RE & Clomid Question - to take or not to take

[Ryan Claire]

Hi ladies - I posted this in TTC but thought I would so try to cast a wider net by posting out here.

Quick background: We went off BC in September. I was on it for 9 years (1 six month break in which I only got my period once). I have not ovulated or had a natural period since. We have been charting and TTC for about 6 of those 9 months (obviously unsuccessfully). Tee blood work all came back "normal" and my OB has said she thinks it is just a matter of time. I have been proscribed provera 3 times to get a period, and prescribed provera and clomid (50mg) once. The clomid cycle was in March and continues today (CD83).

So I had an OB appointment today... and I am interested in any and all input about how to proceed. The OB prescribed me more provera+ clomid (100mg) but also recommended I proceed to an RE. If I start the provera today - I will probably be around CD18 when my RE appointment comes around in June. Soooooooo what would you do?

a) Take the provera and clomid and then just let the RE know where I am at with things
b) Abstain from the provera and clomid in order to wait for the RE appointment

The anal part of me says to take it and see what happens... I will be on vacation during the presumptive fertile window so that is kinda cool.... and if I ovulate - super and then the RE will have that info. Even if I don''t - that is more information for the RE to work with.

But the more rational part of me says to wait until the RE appointment so that she can run her tests and get a better snapshot of what is going on with me. My fear would be that the Clomid would somehow effect the test results or mask a problem that would be detected otherwise.

For those of you have been to REs - do they do an u/s or take blood that first appointment? Do you think it''s wise to hold off?

Thanks so much for any thoughts.

 

[brightlight]

Can you call your RE before your appointment and ask him/her if taking the meds would mask any problems and if you should wait until after your appointment?

 

[Lanie]

I meant to answer your question on the TTC thread, sorry Ryan Claire.

I was in your exact position. My OB prescribed me with 50 mg of Clomid, which I never took, because my RE appointment was just around the corner, and I figured I would go in with a clean slate. It was hard, but they like to check out things at "ground zero" so to speak. I wanted to take it so bad, but the ladies on here convinced me not to, because it would put me even further behind. They like to do non medicated bloodwork, take a look at your uterus non medicated, etc. I''m so glad I didn''t take it, but I only know that in hindsight.

First appointment with my RE, they did bloodwork on CD3 and an u/s to see if everything looked okay. It''s pretty standard. From then, he prescribed Clomid 100mg, and an u/s on day 12 (I believe) to see if it worked. It didn''t end up working, and he went straight to Femara. Having said that, one of my friends took 100mg and her ovaries retaliated...it was clearly too much of a dosage for her, and I''d hate for that to happen to you.

What I would do in your situation, if you can time it, (and you prob can since you''ve taken Provera before, so you know what to expect) is to hold off on taking the Provera until you would be about CD 1 or CD 2 when you go in for your RE appointment. That way, they can bring you back and you can ask if you should take it. They will probably tell you no, but if they tell you yes, you would take it either day 3 or day 5.

But the irrational, impatient side of me would want to take it now! If you choose to do provera, then Clomid right now, they will still see you, they might just make you wait out a cycle to get anything done. Worst case scenario is that they tell you to wait, best case is that you ovulate. There are so many issues it could be other than ovulation, so that''s why they want you to come in "clean". Can you not get an appointment any sooner? I have to say I''m glad you''re going to see an RE. If I could send mine a one million dollar tip, I would. Good luck!!!

 

[Loves Vintage]

Ryan Claire - Since you would be CD18 on your first RE visit, I would take the provera and clomid now. On CD21, they can tell whether you ovulated (u/s and b/w) or will ovulate. I think you will save yourself a month this way because you will know whether the clomid 100 works or not, which seems to be where most REs will start anyway. Would your OB/GYN be doing any monitoring -- u/s or b/w? I don't see how taking the clomid now would delay anything. It will either make you ovulate or not. I can't think of how it would affect your test results otherwise, aside from maybe thinning your uterine lining. Of course, I am not a doctor and am only speculating based on my own extremely limited knowledge.

