What to expect. Clomid failure, now to IVF.

[AmyC86]

I have just had my 6th and final round of clomid result in no folicale production. It's been 18 months of hell if I'm honest, mood swings, tears, tantrums, hot flushes and a lot of disappointment; I'm sure that most of you have been there!!

I've been told by my consultant that I'll be referred to the ivf clinic at another neighbouring hospital, however I do need to get my BMI to 30 or under before I can be considered.

My questions are:

1, how long is the adverage waiting time for referral.
2, what treatment would you expect me to be given? I have PCOS and Clomid hasn't worked.
3, they have mentioned metformin but at the moment I'm not in receipt of this.
4, roughly how long is the process. Obviously, this depends on if it works straight away or what treatment I'm offered, but in general terms I'm just wondering.

Hi Amy
1.im afraid it's depends on your clinic's waiting list. It's different in each area. Mine was 6 month

1. Treatment would most probably be long protocol IVF
2. Metformin- they mentioned this to me as I have PCO but not the syndrome but they told me they would tell me once I have my baseline scan, which is tomorrow.
3. Process of long is 6-8 weeks. They may give you the contraceptive pill for 3 weeks beforehand. 2 weeks in, you'll start with the Buserelin injections. You'll be only them 10-16 days, then you'll go for your baseline scan and if everything looks okay, they'll start you on stimming, menopaur or something similar for 10-14 days, egg collection then egg transfer 3-5 days after.

Hope this helps

Thanks broody that's helped a lot xx when you say long IVF. Do you mean egg collection & test tube fertilisation?

Egg collection is where you get put to sleep/in a daze and then they retrieve the eggs from your ovaries. Then yes they'll fertilise them (they might use ICSI but they'll tell you) and then they get put back 3-5 days later.

Cool xx thanks for the information 😊

Its a massive jump to go from clomid to IVF; I am wondering why no other treatment options were actually talked about and given to you. It sounds like they really do not know what to do with you really so have referred you onto somewhere else.

PCOS and IVF can be very uneasy bedfellows; the risk of ovarian hyperstimulation is high because of PCOS. IVF should really only be tried after all other treatment options have failed. Discussions about other treatments and IVF should happen before you embark on this process, you need to fully understand why they are suggesting this now.

attilla what other treatments would you expect me to be offered?

I have had two different consultant's. One who weighs me and gives me all the information and the main planning. The other consultant has completed my scans following when I have taken clomid etc xx

It was the second consultant who said that it appeared I've become ammune to clomid as it's worked every other time I've just not ovulated. This time there wasn't any folicales large enough. She then said that I'd be referred for ivf, but I could be offered metformin in the meantime.

My next appointment with the first consultant has been rearranged by the hospital for June.

Clomid resistance can happen with PCOS; its certainly not unknown unfortunately.

Injectible drugs, metformin and laparoscopic ovarian diathermy to name but three possible treatment options. Its still a massive jump to go from clomid straight to IVF particularly if there are no male factor problems. I am only wondering why they are suggesting this now as an option to you, it does make me think they are not entirely sure themselves.

I do need to loose weight before any other treatments are offered. As I need to get my BMI to 30 or under.

There has been talk of metformin, but nothing else.

Do you think that theyve said ivf because I'll have to be referred to a fertility hospital as my local general doesn't have any other clinical ways of helping me?

Yes I do re your last question and I do wonder as well why they never prescribed metformin in conjunction with clomid.

I would still tackle them on the subject of IVF and your suitability for it anyway given the fact that you have PCOS.

Weight loss is the first thing you need to focus on (possibly in conjunction with metformin). Getting your BMI under 30 and as close to 25 as possible may get you ovulating naturally. Low carb is the quickest way to achieve this with PCOS. IVF can be very successful in PCOS but you do run the risk of hyperstimulation. However, a good clinic should be able to account for this and minimise your risks (I did short protocol, starting with very low doses and scaling up, got 16 eggs and was a successful cycle). How old are you? This would have a bearing for me as to whether you should press on with IVF or try other things first. Personally I'd avoid ovarian drilling and I think it's unlikely you would be offered it.

attilla you've sparked a memory of my last appointment where I mentioned metformin and was pretty much poo-pood as an idea 🤔 I will ask when I next have my appointment.

Welsh I'm just about to turn 31 in the next few months. I've started a low carb diet this morning, been to boots and got weighed...... also started up with some supplements: high dose vitamin D, multivitamin, high dose fish oil, vitamin B complex and magnesium. When I get paid I'm going to add inofolic as recommended by my consultant at my last folicale check.