Unique Situation- Help

Emy426 · January 2015

Hi all, I am new to the boards. We have been trying to conceive for 8 months. I have some prior medical history that is adding to our problems. I had a Pituitary tumor which resulted in possible issues with my pituitary glad not functioning properly. I do not get my period or ovulate on my own. And I never seem to have any follicles growing. :-(

I took Provera to try to get my period. but I barely got a period -less then a day (more like a few hours) and it was really nothing. Then I did 50MG of Chlomid (hot flashed and belly ache). No follicles grew on either side.

14 days later he started me right away on Chlomid 100 (without trying to induce another period). I believe my lining is pretty small too. Is that normal, to not try to do a period before Chlomid again? Anyway. I am on my 3rd day and my stomach is killing me. I've been using the bathroom all last night and this AM.

Anyone else have these side effects? Is this normal?

Also, after day one of this 2nd round I got that white discharge that signals ovulation so I took an ovulation test and it said I was ovulating. I asked my doctor and he said that sometimes they can give off false positives on ovulation test .

Emy426 · January 2015

Thanks for your quick response. This is so discouraging. I go in for ultrasounds and blood work like every 2-3 days- before work which is stressful enough. It is hard because I feel like I have no chance if my pituitary glad isn't working properly.

I know my RE wants to go to IUI or IVF, but I am having a harder time accepting that. I know women deal with this and go through them all the time. And I absolutely will, I just was really wishing and hoping this wouldn't be so difficult for us, so many other things have been difficult due to my health.

Sorry for the rant and thanks for your support!

BunnyBerry · January 2015

Hi there! I'm so sorry for everything you have been going through, it doesn't sound fun.

It's true that the OPKs can register false positives if your body is producing more LH than normal even before it's ready to O. However, if you haven't had an ultrasound to check for follicles in a couple days, I would definitely ask to go in for a scan - it's possible some small follies finally got growing with the increased Clomid! (BTW, if it's white discharge, you're likely still a ways away from O - it's the more fluid, sometimes more clear discharge that usually signals O; but, Clomid can also dry up fluid and make it whiter/stickier at O time).

It makes sense to have a thin lining still if follies aren't growing - it's the estrogen produced by developing/maturing follies that builds up the lining in time.

Since you're having such SEs from Clomid, and possibly lining issues, and not a great response at least on 50mg, you might consider asking about using a different medication if needed next cycle. I used Letrozole/Femara for 4 cycles and experienced only mild headaches and hot flashes, and from what I've heard on 3T, the SEs are often milder than with Clomid.

Just want to make sure, are you working with an OB or RE? REs are much more expert on this kind of thing and with things not going as smoothly as you'd hope, I just wanted to make sure you were in the hands of an RE.

Emy426 · January 2015

Thanks BB. Yes I have been working with a RE for 8 months. I am the one who is holding back on the IUI or IVF. I am trying to be positive. This WILL work, I just know that it is so frustrating to get no growth of follicles at all.

He wants to go to IUI if the 100 Chlomid doesn't work. Do you think I should suggest doing another round of 100? Does it go hire then that? Or ask to be switched to Femara?

He thinks it is my pituitary not responding, that is why I think he wanted to do to IUI. Any information on that. I know what it is, but do you need to take off of work for that day and more days after? My job is not he easiest in that way.....

AnnaClaire256 · January 2015

Hey there! Sorry to hear about your journey so far.

I guess the part Im struggling with is that you're saying your doctor wants you to move to IUI if this dose of clomid doesn't work...but for IUIs you will still have to take drugs (oral or injectable) to make your follicles grow. IUI would only take the place of TI once your follicles were mature. If you're not responding to the drugs at all, IUI wouldnt make any sense. Like @BunnyBerry‌ was saying, a lot of women who do not respond well to Clomid have success with Femara and it usually causes less side effects.

IUIs *generally* aren't painful, although every women has a different experience. I did my last one on my lunch hour and then went back to work. I just still don't quite understand why that's the next logical step for you. Hopefully your RE can find you the right dose of the right drug to help you ovulate and that's the only intervention you'll need.

Good luck with everything!

BunnyBerry · January 2015

@emy426 I understand your feeling about IUI and IVF...they are definitely more invasive. Take your time as you decide if/when you feel ready to take that step.

IUI won't do anything to help your pituitary. What it might help is to give you better chances in each month that your RE does get you to ovulate successfully...since it seems to be tough to get a good response in your ovaries, maybe IUI can maximize chances with every mature follie.

150mg Clomid is pretty typical if needed, and 200mg is the max but can be dangerous. If your RE determines that injectables are the best bet, carefully weigh cost/stress and success rates - sometimes IVF makes more sense than injects + IUI. Femara is less likely to give multiple follies, but it can work in women when Clomid doesn't (perhaps your RE would start you on max dose 7.5mg, and/or include a few days of injects on the same cycle).

Is there anything that can be done about the pituitary? You said you had a tumor...has it been treated with medication or removed surgically?

Emy426 · January 2015

Most of the tumor was removed through surgery then radiation. Although my growth hormone levels were off for a very long time. Normalized now w/ medication.

I'm going to ask about Fermara. I wonder why they don't use that instead of Chlomid if it works when Chlomid doesn't? Is Chlomid safer?

He said something about doing 9 days of injections then IUI. Now I feel silly.... Your right if my follicles aren't growing IUI wouldnt work. I guess he's hoping the injections would stimulate follicles- but then couldnt we do timed intercourse w the Injections (not sure the name) instead of insemmination?

Rachaeleigh · January 2015

PPs pretty much addressed all of your concerns. I just wanted to chime and say that I definitely experienced upset stomach during my cycle with clomid. It was pretty bad. That was about the only side effect I experienced.
GL!

Emy426 · January 2015

@Bluefairy6 and @rainbowbridge14 thank you so much for your detailed responses. I feel better already getting some more clarity from you both! Sometimes my doctor talks so "doctor talk" and sadly I did not know all of this about the reproductive process! So when he first started talking about follicles and FSH and LH and egg etc... I was a little overwhelmed. And I know it is so normal for him to be dealing with this kind of stuff that sometimes it seems a little to nonchalent for me!

Anyway, fingers crossed two more days on Chlomid 100 and I go back Tuesday for an ultra sound. I am just dreading the stomach problems that will come in the next days :-(

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