Lanie - I don't remember what your timing was before your first RE appointment. Was it similar, or were you only a week or so away from you appointment? What did you mean when you said your friend's ovaries retaliated?

 

[Lanie]

Date: 5/21/2010 4:13:34 PM
Author: Loves Vintage
Ryan Claire - Since you would be CD18 on your first RE visit, I would take the provera and clomid now. On CD21, they can tell whether you ovulated (u/s and b/w) or will ovulate. I think you will save yourself a month this way because you will know whether the clomid 100 works or not, which seems to be where most REs will start anyway. Would your OB/GYN be doing any monitoring -- u/s or b/w?

Lanie - I don''t remember what your timing was before your first RE appointment. Was it similar, or were you only a week or so away from you appointment? What did you mean when you said your friend''s ovaries retaliated?

This is a good point, which I meant to ask as well. If the OB/GYN is monitoring, then by all means start now.

I don''t remember my timing exactly, but I had the rx for Clomid for about 3 months before I even thought about going in to see the RE. I ended up never getting my period, went back and got an rx for Provera, and then my appt with the RE was just 2 weeks later or something like that. My friend (the one that was using Follistim...and is not pregnant

) said her ovaries got huge and she had to take a cycle break. They developed a cyst too I believe. She said that instead of the normal 1-3 follicles, there were a bunch of big ones in there. I haven''t heard of many people having that problem with 100mg. They backed her down to 50 again, which didn''t work. UGH...I hate TTC troubles.

 

[Ryan Claire]

Thanks SO MUCH for your feedback brightlight, lanie, and LV. Your thoughts and perspective are really appreciated.

I think I am going to honor instant gratification and go for it. Hopefully it won''t delay my process with the RE. And just maybe it will help me ovulate... I am not gonna hold my breath but it''s nice to at least feel like there is forward progress. Let''s hope LV is right and it will actually be good timing to see the RE.

Definitely open to more feedback if you''ve got it.

 

[Loves Vintage]

Lanie, I haven't heard of that happening on Clomid before either. Maybe there were a lot of cysts, in addition to follicles? I thought maybe she had ovarian hyperstimulation syndrome, which is more common with the injectable drugs. So, they put her back on clomid, after the follistim didn't work? I hope they are able to find the right combo for her. It can be so terribly frustrating!!!!

RyanClaire, Be sure to pack some nice smiley face OPKs for your trip! Where are you headed, by the way?

Oh, and I meant to say earlier, I am so sorry that the acupuncture did not work. Did your acupuncturist say anything about why it didn't? Did he want you to just take more time with it?

Oh, a few more questions - you said the blood work all came back normal. How much blood work have you had? CD3 and CD21? Did you ever do the glucose test? Have you had an u/s?

 

[Loves2Laugh]

bsp; I'm so sorry that you're going through TTC issues. BTDT and I ended up pg with our first using Clomid. I'd say go ahead and go for option A. The RE is used to having patients come in where you're at. Meaning, OB's will give a patient the Clomid a few cycles before suggesting they go to the specialist. By the time you go in the RE will probably continue with the Clomid but monitor things more closely. Are you getting mid-cycle u/s done to see how your follies are doing? Also, are you starting OPK's around CD10 for a peak? I'm sorry if you've answered some of this in the TTC thread but I don't venture over there very often. I actually got pg on my first cycle with Clomid at 50mg but my OB also was monitoring me with u/s and I was using the OPK's. Do they make them with a smiley face now? I used ANSWER brand and I remember on CD24 finally getting a positive line. It was almost as exciting as the BFP because I finally knew when I was ovulating! My u/s on CD13 had only shown 3 follies and one that was hardly big enough. My OB had already given me a new prescription for my next cycle because he thought it was a flop. We were very surprised!

