CLOMID GANG - the new thread

Have just started first cycle of clomid, but forgot to ask the consultant when and how often I should be ttc. Can anyone advise?
Thanks

Hi everyone

I'm on my third round of clomid having had two clomid pregnancies before (one of which resulted in my son!). However my gyn says I can only have up to eight months of clomid in my lifetime (I ov with 50mg). I am really worried about this as this time it is taking longer we're on our 3rd month now and that only leaves 3 more tries and that's it! I'm sure I have heard of people taking it for longer, can anyone enlighten me??

Many thanks,

K

Roobedoo,

This operation is always done under GA. Basically the surgeon punctures the cystic follicles on the ovaries with an electrical laser on needle. Sounds pretty much awful but it can and does work with some PCOS patients as it can lower excess LH levels in the bloodstream and thus kickstart ovulation. I conceived my son as a direct result of having this surgery.

This keyhole surgery op has a steep learning curve so I would ensure that the surgeon performing this op has done a lot of them beforehand.

It is NOT a cure for PCOS though, no one therapy or treatment will completely eradicate the cystic follicles. It however, may give a window of opportunity that was not previously there.

Although clomid is often the first line of treatment it is not suitable for all PCOS patients to take primarily because clomid can increase hormone levels. Some such women can become clomid resistant therefore in quite a short space of time.

I think a detailed discussion re your treatment and where's its all at is very much in order and I hope you will be able to put your points across to them. The three of you need to be able to communicate effectively and work as a team.

Roobedoo,

Would advise you to ask him whether he considers you suitable to have ovarian diathermy surgery. This can have success with some PCOS patients.

Although IVF is an option for some PCOS patients it should only be tried when all other treatment avenues have failed. Also such women run a higher than average risk of ovarian hyperstimulation syndrome (due to the multiple cystic follicles associated with PCOS) so you should be carefully monitored.

HTH

hi
sorry to hear that roobee, I think you're probably doing the right thing, my consultant says he doesn'#t really like prescribing Clomid for longer that 3 months as it can be a bit depressing carrying on when it's not working. AF is due tomorrow /wednesday so then will start injections/run up to IUI.

Roobedoo,

No not medically trained at all but write from experience re the HSG. Its purpose was also explained to me as well.

With best wishes

Hi all,
Sorry to barge in here but just want to say that after a lap & dye, a failed procedure to pop the cysts on my ovaries, norethisterone (the pill- used to regulate my cycle) which made my ankles swell up like balloons and a spotty registrsr who said 'I can't help you with your ankles, I'm not an ankle doctor!!!!!!' and 4 cycles of clomid I am finally mummy to a beautiful dd.
I actually got pregnant 2 weeks after finally meeting my consultant for the first time (instead of one of his cronies) and I actually believe that he has magical powers!!!!(well, he did double the dose of the clomid....maybe that's it then....)
Anyway, stick with it girls. I'm rooting for you all!

oooppss sorry about the spelling was eating pizza while i was typing !!

thanks so much for your advice mkr you have such a help . im really impressed by ll the info you have given me ty

Hi Milesygirl,

A HSG is a tubal x-ray. Its a useful test to have done as it gives information not easily accessed by other methods. For instance any deformities inside the tubes can only be seen on x-ray.

A teaspoonful of special dye is inserted very slowly through your cervix and this passes into your uterus and tubes. Any blockages will be seen on the x-ray and the dye will not pass through there.

I was given my results there and then (tubes were described as patent - that's another term for open) but some people can wait a short time to get these.

There should not be any pain providing the procedure is done carefully and the dye is injected slowly.

I was given a couple of painkillers beforehand which helped a lot and can say that the fear of same was far worse than the reality. Sanitary protection should be given to you as a matter of course (that colourless dye does come out) but you could always bring along your own.

I wish you well with both this forthcoming test and the clomid courses.

and he said another 4 months on clomid scans and this hsg ? got to go back and see him in march hopefully be pregnant by then though its sounds so far of!

hi sorry totally messed the last bit up im not having a lap and dye im havin a hysterosalpingogram [hsg] do you know what this is ??? havnt really got a diagnosis i went on the depo injection after having ds 1 was on it for about a year when i come off didnt have any periods so i was reffered to the consultent at the hospital who gave me something to start my periods then started clomid been on that for 4 months and today was my 2nd app with him !

Milesygirl,

The minimum normal dosage for clomid is 50mg (though I know of someone who was given less; the maximum is 150mg.

Was wondering why he suggested the laparoscopy and dye procedure; presumably he will look at the ovaries at the same time to see how they appear. A lap is keyhole surgery so there is no scarring. (The worst thing I found about this was the pain post op caused by the carbon dioxide gas that travels upwards however, painkillers took the edge off it. CO2 is used to give the surgeon a better view of your organs).

Do you have a diagnosis?.

hi all been to hospital got to have scans next month and a lap and dye thingy???? keep my dose the same for now . what other doses can you be put on?

Hi Lunarsea,

Day 3 is a standard test to be looking at LH and FSH but it can be done later in the cycle as well (around day 10). The main thing is that these two hormone levels should be compared against each other regardless of when the test is done.

I hope you get a diagnosis soon from the consultant.

I've had progesterone pessaries and I had no ill effects from them but they can be a bit messy.

Oh - meant to say, no definate diagnosis yet

Meerkats - when in the cycle should they be checking for LH and FSH levels? Is this the ones they do on day 3? Or is that just a base level and do they need to do it again later?

Lunarsea,

Think its a good idea for you to be asking for earlier tests for the reasons you give but also to check your LH and FSH levels. What may be happening is that there could be muliple follicles with no egg actually being able to mature fully due to such an imbalance. Progesterone is only part of the story.

Progesterone supplements if given are often in the form of pessaries which are taken for a number of weeks.

Do you have a firm diagnosis of the problem from the consultant?.

Wishing you the very best of luck at your next appointment.

Don't know what they'll do milesysgirl, but mine are upping the dose because it's not working. However they know (think?) it's not working because I've had blood tests (twice), and scans (have lost count - but about 8 I think).

Actually I'm not sure that it's actually the case as scans have shown follicles developing, but then day 22 bloods show low progesterone. As 23 or 24 days is a long cycle for me , day 22 is very close to the end of the cycle - not mid luteul phase which is when they should really be doing the blood test (21 or 22 days is assuming a 28 days cycle and a 14 day luteul phase), I rather suspect that what they're actually seeing could be ov but then a post-ovulatory progesterone deficiency (luteul phase defect). Am going to discuss this with consultant next time, and hopefully will be able to persuade them to do blood tests earlier in the cycle at some point to check this (which basically means doing the blood test 7 days after a +ve opk result). My consultant has suggested trying progesterone supplements to counteract this if it does turn out to be the problem, which should help to lengthen the cycle.

We started ttc in May 04 and luckily got diagnosed really quick, so was on 1st round of Clomid within 4 months. I did a further 2 rounds of clomid unsuccessfully and then 1 of Metformin before having the L&D in July this year. Had a course of Clomid the month after (to maximise the chances of oving) and fell that month.

I think I was very lucky to have been diagnosed so fast and then being refered to an excellent Consultant (who is now on my birthing team too, which I am really pleased about).

Obviously the same treatment won't be right for everyone (in the same way everyone else's treatment wasn't right for me) but it is just a case of fining the right trigger for you. Keep plugging away at it, it'll come good in the end.