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Clomid - Do you think its suitable (for me) based on NICE guidelines

(14 Posts)
Figaro82 Tue 26-Mar-13 20:52:18

I have been diagnosed with unexplained infertility following all the standard tests coming back positive. I met with my specialist a few weeks back and they recommended that the next step we take is a HSG test and then a course of Clomid as a stimulate. I ovulate fine so was surprised this was recommended. I have since read the NICE guidelines and it sounds like this has been offered to me to 'keep me happy' and to make me feel like they are doing something for me. Following clinical trials, there is no proof that clomid helps with unexplained infertility and its not a recommened treatments for someone is my position. Obviously I want to try anything that works, but I am left slightly confused. Has anyone experienced anything similar or can suggest anything to me??? Thank you in advance.

rainbowbreeze Wed 27-Mar-13 16:00:04

Hi Figaro82

Im in the same situation, they told me it would 'boost' things but I feel like it was just a way to get me to go away for 6 months and in that time hopefully the magic will happen.
Its very frustrating but you feel like you have to go along with the system..

Figaro82 Wed 27-Mar-13 18:15:17

Hi Rainbow smile

It's difficult to know what to do. There's always that hope that it will work for you, but I just don't feel confident in taking it when there is no proven benefit for someone in my situation. Your right that you feel like you have to as ultimately I think I will need IVF and you have to be seen to be trying. Still have awhile till my HSG test so I have time to think. Rubbish isn't it!!!

lozster Wed 27-Mar-13 22:09:11

I spent a fruitless 9 months on clomid as I thought it was better than doing nothing while I waited for ivf. I then found out from my pct that the hospital is obliged to 'treat' within a certain amount of time, so, if they give you clomid it is classed as a treatment and they meet their target quickly and easily and cheaply.

Like you, I don't think clomid was appropriate for me. Some one here gave me some references to papers suggesting that conception rates in unexplained cases are no better than chance. Conception rates were only above chance in pcos cases. When I tried to discuss this with my consultant he got quite shirty with me. My first five cycles were all unmonitored too hmm

FriendofDorothy Wed 27-Mar-13 22:15:04

About this time last year I had an HSG and then one round of Clomid.

My 15 week old baby is now asleep in the bedroom across the hall.

Who knows whether it was the HSG or the Clomid that did the trick but I am sure the medication can't hurt and it may have a successful outcome.

FabiOne Mon 08-Apr-13 10:41:38

Hi all

Thought I'd share my story.i was put on clomid for 3 months following 18 months ttc. All tests had come back normal at this time and the specialist thought I just needed extra help ovulating to increase my chances of conceiving (even though I was ov'ing fine). All of this was before the NICE guidelines changed recently. The three months were unsuccessful and then I had a lap and dye which identified endometriosis even though I had no signs of this. Following the op I asked for more clomid even though technically I didn't need it. He prescribed me six months worth and still no BFP. I am waiting for my first IVF appt and don't see the harm in trying it.

I should add, all appts with the gynaecologist were private and there would be no benefit for him to prescribe me something just to keep me happy. It would have been better for him to suggest the lap and dye in the first instance as he would have got his money sooner!

Dreamy33 Wed 17-Apr-13 18:30:31

Hi all,

I've just returned from an appointment today and have also been given 3 months of clomid. We're in the unexplained category and tests suggest that I'm ovulating fine on my own. I'm in two minds about clomid at the moment- part of me thinks great at least I'm doing something (after nearly 3 years of ttc, I'm getting pretty frustrated!) but the other part of me wonders what it could possibly do to help our situation!

I had an hsg a few months ago and was told that was likely to help but no luck. Feeling a little cynical!!

FriendofDorothy Wed 17-Apr-13 18:46:47

Take it. It can't hurt.

Happilymarried155 Wed 17-Apr-13 19:46:46

I've looked on the NICE guidelines, it actually states that people should not be given clomid for unexplained fertilty, as it does not increase the chance of pregnancy unless using it alongside iui. I'm half expecting them to say the same to me hence why I'm going prepared!

AttilaTheMeerkat Wed 17-Apr-13 20:41:02

Unexplained is no diagnosis at all; all this means is that they have failed to find out what is wrong.

Sometimes it is a "diagnosis" given to couples when they as a couple have not been adequately investigated. How thorough have the tests on both of you been to date?. Any test result over six months old should be discounted; both of you need up to date test results.

Do you feel you have been adequately investigated as a couple?. I ask this particularly with regards to possible male factor issues. One or even two semen analyses is not enough. Some tests can and do get missed out (can provide a list of missed tests if you want).

Clomid should not be given unless there is definite proof that ovulation is a problem; if you are ovulating then it can have the opposite effect.

Also dreamy you should be monitored whilst on it preferably with both blood tests and ultrasounds as it is quite powerful stuff. No monitoring therefore is a complete no-no.

I would now consider seeking a second opinion; it is fair to say that some units are far better than others.

Dreamy33 Wed 17-Apr-13 22:24:28

Thanks for all the replies.

atilla I did ask the consultant if my cycle would be monitored and she laughed and said 'no!'. We've had basic tests (SA, day 21 bloods, ultrasound, hsg) but these have taken so long to do. The consultant looked at me today and said she has referred us for ivf but in the meantime, we might as well give clomid a go! You mentioned missed tests, please could you advise.

Maybe a trip to my sympathetic gp is in order to clear up a few queries...

AttilaTheMeerkat Thu 18-Apr-13 10:53:38

Hi Dreamy,

The most common tests that tend to be omitted are:-

Adequate x-rays of the uterus which may show abnormalities not otherwise seen at laparoscopy.

Hysteroscopy - telescope inspection of the inside of the uterus which may occasionally show abnormalities not seen otherwise

Repeated sperm counts over several weeks and months to make sure there is no subtle abnormality

Testing the sperm in special media such as swim up testsvelocity testing. However, when they are done, they often uncover a hidden cause for the suppposed unexplained problem

Thorough hormone tests to detect abnormalities of male hormone or early falls in progesterone

Scanning of the ovaries to see if follicles really are developing and there are no sign of polycystic ovaries.

Awful too of the cons to laugh and say no to any monitored cycle. No monitoring means that you have no way of knowing whether clomid is doing what its supposed to be doing i.e making the ovaries work harder.

I would seek a second opinion from a cons gynae at another unit; feel you are being messed around here.

Figaro82 Sun 21-Apr-13 10:18:52

Dreamy, I've had the same tests as you (got HSG the week after next). I have had no repeat testing. The more and more I read and hear comments on here, the less likely I am to take it. The only thing I worry about is whether it could potentially impact on having IVF as it may appear I've not taken their recommended course of treatment. We will see!

ali763 Thu 31-Oct-13 16:34:07

I see that this thread was started over 6 months ago, was just wondering if anyone had any update as im currently in the same position and wondering whether I should start my clomid or whether it will do more harm than good as im currently ovulating without medication

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