Clomid: A faux pas? or a valid request?

[dontcarehow]

Hi all, I'm new. I'm 25 and am hoping to start ttc. Here's my issue...

I've been on the pill for about 8 years and came off in July last year. Had a pill induced bleed, but havent had a period since. Obviously since I can't ttc until I'm actually ovulating, this is getting most annoying so I've booked to see my doctor. Now I've heard of Clomid,(it helps kick start ovulation right?) My issue is, would I be making the worlds biggest faux pas if I asked my doctor for it, or is it one of these super expensive fertility drugs only to be used by those who have been trying for years and have a list as long as your arm of fertility problems? I just can't bear that patronising "you're too stupid to be alive" look that my doctor gives me when I ask dumb questions.

i had clomid 9 years ago when ttc dd1 as have pcos. gp referred me to fertility specialist who gave me the prescription, i think its a valid request but gp may want to refer you for other investigations first, id already been diagnosed with pcos a year earlier so they gave it at first appt as scans,etc had been done previously.

good luck

Before prescribing Clomid you really need to know why you are not having periods. Where I live, the fertility service prescribes Clomid, not the GP.

First your GP should do basic investigations and then may refer you to a specialist depending on the outcome. This may be fertility.

Basic things the GP will consider

Body Mass Index (is it too low or too high)
Fasting blood glucose test to rule out diabetes
Thyroid function test
Endocrine (hormone) function tests: LH / FSH (can indicate polycystic ovaries or ovarian failure) and is usually done between day 2 and 6 of your cycle.

They would normally do a day 21 progesterone test to confirm ovulation, but in your case this will be impossible and the lack of periods does suggest that you are anovulatory.

Hope that's useful.

Good luck

Thanks both, I think (I hope) the reason I'm not having periods is just because I've come off the pill, but I will certainly be asking for tests for other stuff, I've basically been on and off the pill since I started having periods so it could well have been masking something nasty (fingers crossed it wasnt though!). I just didnt want to go asking for something that they wouldn't give out at this quite early stage and look really stupid. I like to sound like I know what I'm talking about with doctors otherwise they tend to fob you off with "wait and see what happens"!

I am sure your GP will automatically start investigations, it's doubtful you will need to ask for any of these tests. They follow an algorithm generally.

also, you are limited on how many cycles of clomid you can have, so make sure you have investigations for things like blocked tubes (HSG) before you start it

When DH and I started trying, I came off the pill in June (2007). Had a couple of irregular periods, and the last was in November - then nothing. I took pregnancy tests in December and January, all negative.

And then I got pregnant at the start of February! Still no periods, but at some point I started ovulating and got pregnant before I actually had a period. So, I think I'm just saying it can be very normal (I'd been on the pill since a teenager as well).

I did go to the doctors though and they said that once I'd gone about 5-6 months without a period they'd start to look in to why, and I was booked in for an ultrasound before I found out I was pregnant.

Are you using any other contraception in the meantime? I only found out I was pregnant because I mentioned to the doctor (during the appointment to discuss my periods) that my breasts were tender - I'd associated it with another tablet I was being prescribed, and in my head had assumed I wasn't pregnant because of the negative tests I'd already done. She pointed out that I could start ovulating at any time and not know, and since I wasn't using contraception I could be pregnant, so I should do another test. And that was DS.

Thanks Rhian82, thats reassuring. we arent using contraception because, really, we don't know anything about what's happening now and I suppose we're hoping that the same will happen to us, that I'll ovulate without knowing. but I've been testing every fortnight or so, just to be sure, and I'm about 5-6 months off it now so hopefully they can do something for me. I just feel like I'm in limbo waiting for either a positive result or a period. Obviously I'm hoping for the former rather than the latter!

Hi dontcarehow I hope you get a nice sympathetic GP, mine wasnt at all!

knackeredcow is right in that there is an algorithm, sympathetic GP's will bend the rules but some stick very rigidly to them so you might want to consider your dates very carefully and fib if necessary

If you havent had a period for MORE than 6 months - this should investigated as it is a health issue. I hadnt had one for 6 months but was still fobbed off and told to wait and see because I had had a child (but wasnt breastfeeding)

If you have been trying TTC for MORE than one year you are eligible for basic testing (as mentioned by knackeredcow)

Try and get a referral to the gynecologist asap becuase most GP's really arent that good with fertility issues. You get referred to them if basic testing doesnt explain lack of periods, or throws up something that needs further investigation or if you have pelvic pain and therefore need a scan.

Hope you get the BFP first though! xxx

dontcarehow

Clomid makes the ovaries work harder.

If you have not had a period since July of last year then the chances are this is due to hormonal problems. The pill also leaves your system very quickly after taking the last tablet. In that regard a condition called polycsytic ovaries is often to blame (pill can mask symptoms of hormonal imbalances). However, this is not the only possible cause and others include problems with the thyroid gland.

Knackered cow has given you good cousnel re what the GP may test for. Both thyroid and PCO should be looked for via blood tests. You may also be offered an internal ultrasound scan.

You need a DIAGNOSIS first and foremost rather than just focusing on clomid at this time. Clomid is quite powerful stuff and you should be monitored whilst on it, it is certainly not suitable for all women who present with ovulation problems.

GPs cannot always monitor patients properly so it should be prescribed by a gynae ideally. No monitoring basically means that you have no idea of whether its actually working or not.

You should be referred anyway to the subfertility unit if you have not had a period since last July. My GP referred me after 6 months of ttc without success due to my irregular periods.

You will need to be persistant in order to get answers and it is all too easy to be fobbed off.