Clomid Cycle Protocol Question

dancerspose · November 2014

I have a question for those of you that have done a Clomid TI or IUI cycle. My RE told me that starting with my vert first medicated cycle I would do the Clomid, a trigger shot and the progesterone. Is it normal to start with all three of those? The trigger shot only slightly surprised me, but I was really surprised that I would do the progesterone right off the bat. Has anyone else started like that or do you usually try a cycle with the Clomid alone or Clomid and trigger?

Sorry if I'm just being totally dense and this is the completely normal protocol for the medicate cycle. I guess I just didn't expect to be using so many meds the first time around.

Thanks!

lsangel304 · November 2014

I had the same reaction as you when I met with my RE after all the tests and he gave me the same treatment plan. I thought I'd start off just with drugs and then go from there, but I guess they like to be more aggressive and believe that by taking the progesterone it eliminates the concern if you get a BFN or MC that it wasn't due to that.

briannaescplan · November 2014

:lurking from TTGP:

I met with an RE and got put on the Clomid Challenge right away for insurance reasons. It included all the testing, clomid, and trigger shot. Could it possibly be for insurance purposes?

To be more clear, my insurance covered testing but not treatment. So in order for me not to pay $1000+ for a clomid cycle, I got the testing/clomid/monitoring covered because it was labeled a "test".

coaster102516 · November 2014

My RE put me on Femara and Ovidrel shot...my lining was measuring thin so I am wondering now if they should have put me on progesterone. I was so excited about my results today but now I am bumming out.

katie0919 · November 2014

****SIGGY WARNING***

I had the same first medicated cycle as well. I O late in my cycle (day 20 or 21) and I believe she just wanted to take the guesswork out of the timing on intercourse. I also have a lot of spotting starting at 5 DPO, so that's why they put me on supplements right away....I suppose it could have something to do with lining as well? But my RE diagnosed me with a ovulation defect. I ovulate on my own, but it's just too weak. So therefore, the weak ovulation causes me to have too low of progesterone levels in the LP. That could be your RE's determination as well?

ETA: Siggy warning.

wanderlust508 · November 2014

Definitely talk to your RE about the purpose of each of these meds in your treatment cycle. My 1st IUI cycle was only Clomid + Trigger (no progesterone). The next 2 included progesterone suppositories. Like a PP said, I would not have wanted to do IUI without the trigger shot. I was told that the progesterone support decreased the chance of an early miscarriage due to low progesterone. My progesterone was never checked but I thought it was well worth it to take the progesterone as a safeguard again MC. Good luck and hope you are comfortable with the plan (or have it changed if you're not) after discussing with your RE.

typo31 · November 2014

katie0919 said:

****SIGGY WARNING***

I had the same first medicated cycle as well. I O late in my cycle (day 20 or 21) and I believe she just wanted to take the guesswork out of the timing on intercourse. I also have a lot of spotting starting at 5 DPO, so that's why they put me on supplements right away....I suppose it could have something to do with lining as well? But my RE diagnosed me with a ovulation defect. I ovulate on my own, but it's just too weak. So therefore, the weak ovulation causes me to have too low of progesterone levels in the LP. That could be your RE's determination as well?

ETA: Siggy warning.

This is also my protocol, exactly.

I also go to a very large and fancypants fertility center, and I feel like they prefer the "kitchen sink" method. I'm okay with this because I want this DONE already, but if you feel like they are giving you something you don't need @shafwilson, don't be afraid to ask a lot of questions! Progesterone supplements are expensive and gross, and you should confirm that you need them before dealing with either of those headaches.

dancerspose · November 2014

Thanks for the input! So the progesterone is used to thicken the uterine lining?

@lsangel304 it's good to know I'm not the only put on that protocol right away, thanks!

@briannaescplan I wish my RE were doing it for reasons like that. We're 100% OOP for treatment too, and with the meds with cycle will cost a little over $1000 so it's definitely not for that. Being the cynic I tend to me, I actually wondered if were to give contstant business to the drug company...when they were telling me the cost breakdown for the meds I think the progesterone was the most expensive too.

@firstarabesque it'll be TI, but apparently they use the same baseline protocol for both TI and IUI.

dancerspose · November 2014

@typo31 you hit it exactly, it definitely felt like a "kitchen sink" method rather than a tailored to me approach. Obvioulsy I want whatever gives me the best chance.

I think it's all anxiety compounded by the fact that I didn't really feel like the stand-in RE while mine is out really knew me or my case, and had a very different bedside manner. I will definitely send her a message asking for some more clarification on each of the drugs.

Thanks all!

LindseyM2012 · November 2014

I understand the Clomid is known for thinning the uterine lining, so the progesterone is for that. If your lining is fine, I don't think there is any harm in adding progesterone just in case as a preventative measure (somebody correct me if I'm wrong). I'm doing Letrozole, but did trigger shot and will be starting progesterone sups in two days. My lining looked good and I don't think lining thinning is common with Letrozole, but my RE is still putting me on progesterone "just in case". It is a tad costly (I think about $4 per sup from Freedom Pharmacy), but luckily my insurance picked up quite a good chunk (I only had a $70 copay for 30 days worth). I'm going to do it this time, but if the side effects are too much and the messiness is too much (like I've read based on other 3T ladies' experiences), I'm going to ask the RE about the necessity of the sups.

If your lining was measuring fine during your baseline u/s, your RE probably has the same thought process. I hope that helps!

deelopi9 · November 2014

For all of my medicated natural/IUI cycles they put me on progesterone. For me it had to do with my progesterone levels. My RE procedures are to include testing progesterone levels 7 days after TI or IUI.

lebradford · November 2014

Our first IUI, they just checked my progesterone at about 7 dpiui to decide if they should put me on progesterone. However, when I was reading at the time, it seemed like most people just automatically started progesterone support, and I would definitely want a trigger, so I think it sounds like a solid plan.

I agree with @NariaDreaming though, if you're worried about cost, Crinone is about the most expensive progesterone supplements. You might want to look into endometrin or prometrium.

moto611 · November 2014

I've always had a trigger shot and progesterone. My clinic is also the kitchen sink type - I think they throw all these medications at everyone. It through my for a loop the first cycle but once I got used to the idea I like it... the trigger shot should really help with timing and that would be well worth it (I say SHOULD because I always happen to have my LH surge before trigger so it doesn't work for me, unfortunately) and the progesterone is just in case, better-safe-than-sorry type thing.

I'll echo what others have said about Prometrium - ask if you can switch because it's probably much cheaper. Everyone is always talking about how expensive Crinone is and the side effects seem even more gross... is it better than Prometrium in some way?

dancerspose · November 2014

Thanks so much for the input everyone! It definitely puts me at ease to know it's not unusual to use all the meds to first time around.

sweetball33 · November 2014

I had 2 IUIs with clomid and no progestrone before they indroduce preogestrone. I'm not a huge fan of it due to the nasty side effects, but at this point I just smile and nod and head to the pharmacy! I think my lining started to slightly thin do to multiple cycles with clomid, so the progestrone was introduce to keep it thick and in tact. I've only had one IUI without a trigger, because my body was already ovulating. I've never had ovulation problems, but the trigger simply pinpoints the perfect time for your best chance at conception. Good luck!

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