My heart goes out to you because I know of any time in my life that I was the most stressed, depressed, anxious, frustrated.... those months leading up to my BFP were the worst! Hang in there! It makes seeing that BFP all the more sweet!

 

[emeraldlover1]

RC...I didn''t read all of the responses and I don''t have a lot of suggestions regarding TTC, I do however, have experience with the missing period comming off of BC and all results coming back normal. I also took provera twice without success.

So, what happened? I really have know idea but a year and a half or so after I came off of BC my period mysteriously returned. It was after six months of accupuncture. I''m not sure if that helped however I was actually in my gyn''s office crying about how it had been 18 months with only one period and I didn''t know what to do. At the time I was 26th. The weridest thing happened and I went to go give a urine sample while I was in the office and to my surprise my period had started.

The difference is that I wasn''t TTC but at 26 was worried about my fertility. Since then (I''ll be 31 next week) I have had normal cycles ranging from 25 to 30 days for the past 4 years or so. I know that probably doesn''t make you feel better however my experience with that sounds so familar to yours.

Good luck!

 

[snowflakeluvr]

hi,
I am sorry for your struggles regarding ttc. We had secondary infertility with #4 so that was very surprising and hard on me. My RE first prescribed 50mg clomid(did not work), then 100mg clomid(did not work, and turned me into the girl from the Exorcist!) but I suspect an RE may start with clomid anyway so I think trying it is a good idea. I ended up with Pergonal and then baby #4, but I was much older and drs may not pull out the "big guns" right away if you are young, wanting to avoid hyper-stimulation of ovaries(hence more eggs). Bless your heart. My fertility struggles were very difficult but we ended up having a 5th child as a surprise bonus . So, hang in there and be persistent-good luck to you!

 

[Ryan Claire]

So I did go ahead with the provera. 5 days at 50mg. I am on day 3 today... and hopefully on our way.

Loves Vintage - Thanks again for your feedback. We are heading to Costa Rica - can''t wait. In regards to the testing, since I have not had a real cycle since coming off BC, I have not had specific day testing. But my blood has been tested twice at the OBs office and I guess for what they were looking for (PCOS ratio and things like that) they did not seem too concerned. My Ob says I may have "a little" PCOS... my FSh to LH ratio was about 2:1. I believe and my prolactin may have been low. But I do not have the physical attributes and do not have cysts on my ovaries. My u/s also came back "normal". My acupuncturist said to give it 3 months... I am gonna be stopping at 2 months so I am sure he would like me to continue a little while longer... I just can''t justify the expense right now. I really wish it had helped more but it still was a great experience and I am glad I did it.

LovestoLaugh - thanks so much for sharing your experience, empathy, and advice. There will not be any monitoring unfortunately. I will definitely be charting, using the Clearblue fertility monitor and OPKs... so at least I should be able to tell if I ovulated. Since she is treating me for ovulation issues not fertility, I don''t think they typically do much monitoring. I am thrilled to hear of your success with clomid and I hope it won''t be much longer for me. It''s a trying time for sure but it helps to hear from woman who have made it through. I will be OVER the MOON when I get a positive OPK, so I can definitely relate to getting excited about the little victories.

Emeraldlover - I really appreciate hearing your experience. I am relieved to hear that things straightened themselves out eventually. I went off BC about 6 months before starting TTC so I thought it was ample time. I guess our bodies just needed/need a lot more time to adjust that what is typical. Glad you can relate to this frustrating situation... it''s nice ot feel like you are not the first person to deal with these things.

Snowflakeluvr - thank you for your post and sharing your story. I appreciate your advice too - I definitely will not be the first woman visiting an RE already having tired clomid so I think it will be fine. I hope I do not have the same 100mg clomid experience - not sure DH would like being married to the exorcist I worry about being clomid resistant because my sister is... guess we will see.

Thanks again for everyone''s thoughtful advice and feedback.