrel+IUI. At the appointment discussing these options I didn't ask many questions because I felt that first and foremost I needed to lose weight before thinking about moving forward. Now that time has come I have so many questions. I've called my RE to ask and am waiting for a response.

I know so many of you have lots of experience and knowledge so I wanted to ask for your opinions/advice as well. I'm diagnosed with unexplained recurrent pregnancy loss and progesterone deficiency. I'm wondering how Clomid would help address these issues. Won't taking the progesterone without Clomid address the low progesterone issue? Also, I know this is my decision to make but what route do you all think you would choose and why?

Thank you all!! Hoping to jump in the Waiting to O and TWW threads soon!!

divinemsbee · July 2014

MeatandBandP said:

I don't really know your history etc. How long have you been trying/ how easily were you getting pregnant?

The idea for adding in clomid is that it may lead to a stronger egg. Ovideral will force ovulation and they say it can cause 'a stronger ovulation.' If you are getting pregnant easily you may not need IUI.

This, is there a reason why you have to jump straight to the IUI and trigger with Clomid and couldn't do a TI cycle with meds? That would be my thing. It seems like a big jump from just TI with progesterone to full on IUI with trigger. Also, at least for me, IUI would add a lot more money to the cycle. But, it would also depend on the odds my doc had for IUI vs. TI +meds.

I also deal with RPL, but I get pregnant pretty easily. I'm going to be doing a couple of monitored Clomid cycles because, as PP said, it's thought to lead to a stronger/better egg. Since I ovulate on my own, and my husband's SA was clear, the idea is that the Clomid might fast-track everything. Give the sperm a better egg.

cdubs85 · July 2014

MeatandBandP said:

I don't really know your history etc. How long have you been trying/ how easily were you getting pregnant?

The idea for adding in clomid is that it may lead to a stronger egg. Ovideral will force ovulation and they say it can cause 'a stronger ovulation.' If you are getting pregnant easily you may not need IUI.

We had been trying since November and got pregnant that first month then CP in December. We waited one cycle and then got pregnant the second cycle miscarrying at 8-9 weeks.

cdubs85 · July 2014

divinemsbee said:

MeatandBandP said:

I don't really know your history etc. How long have you been trying/ how easily were you getting pregnant?

The idea for adding in clomid is that it may lead to a stronger egg. Ovideral will force ovulation and they say it can cause 'a stronger ovulation.' If you are getting pregnant easily you may not need IUI.

I also deal with RPL, but I get pregnant pretty easily. I'm going to be doing a couple of monitored Clomid cycles because, as PP said, it's thought to lead to a stronger/better egg. Since I ovulate on my own, and my husband's SA was clear, the idea is that the Clomid might fast-track everything. Give the sperm a better egg.

My RE just called back to answer my questions. She said that since I already ovulated Clomid will not necessarily help get a "stronger ovulation" but it will speed the process of getting pregnant faster. Also with Clomid, I might ovulate 2 eggs which will help my chances of getting and keeping a pregnancy.

The reason she suggested an IUI was because I expressed concern over hostile CM. I usually have a lot of CM and was worried this would be a problem for me. Since we were ok with spending extra on the IUI, she said she was ok with doing this.

cdubs85 · July 2014

MeatandBandP said:

I'm curious as to why you think you have a problem with hostile CM? 2 out of 3 cycles you were able to get pregnant. That is pretty amazing stats.

I read that Clomid can cause hostile CM and because I usually have a lot of CM every cycle, I asked my RE about it. I'm not sure if hostile CM would be a problem for me or not, I just know that I would hate to waste months on Clomid and find out I have hostile CM while on Clomid. Like @whocanitbenow mentioned an IUI cycle would cost $400 more which I was willing to pay if it increases our chances of pregnancy.

cdubs85 · July 2014

WhoCanItBeNow said:

divinemsbee said:

MeatandBandP said:

I don't really know your history etc. How long have you been trying/ how easily were you getting pregnant?

The idea for adding in clomid is that it may lead to a stronger egg. Ovideral will force ovulation and they say it can cause 'a stronger ovulation.' If you are getting pregnant easily you may not need IUI.

This, is there a reason why you have to jump straight to the IUI and trigger with Clomid and couldn't do a TI cycle with meds? That would be my thing. It seems like a big jump from just TI with progesterone to full on IUI with trigger. Also, at least for me, IUI would add a lot more money to the cycle. But, it would also depend on the odds my doc had for IUI vs. TI +meds.

