Thin PCOS Femara Combo

[northwestgal]

Hi Girls!

I'm trying to put together a poll for the thin cysters out there without insulin resistance. My doctors said that if I was a 'thick cyster' (higher BMI) then my treatment would be different, so I'm looking for what worked for the thinner cycsters (lowers BMI) out there? From what I've seen it seams most thick cysters are on metformin but not all thin cysters are. I have looked all over the web to see what the most popular femara combo is and from what I have seen it looks like 7.5mg femara and at least 1000mg metformin seams to be a magic combo for thin non-ir women, but I wanted to get more up to date results.

I'd really love to hear what combo you used to achieve OVULATION or pregnancy (bfp).

1.) Do you have insulin resistance?
2.) Do you have high testosterone and or DHEAS? If so, how high? Has the metformin or dexamethasone help lower them?
3.) Other. Did you use any low does injections (not HCG)?
4.) Do you release on your own or need the HCG trigger shot?
5.) Did you ever respond to clomid?

For anyone out there searching for more info on femara dosage I love the Femara Grid post http://www.soulcysters.net/showthrea...rs-Grid-Format

Hopefully this poll can inform other thin cysters the femara combo used.
Please, this not intened to exclude other women, any and all input is very helpful to all of out there!

[llg04]

hey girl! im on the other thread, but i thought id post here. i am not IR and am a thin cyster - 5'6" 115 lbs before i got pg with these 2 beans. ive put on about 10 lbs now. anyway, i was on met 1000 mg/day, even though i dont think it helped me at all bc i was on it for months and months with no af. then, i added 5 mg femara in november - no response. in december, i asked the dr to up it to 7.5 mg femara, which i ended up with one 20 mm follie on about cd 20 - trigger, TI, BFN. the months i addewed femara, even the one i didnt respond, i got af on my own!

my testosterone is super high. cant remember my number but it is really, really high. the re did give me .5 mg dexamethasone for my last cycle. i started it on cd 1, took it every day and stopped it once i got bfp. i had asked before the bfp to test my testosterone again while on the dex (bc ive read it can drop it like 80%) but she said i need to be on it at least a month or 2 before testing. oh well, didnt get that far.

i did trigger on cycle 2 with the one 20 mm follie, TI and got bfn, but i did not trigger on the cycle they cancelled me due to too many follies. i didnt know prior to that if i was releasing on my own or even if dh was healthy. he hadnt been checked but i guess he is. LOL i was thinking in my head that maybe i had to have the trigger or something, but we ended up pg without it. if we didnt get pg, i was going to have all my testing done like hsg (i think) and MAKE dh test.

i never tried clomid. my re wanted me to, but it was after i did one round of femara with no response. so cycle 2, she wanted me to try clomid, but we were flying to NY for 2 weeks to visit my inlaws for christmas and i didnt want to go crazy in front of them - after everything negative i read about clomid. so i begged to just do another femara cycle and she agreed - even she said i may have mood swings. never got around to trying clomid, but i really never wanted to. ive just read lots of research that said femara worked better on thin cysters, although tons of thin cysters get BFP's on clomid. it was just a personal choice.

after that i asked to do 7.5 mg femara again and add a low dose follistim. i did femara cd 3-7 and 75 iu follistim cd 8-14. i went in starting cd 10 for u/s's - it was no response, no response, no response, then finally on a friday ONE 10 mm follie, continues the 75 iu follistim saturday and sunday, then on monday (cd 15) like 6-7 mature follies with about 10 more under 16 mm but above 9 mm. we had bd'd that saturday before that last u/s. my e2 went from 217 on friday to 1500 on monday. they cancelled my cycle, we did not bd, but as you know, those spermies lived in there for about 3 days bc i think i O'd that tuesday, the day after my cancelled u/s. i assume that but i wasnt opk'ing or anything.

they also told me, "girl, i cant believe you responded like this to such a low dose. you souldnt waste your time on oral meds etc and just do ivf." im 29, but they just meant producing all those follies makes for an amazing candidate for ivf. they did give me bcp's to start, BUT i decided id give my body a break from all meds for a while before starting the ivf process. i wasnt in pain or anything. again, we didnt bd after being cancelled but it was God's will and now we're pg with twins! seems like you have a few more follies than me, so yeah, i wouldnt bd. were they monitoring you every other day? i knwo with injects you can have none one day then 10 the next day. lol since you do respond so well, id either do just 7.5 mg femara next or the femara with low dose injects again but for much fewer days. if your dh is fine and all that jazz, i dont see why you cant get pg on your own before ivf like we did.

sorry that was so long, but there are so many details on this journey. i also like to relay everything i did in case it helps anyone bc i was always searching other peoples' posts to see what i could try, and it seemed like they had gaps in the post and id have to ask tons of questions. LOL hope this helps!!

