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Conception

Clomid Twice in same cycle?

6 replies

Snowdog37 · 26/07/2016 20:00

So I had no mature follicles cd12 after doing 100mg Clomid cd3-7. My estradiol was also only 109. My RE has put me back on Clomid for 5 more days to kickstart my ovaries. Has anyone else done this?

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stealthbanana · 27/07/2016 09:35

Hi - yes I have done this, they refer to it as a stair step protocol. I had 5 days of Clomid at 100mg (from memory cd2-6), scan on day 10 and nothing, so I was given 5 further days of 150mg which I took on cd11-15. It work in the sense that I grew a single 24mm follicle. However my lining was borderline at the last scan (just on 6mm) and the cycle wasn't successful. I moved straight into injectibles after that as my doctor felt that the lining would thin as I needed such a high dose to produce a Clomid response.

For some reason uk clinics don't often go with this approach but it is very common in the US and seems to get great results. I would recommend that you insist that you are scanned if you go down this route as the main risk is that pesky lining thinning.

Hth

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Snowdog37 · 27/07/2016 11:26

Thanks stealthbanana I'm in the US, and it does seem to be done a lot more. I just had no idea it could be done. Hopefully my lining won't be too screwed. At cd12 it was 8.5mm, I might ask for estrogen patches just to keep it from thinning further. My RE has put me on 150mg cd12-16 with an ultrasound and more blood tests on cd16 to see if it helped. It's strange as this is my third month on Clomid. Both of the completed cycles I only produced one good follie. So my RE is saying I'm a poor responder and we are moving onto injectables next month if this one is a bust.

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stealthbanana · 31/07/2016 21:10

Why are your blood tests on cd16? They should be a week later at least.

Also not sure why one good follie per cycle means you are a poor responder - the point of Clomid is to get you to mimic natural ovulation, which is one follie! This might be an American RE thing where they like you to have 3 follies and don't seem to care about multiples. Here in the UK if I'd had more than 2 my RE would have cancelled the cycle. Also, you don't say if you are having scans - these really are essential.

If you're growing one follie per cycle I don't understand why you need more Clomid. Are you confirming ovulation with a progesterone blood test? If you are you're golden! Good luck, will keep my fingers crossed for you for this round.

FYI here the advice is to have a 1 month break from Clomid after 3 months and to not do more than 6 months as it can start to actually inhibit ov at that point and, longer term, elevate your risk of some sort of cancer (breast?). So moving onto injectibles if this round doesn't work is probably not a bad idea - they're fairly straight forward. Good luck!

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Snowdog37 · 31/07/2016 21:35

I took 100mg Clomid cd3-7. On cd 10 I had an ultrasound that showed no mature follicles, bloodwork revealed low e2. I had repeat ultrasounds and bloodwork showing no follicles at all grew from the "stair step" second course of Clomid cd12-16. They tested my estradiol, lh and progesterone. All signs point to Clomid resistance in their view as in two previous Clomid cycles I had one good sized mature follicle at cd10, rising lh, and good e2 so was triggered and ovulated cd12 and had IUI that day too. This cycle is a freak. No mature follicles at all are growing. There are some on each ovary but they are too small and are not growing despite the Clomid. I'm being monitored every 2-3 days and nothing. If there's nothing on Tuesday then they won't do IUI and I'll just dtd and have twice weekly bloods to see what the heck my progesterone etc are doing. It could be anovulatory despite the Clomid. I meant they said I'm a poor responder THIS cycle as I didn't even produce one good follicle and things have been textbook up to this cycle. My blood results are nothing like the last cycles. I'm flummoxed.

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stealthbanana · 31/07/2016 21:42

Got it. You've responded before but not this cycle. It can be funny like that. I feel your pain - I had 2x non responsive cycles before they stair stepped me and eked out the large follie which mashed my lining. So I am deemed to be Clomid non responsive.

As I said Clomid can eventually inhibit conception. It might just be that you are reaching that point.

Out of interest are you taking Clomid for PCOS or something else?

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Snowdog37 · 01/08/2016 00:21

I'm an early ovulator so I was taking it to mature the follicle as they felt this was causing issues with conception. Based on my rising e2 levels on day 10 the last two cycles (247 1st cycle, 347 I think the second one) they thought it worked fine. This cycle everything is out the window though.