I also deal with RPL, but I get pregnant pretty easily. I'm going to be doing a couple of monitored Clomid cycles because, as PP said, it's thought to lead to a stronger/better egg. Since I ovulate on my own, and my husband's SA was clear, the idea is that the Clomid might fast-track everything. Give the sperm a better egg.

UO? TI cycles are a waste of everyone's time.

The success rates of them are like 3-5% without MFI. The success rates of unexplained with IUI is around 12-15%.

Those success rates are disheartening

I hadn't looked up that information and just seeing that makes me feel like I shouldn't be holding off TTC any longer.

divinemsbee · July 2014

I do think if you've got the money and it dramatically increases your chances, then going for it isn't a bad idea. Speaking of hostile CM, is there a way to test for that? Did your RE say anything about it affecting outcomes?

See, for an extra $400, that makes sense. For me, if we're doing TI, even with drugs, ultrasounds and blood work, I pay exactly $0. But when we switch to IUI then we have to pay for all or a great portion of it, which is why I'm more willing to give TI a few cycles. Also, after my hysteroscopy, my losses may switch to 'explained' depending on if my tube is a hydrosalpinx or if there are adhesions in my uterus that could have caused them, so if that's fixed then there's less need for IUI.

cdubs85 · July 2014

divinemsbee said:

I do think if you've got the money and it dramatically increases your chances, then going for it isn't a bad idea. Speaking of hostile CM, is there a way to test for that? Did your RE say anything about it affecting outcomes?

See, for an extra $400, that makes sense. For me, if we're doing TI, even with drugs, ultrasounds and blood work, I pay exactly $0. But when we switch to IUI then we have to pay for all or a great portion of it, which is why I'm more willing to give TI a few cycles. Also, after my hysteroscopy, my losses may switch to 'explained' depending on if my tube is a hydrosalpinx or if there are adhesions in my uterus that could have caused them, so if that's fixed then there's less need for IUI.

There is no way to test for hostile CM. My RE said hostile CM would decrease the chances of a pregnancy because most sperm would not make it to the fallopian tubes. She did say hostile CM with Clomid is uncommon and this probably would not be an issue, but I'm still concerned. As far as the treatment goes, my insurance will cover NONE of it so I'm inclined to pay the additional $400 as it will increase our chances. I know this isn't even a big deal, but I'm having a lot of trouble making up my mind on whether I want to do a medicated cycle of not.

cdubs85 · July 2014

MeatandBandP said:

cdubs85 said:

divinemsbee said:

I do think if you've got the money and it dramatically increases your chances, then going for it isn't a bad idea. Speaking of hostile CM, is there a way to test for that? Did your RE say anything about it affecting outcomes?

See, for an extra $400, that makes sense. For me, if we're doing TI, even with drugs, ultrasounds and blood work, I pay exactly $0. But when we switch to IUI then we have to pay for all or a great portion of it, which is why I'm more willing to give TI a few cycles. Also, after my hysteroscopy, my losses may switch to 'explained' depending on if my tube is a hydrosalpinx or if there are adhesions in my uterus that could have caused them, so if that's fixed then there's less need for IUI.

There is no way to test for hostile CM. My RE said hostile CM would decrease the chances of a pregnancy because most sperm would not make it to the fallopian tubes. She did say hostile CM with Clomid is uncommon and this probably would not be an issue, but I'm still concerned. As far as the treatment goes, my insurance will cover NONE of it so I'm inclined to pay the additional $400 as it will increase our chances. I know this isn't even a big deal, but I'm having a lot of trouble making up my mind on whether I want to do a medicated cycle of not.

Are you sure they will pay for none? I have no infertility coverage and ultrasounds and bloodwork have always been covered.

It is my understanding that they would cover everything up to a diagnosis. They have covered all blood work and ultrasounds so far because it was coded as "testing for RPL" or something of that nature. I believe she will code future ultrasounds and blood work as "infertility", but I should definitely check it out. Her office is so far away from me, so I might have one of the monitoring ultrasounds with my OBGYN who might code it differently and have it covered. As of now, we're planning on paying everything out of pocket. My insurance never gives me a straight answer for anything and it's so frustrating to deal with them. If they cover anything, it would definitely be a big surprise and a huge help for us.

cdubs85 · July 2014

GhostMonkey said:

cdubs85 said:

MeatandBandP said:

cdubs85 said:

divinemsbee said:

I do think if you've got the money and it dramatically increases your chances, then going for it isn't a bad idea. Speaking of hostile CM, is there a way to test for that? Did your RE say anything about it affecting outcomes?