[northwestgal]

Hi llg!
Love the post! what a great story! Anybody looking in, I posted on another thread that I oversimulated BAD on femara and gonal f....all of my 30 plus follicles all matured (18-28mm each)! I actually bd'ed everyother day until yesterday when my RE said stop....so we'll see... She looked at me and said "Hope you dont surge because there is not one follicle that is NOT ready to release, they all want to go". The nurse covered her mouth in shock. So they took blood but still haven't seen what the results are.
My DH is fine (check him twice) and I had high testosterone (not super hight just above the stats). I took dex .25 for a month and it lowered my DHEAS from 360 (ithink) to 76!!! Femara seams to be the winner with the pcos crowd, but so many women list meformin in their signature.

[llg04]

oooh you could maybe get a bfp this cycle then, although i dont know what happens if you start the bcp - if that prevents it. i dont know. we only bd'd like once or twice before they cancelled me. LOL they thought we may have 4-5 kiddos in there. of course its not safe for you or the babies really so there is always the option of selective reduction, which is a very personal decision, but that is somethiing they talked to us about just in case it happened. luckily, God blessed us with 2 bc id be worried about the health of the babies if i carried any more.

i did take met from last july until about 6 wks pg. my re said i could stop it if i got morning sickness, which i have every day now morning and night. i took it out of my signature bc i ran outta room. again, i dont think it helped me though, but i took it bc it cant hurt to take it. maybe the bcp reduces some of the follies, but you can maybe get a bfp? i dont know, but good luck!

[deltanwad]

In short, both clomid (with and without met) and femara (with met) made me ovulate with differing results. My story is that I miscarried at 6 weeks in fall of 2006 after 3 months off birth control, and then started clomid (three rounds) in the spring of 2007. I got pregnant on the third round of clomid - ovulation indicators high for me- I think my progesterone was like 25 or something, then miscarried at 8 weeks. Got full fertility workup after second miscarriage. Dx with PCOS (androgens high and cystic ovaries). Went on metformin (1500 slow release I think). Did another 3 rounds of Clomid through the end of 2007. Nothing happened. Took a break but stayed on metformin. Adopted our first son Fall of 2008. Added levothyroxine for hypothyroidism, still taking metformin as well. Tried 3 IUI's with Femara in the Fall of 2009. I ovulated but no pregnancy. Took another break. I was frustrated with taking medicine and insurance being difficult going from COBRA to my husband's policy, so I stopped taking metformin and levo in the early part of 2010. Adopted our second son Summer of 2010. Found out I was pregnant (no meds) when our second son was 4 months old in Fall of 2010. Wish I had stayed on the levothyroxine because my TSH was reading in the miscarriage range and they quickly put me on levo. again at 5.5 weeks of pregnancy. Delivered third miracle baby Summer of 2011. God is good!

[GodCan]

Hi ladies! I know this is an older thread but I was looking into what is the best ovulation med to take for a thin cyster, femara or clomid? Well, I just happened to stumble upon this thread. First off, congrats llg and deltawad! It's so great hearing stories like both of yours! llg, I met you in a metformin thread last December I think and it's so great to see that you are pregnant with twins now! So exciting! I see that you went straight for the femara. I am leaning towards that as well but I don't live anywhere near an RE (would have to fly to another island) and my doctor is not familiar with it so he wants me to try clomid first. I'm not sure if I should try it or just beg him to look into femara. Also, there is no way for me to get monitored as my only option is going to the hospital to get an ultrasound then having to wait for a week to get the results... Right now I'm just trying a couple soy cycles and then plan on talking to my doctor in a couple weeks about either clomid or femara. I just don't know what to do! Also, my testosterone was high but is now in the normal range (the high normal normal range, but I'll take it!) and I am IR but only 5'4" and 112 lbs, trying to work out as much as I can and stay on a low carb diet to keep my IR under control, glucose numbers have been coming back fine though (Praise the Lord!), also taking 1500mg metformin. Also, if anyone knows where I can find some good info on femara so I can show my doctor that would be great!

