If Clomid doesn't work...

Tonya_G · January 2009

What's next? I know I'll have to talk with my Dr. about this, but just wanted some advice from those who've been through it. We have absolutely no IF coverage, so if we have to go to an RE, it will be out of pocket. How much more can my OBGYN do for IF before we have to go to an RE? DH keeps talking adoption- I don't think he realizes how expensive that option is, and if we're going to spend that amount of money, I'd almost rather keep trying and go the IVF route if we have to. I know I'm probably borrowing trouble, but like to be prepared for all scenarios. TIA

jcombs · January 2009

Are you saying clomid doesn't make you ovulate or you're not getting pregnant? If its not making you ovulate, there is femara and then injectibles. If its because you're not pregnant, it all depends on whether you've had all the appropriate testing and if you're using TI or IUI or what.

krissyh21 · January 2009

I don't think there is much more an ob/gyn should do for you. You need a specialist and although it sucks that insurance does not cover it, it will be well worth it in the end to have someone who does do this thing every day to look out for your best interest.

Chances are IUI would be a possibility, but that depends on if you already had all your testing done and if you have a diagnosis.

You should probably sit down with your H and go over all options and expences. IUIs themselves are really no comparison to the cost of adoption or IVF. I would at least schedule a consult with an RE to go over what things may cost so you can discuss everything with a clear understanding of the expences you may be facing.

Good luck!

Tonya_G · January 2009

We're doing TI, but my biggest problem is that I keep O'ing from my left ovary, not my right, and I don't have a tube on the left, making my chances of getting pregnant very slim. I'm also ovulating late on it- they upped my dosage, but it didn't make any difference. So, I do ovulate, but it's still not being very effective.

krisim · January 2009

We're in a similar situation. I'm on my 4th cycle of clomid and I'm going to see an RE today since we haven't had much luck with the clomid. We are OOP as well and this is going to limit what we can do. We'll probably give clomid a few more cycles and then try injectibles. We won't be able to afford to do very many injectible cycles though. I don't know what we'll do if that doesn't work.

AuburnBride06 · January 2009

Hi. Yep, we need some more background. But first of all, I would recommend seeing an RE over an OB/GYN. I think it depends on "how" it doesn't work for you. If you are O'ing but getting BFNs or whether you are not ovulating. For me, clomid totally sucked. I did 6 crappy cycles of Clomid + TI. I had to go up to 150mg to finally O, and it was a late, weak O at that--BFN. I tried 150mg and for some reason, I did not O the second time. Then I tried 200mg and O'd but BFN. Tried 200mg again and did not O. I was inconsistent on clomid, poor response and out of six miserable cycles, only 2 O's and BFNs at that. We finally moved on to injectables (Follistim) and I respond SO MUCH better on that. 4-5 mature follies usually. We have gotten pg 3 times on Follistim +HCG Trigger+TI but have m/c all three times.

I think besides my sucky ovary response to clomid, that it dried up my CM. I think Follistim is exactly what my ovaries and CM needed.

GL! Definitely consider an RE.

AuburnBride06 · January 2009

I would think that injectables would get activity going on the side with a tube. What has your highest dosage been on clomid? Have you done an HSG? Your OB/GYN won't be able to do anything beyond clomid.

Krs1Krs1 · January 2009

not everyone is comfortable with this route..but you could adopt from your local foster care agency nfor basically no cost...but that process comes with its own difficulties/concerns...just a thought

jcombs · January 2009

Go to your RE...with all that going on, your OB/GYN isn't going to be helpful. Did you discover no tube on one side when you had an HSG? Or do you even know what the deal is or why that is happening or why the other side isn't ovulating? With those chances, don't mess with the person who is learned in dealing with pregnant women, go to someone with experience getting people PG. I'm totally out of pocket no matter who I go to for IF so I feel your pain, but why waste both time and money and not get a result? Has your DH had a semen analysis?

Tonya_G · January 2009

AuburnBride06:
I would think that injectables would get activity going on the side with a tube. What has your highest dosage been on clomid? Have you done an HSG? Your OB/GYN won't be able to do anything beyond clomid.

I've had an HSG, b/c I had an ectopic pregnancy and they wanted to make sure my other tube was clear- that was fine, no problems. My highest dosage on Clomid has been 150- I just know you can only do so many Clomid cycles, and I'm already on my third, so I want to be prepared for what comes next.