See, for an extra $400, that makes sense. For me, if we're doing TI, even with drugs, ultrasounds and blood work, I pay exactly $0. But when we switch to IUI then we have to pay for all or a great portion of it, which is why I'm more willing to give TI a few cycles. Also, after my hysteroscopy, my losses may switch to 'explained' depending on if my tube is a hydrosalpinx or if there are adhesions in my uterus that could have caused them, so if that's fixed then there's less need for IUI.

There is no way to test for hostile CM. My RE said hostile CM would decrease the chances of a pregnancy because most sperm would not make it to the fallopian tubes. She did say hostile CM with Clomid is uncommon and this probably would not be an issue, but I'm still concerned. As far as the treatment goes, my insurance will cover NONE of it so I'm inclined to pay the additional $400 as it will increase our chances. I know this isn't even a big deal, but I'm having a lot of trouble making up my mind on whether I want to do a medicated cycle of not.

Are you sure they will pay for none? I have no infertility coverage and ultrasounds and bloodwork have always been covered.

It is my understanding that they would cover everything up to a diagnosis. They have covered all blood work and ultrasounds so far because it was coded as "testing for RPL" or something of that nature. I believe she will code future ultrasounds and blood work as "infertility", but I should definitely check it out. Her office is so far away from me, so I might have one of the monitoring ultrasounds with my OBGYN who might code it differently and have it covered. As of now, we're planning on paying everything out of pocket. My insurance never gives me a straight answer for anything and it's so frustrating to deal with them. If they cover anything, it would definitely be a big surprise and a huge help for us.

None of my anything ever was coded as infertility because that's not a code. They were treated the exact same way as when I went in for an u/s & blood work for pelvic pain.

They should be able to tell you to the penny what each one will cost you. If they can't, their billing person sucks and you are probably going to have coding issues.

I don't remember the specific code she said she would use, but it was something dealing with infertility and not a "followup" code. I don't have the sheet with codes in front of me so I can't be more specific. I did ask if there was any way she could code it to where my insurance would cover it and she said she couldn't. They did give me the breakdown of what everything would cost, so I know more or less what to expect.

THANK YOU ALL for you advice and insight. I'll definitely take everything into consideration in making my decision. I'm really lost with what to do and really don't know what I'm going to do right now. I'm sure with time I'll know what's the best route for us to take.

MamaBina · July 2014

Just FYI, and I am not a doctor, so please don't take this as any kind of medical advice, my understanding before going on clomid was that it can actually decrease CM. It hasn't been the case for me, but it was something I was told by my RE.

Also, just keep in mind the fact that clomid is no joke. I am on my second cycle with it, and it has not been as easy as I thought. I've been experiencing moderate OHSS and its much more difficult than I thought. That being said, if I thought there was a good chance of my conceiving without it, I wouldn't be taking it. Im not even 100 percent convinced its going to do us any good, but Im giving it a go at the recommendation and monitoring of my RE.

That being said, every person is so different, its hard to know whats best for you, but I wish you the best of luck as you are trying!!!

cdubs85 · July 2014

@wombthereitis-Everything you said is exactly why I'm so hesitant to take it. I already ovulate on my own and am concerned of the side effects you mentioned. The only reason I even continue to consider it is because of the "stronger ovulation" that perhaps might lead to my rainbow. I just don't know so I'm going to take some more time to consider these options.

MamaBina · July 2014

@cdubs85‌ well I've been on it for two cycles. One cycle didn't really help me. The second one did but now I'm experiencing the OHSS from it. So just be careful. And remember to be patient. I thought clomid would be the cure and I convinced myself I would magically get pregnant, but that hasn't been the case although I'm only 9 dpo. I think a lot of women think "oh that won't happen to me" like I did but I did and now I'm in a lot of pain. I'm not saying don't take it! I'm just saying, if I could do it without the clomid I personally would. And if you do decide to take it just take care of yourself and keep on the lookout for negative side effects.
Oh. And take it at night. That helps with a lot of the immediate side effects I found.

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