Clomid/letrozole if I ovulate?

[alaska748]

Hello hoping someone with experience of a similar situation may be able to help! We are fortunate to have conceived DS1 immediately. We have been trying for a second for close to a year now with no success. As we have a child already the NHS isn’t really an option so we have been paying privately for tests.

I have a history of irregular ovulation (ie cannot detect LH at home and progesterone results are borderline) although since starting metformin 5 months ago there is some improvement with LH peaks detected at home between days 16 and 22 depending on the cycle. I have PCOS although all cysts on ovaries seem to have disappeared. My husband’s sample was normal, my tubes are not blocked so in reality we should be conceiving but no luck.

We have spoken to a fertility clinic and they have of course advised IUI or IVF could be an option. I am wondering though if it may be worth trying Clomid or letrozole first without consequent IUI or IVF to see if that helps. Is it worth enquiring about this? Anyone have any experience? Thanks so much.

Following this thread with interest

Yes 🙋🏻‍♀️ I’m 36 and had long cycles where I ovulated late or potentially didn’t ovulate. I went private and got clomid. I conceived on first round but that ended in a MC. I then managed to conceive without it and keep the pregnancy with aspirin and progesterone. I’m not sure how old you are but I’d say if you are younger than me then I’d give it a go. Good luck 🤞🏼

Thanks so much @Amyjones86 - sorry to hear about MC but good outcome in the end :).

I am 34 so definitely want to give this a try. Can I ask, did you see a private gynae, GP or fertility clinic for the prescription? We’ve had a consult and MOT with a fertility clinic but Clomid without IUI/IVF isn’t really a standard offering (margins too low I guess). I could go back to the gynae I saw but hoping to avoid multiple consultation fees if I can!

If you PCOS, you can still have all the tests done on the NHS. You can also have clomid/letrozole. It's only IVF you can't have. (I know this because I've just been through it for our second child).

Oh interesting thank you @Sunnyshoeshine - did your GP prescribe or did you have to be seen by a specialist?

I was referred by GP to fertility clinic. They repeated the tests i had for DD1 (presumably you can skip this bit if you've had them done privately) and then the plan was to prescribe letrozole but i actually found out i was pregnant naturally whilst waiting for my period to start the letrozole. Im 37 and it's been a year since we started trying for #2 so all pretty amazing really.

If theres a long wait for the fertility clinic, you could also investigate if your NHS hospital has a private arm. I did my treatment for DD1 at a big London hospital and they had the option to pay as a private patient through the usual fertility clinic. You basically skipped the waiting list. I think it was around £1500 for consultation, prescription and ovulation tracking at the time (2020).

I have PCOS, Clomid didn’t work for me (5 failed cycles) but I was offered Ovulation Induction on the NHS for both of my DC. OI is similar to IVF in that you inject yourself daily in the first half of your cycle to stimulate follicle growth. You get scanned as needed every few days to make sure you are not over-stimulating and when you have a mature follicle ready to pop are given a trigger injection to get you to ovulate and instructions to have lots of sex for the next 48-72 hours!

It worked for me on the 3rd cycle with each child.

If there are no sperm issues IUI is pointless (my fertility clinic told me there was no point in bothering with it). At a risk of being cynical I’d say that the clinic are suggesting IVF purely because of the £££ they can charge you.

Go back to your GP and ask about Clomid and OI. Your NHS trust should have a dedicated fertility clinic, you could try contacting them direct but I’d suspect they’d say you need a referral from your GP first.

More info on OI here. I’m in Cambridgeshire so this is the NHS clinic for our area, though they also take self-referrals.

https://www.cambridge-ivf.org.uk/your-journey/treatments/ovulation-induction-oi/

Thank you all so much - super helpful ❤

I have PCOS. My husband has kids from a previous relationship so IVF wasn’t an option for us.
I paid privately to get some tests done (sperm, bloods and I had a Hycosy) which was £500 in total. Then I paid £50 for a private prescription of Letrazole which worked the first month (although I found out the day after I’d paid another £50 for another prescription for 5 months worth of tablets 😂)
I had 21 day bloods done at the clinic the first month but the plan was is that worked then I wouldn’t have further bloods I’d be left to get on with it.

@CaveMum when you say 5 failed cycles do you mean you didn’t ovulate? I’ve just finished cycle 5 and no pregnancy but the 21 day bloods have indicated I ovulated. I rang the clinic and OI was mentioned, but I’m not sure what the point of it would be if the clomid was ‘working’.

No I didn’t ovulate on the Clomid at all, hence moving me on to the OI. I think the protocol (at least when I was first TTC 10 years ago!) was a max of 6 Clomid cycles before moving on, regardless of whether you are ovulating or not.

Are you being monitored with scans on Clomid? It may be that with the OI they can keep a better eye on your follicles and when you are actually ovulating. 21 day bloods are assuming you ovulate on Day 14, but certainly even when I was on OI with the higher dose of hormones I was usually not ready to ovulate until at least day 18. If you are ovulating earlier/later than “average” you might be missing your window for sex.

@CaveMum that makes sense about the monitoring. I was prescribed 6 months of clomid and pretty much left to get on with it apart from 21 day bloods for the first 3 months. I had read on here that some people are much more monitored throughout those clomid cycles, which would seem to be a more efficient way of going about it. This feels like six months of wasted opportunity to really understand what’s going on, but I guess keeping interventions to a minimum has merit also.

Hello all - me again. Good news, my gynae (private) has prescribed 50mg Clomid after another low day 21 progesterone result. Hoping for good news. She said to come back for a day 21 blood test on the second cycle of Clomid but no monitoring before then. I’m wondering if I should pay to have an ultrasound done this cycle just to ensure I don’t suddenly have 4 eggs ready to go? Can anyone advise what day of my cycle I should plan to do so? Or if I’m being ridiculous? Thanks so much.