Tonya_G · January 2009

AuburnBride06:

Hi. Yep, we need some more background. But first of all, I would recommend seeing an RE over an OB/GYN. I think it depends on "how" it doesn't work for you. If you are O'ing but getting BFNs or whether you are not ovulating. For me, clomid totally sucked. I did 6 crappy cycles of Clomid + TI. I had to go up to 150mg to finally O, and it was a late, weak O at that--BFN. I tried 150mg and for some reason, I did not O the second time. Then I tried 200mg and O'd but BFN. Tried 200mg again and did not O. I was inconsistent on clomid, poor response and out of six miserable cycles, only 2 O's and BFNs at that. We finally moved on to injectables (Follistim) and I respond SO MUCH better on that. 4-5 mature follies usually. We have gotten pg 3 times on Follistim +HCG Trigger+TI but have m/c all three times.

I think besides my sucky ovary response to clomid, that it dried up my CM. I think Follistim is exactly what my ovaries and CM needed.

GL! Definitely consider an RE.

I'm having a pretty similar response to Clomid, it seems- I O, it's just late and weak.

Tonya_G · January 2009

jcombs:
Go to your RE...with all that going on, your OB/GYN isn't going to be helpful. Did you discover no tube on one side when you had an HSG? Or do you even know what the deal is or why that is happening or why the other side isn't ovulating? With those chances, don't mess with the person who is learned in dealing with pregnant women, go to someone with experience getting people PG. I'm totally out of pocket no matter who I go to for IF so I feel your pain, but why waste both time and money and not get a result? Has your DH had a semen analysis?

I lost my left tube due to a ruptured ectopic pregnancy. They diagnosed me with PCOS, and my right ovary is full of little cysts, so I'm thinking that's probably why I'm not O'ing on that side. DH hasn't had an SA yet, mostly because it looks like my body is the problem- we have had 2 pregnancies since DS, but both ended in m/c.

Quizzle · January 2009

Definitely get an SA done, just in case. We skipped the SA because I got pregnant (but m/c) very quickly.... four rounds of clomid didn't work, and surprise surprise, DH's morph is terrible. We're heading to IVF.

If we didn't have the MFI issue, our next step would have injectibles with either IUI or TI. I'd talk to an Re and get a work-up done, and see what they say. Then you'll have a better idea of what you're dealing with.

Tonya_G · January 2009

Quizzle:

Definitely get an SA done, just in case. We skipped the SA because I got pregnant (but m/c) very quickly.... four rounds of clomid didn't work, and surprise surprise, DH's morph is terrible. We're heading to IVF.

If we didn't have the MFI issue, our next step would have injectibles with either IUI or TI. I'd talk to an Re and get a work-up done, and see what they say. Then you'll have a better idea of what you're dealing with.

Thanks for the advice- I guess it's time DH and I sat down and had a talk about all this.

mrspresley · January 2009

sometimes you can find an ob/gyn who has at least some experience with IF - that is what we are doing right now. that said, she did say that she believes in 3's and will refer to an RE after 3 failed cycles.

if your ob/gyn is comfortable monitoring you, you can try to add injectibles on top of the clomid. you could also continue trying..but use femara instead of clomid. it won't thin your lining or mess with your CM. so if your insurance covers stuff w/your ob but not an RE, then consider trying a few cycles w/femara instead of clomid. also consider asking your ob to trigger you instead of waiting for you to O on your own. that way your timing can be even better. you can also do IUI with your ob, that will increase your chances in a single cycle by 6%, even more if there are MFI issues. if you do IUI they will do a SA first.

Tonya_G · January 2009

mrspresley:

sometimes you can find an ob/gyn who has at least some experience with IF - that is what we are doing right now. that said, she did say that she believes in 3's and will refer to an RE after 3 failed cycles.

if your ob/gyn is comfortable monitoring you, you can try to add injectibles on top of the clomid. you could also continue trying..but use femara instead of clomid. it won't thin your lining or mess with your CM. so if your insurance covers stuff w/your ob but not an RE, then consider trying a few cycles w/femara instead of clomid. also consider asking your ob to trigger you instead of waiting for you to O on your own. that way your timing can be even better. you can also do IUI with your ob, that will increase your chances in a single cycle by 6%, even more if there are MFI issues. if you do IUI they will do a SA first.

Thanks for the advice!

BTW, every time I see the cheesecake in your siggy, all I want to do is run out somewhere and indulge in a slice- it looks SO yummy!

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