[llg04]

melanie - i wish i could remember the site where some drs did a study on femara vs clomid on thick and thin women. it was great. maybe if you google, youll find it. but, i read over and over that femara worked better on thinner cysters, but sometimes clomid is what they need too. it just depends. i asked for femara - also, bc i did not want all the bad side effects people get with clomid. i didnt respond on my first cycle, but did the 2nd and pg on the 3rd. waiting a week for results defeats the whole purpose bc you could miss your O if they tell you you have follies. that really doesnt make sense. cant they tell you while theyre doing the u/s? i dont know, girl. there is an unmonitored femara thread on this site. search for it...those girls order the femara online and dont get monitored. you could ask them O symptoms etc a lot of them are pg now too. good luck!!

i think this is the site i read first: http://www.jarrettfertility.com/PCOS...%20handout.pdf

[GodCan]

Thank you so much for that information! I will definitely check out that site and look for that thread as well. I may be able to see an OB and they could possibly do an ultrasound. But my last ultrasound a tech did and she wasn't allowed to tell me anything about what was going on so that was no help at all. I definitely think that femara is the way to go, especially with the side effects of the clomid you mentioned. We'll see what the doc says! That's amazing you got pg after 3 cycles! I am going on 13 months and getting a little burnt out on not seeing any improvements. Thanks for the encouragement though! Congratulations again! I'll have to try to catch up with you to see if you're having boys or girls or one of each!

[llg04]

youre welcome. well, we got married in march 2011, and i stopped my bcp at the end of march/beginning of april. we did everything the natural way with no luck, but i wasnt temping or checking things or timing. just having fun. we wanted to wait a year anyway. come november though, i started seeing an RE after talking to my OBGYN. first round of 5 mg femara was no response, 2nd cycle was 7.5 mg femara with one 20 mm follie, trigger, TI, BFN, and 3rd i asked to do a combo cycle of 7.5 mg femara and low dose (75 iu) follistim, which gave us our bfp. you just have to know your body and what youre willing to do, and hopefully, you find a dr like mine that agreed to let me try things i researched. we're lucky it happened that fast, but i dont think it would have happened on its own without help. we find out genders june 11th!

[GodCan]

That's so exciting! I've been nervous to try any fertility medicines but I think I'm finally realizing that my body needs some help to ovulate and that it's just not going to do it on it's own. I have never heard of follistim but I'm assuming you probably need to see an RE for that? I wish I lived closer to an RE! My doctor has been pretty good about letting me try things I've been researching but he seems pretty positive that clomid would work, I'm just not convinced. I printed out that information from that Jarrett Fertility Group website so we'll see what he thinks after reading that. I'm really going to push for the femara. I guess ordering it on my own is always an option too. The waiting game is just killing me! But I know it will all be worth it once I see those two lines on a test ! You're definitely blessed that it happened so fast. Plus you got a double blessing with 2 little ones

[llg04]

thanks! yes, we're sooo happy to be having 2 in case we have trouble having anymore. i actually have 3 sets of natural twins in my family, so its funny. my mom always told me id have twins, and i am! haha follistim is what they call injectables. you can do it as a combo cycle or all injectables.

[GodCan]

haha, your mom sure called that one ! Both of my grandmas were twins so my sisters and I always joke that one of us will have twins. Guess you never know ! I'll have to ask my doctor if he would do injectables. I need to write all these questions down so I don't forget them by the time I see him... Thanks for letting me pick your brain!

[gracie381]

1.) Do you have insulin resistance? NO

2.) Do you have high testosterone and or DHEAS? If so, how high? NO, just high/normal. Has the metformin or dexamethasone help lower them? Not sure

3.) Other. Did you use any low does injections (not HCG)? NO

4.) Do you release on your own or need the HCG trigger shot? MY OWN

5.) Did you ever respond to clomid? NO

I got my bfp on 10mg. Femara...never responded to Clomid or even 5mg. Femara. I was taking Metformin 1500mg., 81mg. baby asprin daily, 4mg. Folic Acid, Prenatal Vitamin and Femara 10mg. cd-3-7. I ovulated late around cd 17/18! My son is now 16 months old!! LOVE Femara!!