AF Question... (May be TMI for Some)

doucettechristina · July 2014

So I have very STRANGE menstrual cycles. Generally I will bleed for a day or 2 (which I consider day 1) and then stop for 3-4 days sometimes longer, then begin to bleed again for another 3-4 days - these 3-4 days are the heaviest bleeding - initial bleeding is light but still dark red blood, maybe only .5 ounce of blood. I'm not sure if I should be considering my initial bleed day one, or wait until I bleed for 3-4 days straight to start my "day 1". First question is when should I start my Clomid? I am on my 3rd cycle of clomid. The first cycle I counted day 1 on the 3-4 day bleed and disregarded the initial bleed - progesterone extremely low >1. Cycle 2 of clomid I counted day 1 at the initial bleed - progesterone higher but still not high enough to show ovulation, u/s showed that a follie did rupture, but no way to tell if it was a good ovulation and progesterone shows no ovulation. On this cycle (cycle 3 of clomid) I took counted day 1 at initial bleeding so we'll see how this go. My concern and 2nd question is whether or not since I am counting the initial bleed as day 1, I am now on day 10 of my cycle and am still bleeding (I take my clomid days 5-9) will this be ok, since technically its a induced ovulation and I should be ovulating around day 14. Will my uterine lining be thick enough to support a pregnancy once the HOPEFULLY fertilized egg reaches it? Does anyone else have a similar situation/menstrual cycle? Or am I abnormal lol.

catlover790 · July 2014

Hmm, I'm sorry you are having a stressful time. There are a lot of aspects to your questions but I'll do my best!

What is the initial bleeding like? Spotting? Do you need a pad/tampon or just liner?

Are you having ultrasounds to measure the follicles you get as you go? This will help see if the clomid is working and what the lining looks like.

If progesterone is low after ovulation you can take progesterone supplements vaginally to support a possible pregnancy.

Are you seeing a RE? They would probably want to know what your period is like to know when to start the medications.

As for my period, usually I have a light day then a couple heavier then it starts to lighten up again. There have been times where I'd get a day with no bleeding and then have some more again. After some more info I might have more advice!

doucettechristina · July 2014

Thanks for the advice @catlover790. To answer your questions:

What is the initial bleeding like? Spotting? Do you need a pad/tampon or just liner? I use a menstrual cup so I never use a liner or tampon. during the initial bleeding I normally get 0.5 ounces of blood and it is a dark red blood.

If progesterone is low after ovulation you can take progesterone supplements vaginally to support a possible pregnancy. This is something I plan on talking to my Dr. about at my next visit

Are you having ultrasounds to measure the follicles you get as you go? This will help see if the clomid is working and what the lining looks like. I am only have ultrasounds done to check for cycsts and go in during my menstrual cycle for these. Maybe I will discuss doing more ultrasounds at my next appointment and see what the options are.

Are you seeing a RE? They would probably want to know what your period is like to know when to start the medications. I am not seeing an RE yet. Since my insurance doesn't cover one I am seeing my OBGYN who works closely with an RE and treats lots of PCOS patients for 3-6 months before sending them directly to the RE and having them pay OOP. My OBGYN IS monitoring me while on clomid so I feel comfortable doing this as DH and I can't really afford an RE right now and would need to save up (which we are doing now in anticipation of seeing an RE) to see an RE so it doesn't hurt to try with the OBGYN in the meantime. My OBGYN does know about these weird cycles and we are trying to figure out the right method to treat everything. Thought I'd reach out on here to see what y'all thought and if there was anything in particular I should speak with my OBGYN about since I am clueless and new to this whole TTC thing.

Thank you so much for any advice help you can offer me!

catlover790 · July 2014

Thanks for the update!

I'm not very familiar with the menstrual cups so hopefully someone else can help with that part! I would think though .5 ounces would probably be the start of a period, it seems more than spotting. Sorry I'm not much help there!

It's good that you are having ultrasounds at the beginning of each cycle to check for cysts. I guess it depends on how precise you want to be with timing and everything if you're comfortable going this way. I understand the costs, we are all OOP too.

It's hard to say if the clomid is even working if you don't have a mid-cycle ultrasound and if it is working how many follicles you are producing. Also, if you do end up needing progesterone supplements you would want to know the exact day you ovulate so that you can start the progesterone on the proper day. If you take it without ovulating you could prevent ovulation instead.

If your progesterone was 1.6 last cycle that wouldn't even indicate ovulation I don't think, I think it's supposed to be >5 for natural cycle and 10 for a medicated cycle.

I am only in my first medicated cycle but we are doing a trigger shot so I'm not sure how it works with just using OPKs. I think others have done it this way so maybe others can chime in and help out! Good luck.

edit: just Looked again and saw you already knew there was no O last time. I would at least ask your OB if they can do a mid cycle ultrasound if you are going to do treatment with them. Then you could see how the follicles are growing and if it looks like you are close to ovulating maybe you could add a trigger? I like the idea of it because if I have a mature follicle it will ensure that I ovulate it.

doucettechristina · July 2014

Thanks! Definitely going to ask my OB about a mid-cycle u/s. I like the idea of knowing if the clomid is even working!

catlover790 · July 2014

doucettechristina said:

Thanks! Definitely going to ask my OB about a mid-cycle u/s. I like the idea of knowing if the clomid is even working!

That should help a little. Unfortunately OBs aren't really that great for doing medicated cycles because many of the questions you are having are things that should be figured out before you start the meds. I'm sorry that it's causing you more stress.

If you are going to do treatment with an OB a mid cycle ultrasound would help. Also, usually only 3-6 months of clomid is recommended so if it isn't working it would be good to find that out soon.

Sorry to ramble but for me I was tempted to do clomid with an OB and after lurking here decided a RE would be better just for peace of mind and less stress about the cycles. I know I'm getting the best chance to get pregnant with each cycle because everything is monitored closely so I'm not wasting money and time on a cycle that isn't working. Good luck with everything.

doucettechristina · July 2014

We'll see if my OB is willing to do mid-cycle ultrasounds. He works closely with a RE and has RE training so I know that he knows what he is doing and at this point DH and I really can't afford an RE so I don't want to get my hopes up in seeing one until we can. So while we save to be able to see one and do the treatments with an RE this is unfortunately the best option for us. My OB only planned on keeping me on clomid for 4-5 months then was going to stop and send me directly to his RE. At that point I am hoping we can afford one - we should be able to. I figured as long as I am being monitored for cysts which are the most dangerous things with clomid going through preliminary treatment with my OB was better than doing nothing for 4-5 months. Next month we will probably go for a consultation with the RE though just to get to know her and to see what we should expect exactly finacially.

BunnyBerry · July 2014

Definitely check with your doctor about what to call CD1. I have the same issue with a stop midway, and thought it was just normal, but now I'm having a cervical dilation surgery because the RE thinks my cervix is partially blocked and causing menstrual issues as well as possibly endo, so it might be worth asking about.

Have you made yourself informed about what 4-5 months (even 1 month) of unmonitored Clomid can do to your body? The risk for higher order multiples (super dangerous) or thinned lining (makes implantation impossible) and cysts (which can act as birth control or rupture, especially if more Clomid is taking before letting them resolve)?

Have you had an HSG to show your tubes/ute are clear, and has YH had an SA to show that timed intercourse is a viable option?

Good luck, hope this cycle works out for you! Please take care of yourself.

Glad you are seeing an RE soon.

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