Can I ask for Clomid??

[lucysnowe]

I have PCOS and my cycle length is usually 45-48 days. I chart the cycles so I'm pretty sure I ovulate - also, I had a m/c in January.

But having such long cycles is getting me down, and I think they're getting longer and more erratic. I'm on metformin but it hasn't made any different thus far.

Can my GP give me Clomid, even if I ovulate?

[AttilaTheMeerkat]

lucy

In your case you'd be far better off being under the care of a gynae. PCOS is not a condition that GPs should be messing around with as it is outside their remit.

With your cycle length being as it is it is likely that you are only ovulating irregularly if at all (PCOSers can ovulate spontaneously on occasion but it is more common to have continual ovulatory problems).

Are you also having regular internal ultrasound scans and or blood tests done to see if ovulation is happening or not?. These are more reliable indicators than charting. Charting in itself is particularly problematic if PCOS is there as it can give a chart akin to the Rocky Mountains. Working out the date of ovulation (if it is happening which again with PCOS makes it more difficult)is nigh on impossible and it is all too easy in any event to get the date wrong.

You should not take clomid if there is definitive proof that ovulation is happening regularly as it can have the opposite effect. You certainly should not be left on clomid without monitoring, also it can be problematic for some PCOSers to use (they can too easily become clomid resistant).

Some PCOSers can find that a combined met and clomid approach can work in that ovulation resumes however, this is best left for a gynae to tackle in terms of dosage.

[lucysnowe]

Hi Attila

Thanks for the reply! I did have bloods once - actually on the cycle I got pg on, back in January, but nothing since.

I've had one or two quite nice-looking charts since but the more recent ones have been a bit hairy, IYKWIM, and actually thinking about it, they don't really show how well I've ovulated, do they? Hmm. And yes, I have had some problems predicting ov. So maybe I am ovulating but a bit poorly, is that possible and can clomid help that?

I think you're right, I need to see someone!

[Miffles]

Hi Lucy

It sounds like you would be in much better hands under a consultant. If you have PCOS, then you can get referred without having to wait for a year of TTC.

My GP had to get a diagnosis of PCOS first (I suspected it from my mum and sister, and also my cycles and weight, etc). Once we had definite diagnosis (from an ultrasound) he had to have some bloods (CD21 for progesterone, which was a joke as I never make it to CD21!), a chlamydia test, seman analysis from DH, I'm sure there was something else, can't remember.

Anyway, that all got put onto the referral and I am now waiting for the appt with consultant. I've looked up the NICE guidelines for assisted fertility.
If you have PCOS, first thing they offer you is 6 cycles of clomid. The guidelines say "if you do not ovulate regularly". So even if you do occasionally ovulate, it sounds like you'd fall into that category.

If that is not successful, recommendations are a further 6 months with clomid and metformin (if your BMI is over 25).

But using clomid has risks of mulitple pregnancies, so guidelines say you should have a scan to monitor how you respond to it and determine if you ovulate or not.

Good luck!

[lucysnowe]

Hi Miffles

I have a sneaking desire for twins - but just one would be nice (I already have a DD, and am v. lucky in that, I hasten to add).

That all sounds good stuff, esp the sperm test for DH (DH has recently turned 40 so I suppose he needs to get checked out now as well). The thing is even I do regulate every cycle, that still means only around 6 cycles a year, and I'm getting on a bit as well. .

How long does the wait for a consultant take? I am half way through a cycle at the mo, and don't know whether to see my GP now, or wait.

[Miffles]

I don't know for sure, but think to "ovulate regularly" you need a "regular" cycle. And that can vary from person to person. I think normal cycles could be 21-35 days. 45 days, though you may have that cycle every time, doesn't sound regular!! Do you see what I mean? It doesn't suggest regular ovulation.

But a consultant would be able to tell better with blood tests - CD21 progesterone is meant to show if, on a 28 day cycle, you ovulate. If you're really long cycle, they would then test you every 7 days after that to see if you ovualte. I'm sure Atilla could tell you all sorts of other tests they'd do to confirm ovulation.

In regard to waiting times....I went to the GP in May, had my ultrasound in June, other blood tests and DH SA in July, then referral left the GP end Aug. Once the referral is received by the hospital, they have 13 weeks in which to see you before they "breach" - which means they have to see you before the 13 week clock stops!! My appt is for October - only 9 weeks after the referral. All NHS.

[lucysnowe]

Thanks Miffles, that's really useful. Looks like a consultant is the way to go... I can show them my charts at least.

I wish I could ov before CD21!!