TTC Newbie,Metformin, Provera, Clomid, etc etc

[jazzistar79]

Hi ladies..

Well, it's official..we are in the whole TTC game and I am not gonna lie, it's terrifying me already.

I just finished 5/5 days on Provera yesterday and waiting for dear AF to rear her ugly head...I had AF with just metformin in January and February but March was nothing so that prompted me to get to the doctor. I turned 33 in January so obviously it is time to stop playing around and get serious. I probably should have started sooner but I honestly never thought I would find a guy that would inspire me to want a family (because good guys are such slim pickins around here), but I did and we got married in October. I went of BCP in August to see where things stood...basically at a stand still until my Metformin was upped to 2000 mg in January and AF came shortly after.

Like I said, I am waiting for AF to show up. Doc said within two weeks. I am to take Clomid on cycle days 5-9 and then on day 10 start OPKs for 10 days. I will be honest...I am not feeling very positive about Clomid. It seems like everyone I have even encountered either in person or online has tried Clomid for several cycles and had no luck or they got their BFP and m/c shortly after. Hubby, who is only 26, doesn't really get it yet as to why I approach TTC the way I do...he tells me to think positive but to me I am thinking realistically. I have been hard on myself though, I have been telling myself since I was 14 that I was infertile and would never have kids so it's hard to get out of that mindset and I have warned him that if we ever get a BFP he better be prepared for us to go buy about 20 brands of tests for confirmation LOL. So please, tell me I have the wrong idea about Clomid. I expressed my concern to my Doc and she said that most of her patient's do respond to Clomid so maybe we will get lucky as well.

My Doc has a plan for us. First the Provera. Then, 3 rounds of clomid ...one at 50, 100, and 150 mg. After those 3 rounds she said she will move on to the other drug...I can't remember what she called it, she said it was a newer drug for TTC that was actually a breast cancer treatment drug...Femara? Anyway, same with that one, 3 rounds increasing the dose each time. If we are still unsuccessful she said she would send me to a fertility specialist out of town that she works with. So basically 6 months of trying give or take. I immediately told hubby that after 6 months we would have to really talk about it because I don't know about a fertility specialist or just how far I am willing to go. I am trying to not even think of that at this point.

My own personal plan is to not overdo it. For the last few months I have been learning about checking your cervix and your cervical mucus and temping etc. but I have decided to try and stay relaxed, let the meds do their jobs, and just see what happens. Some ladies, many ladies stress themselves out over it and I think that ends up being a factor as well...obviously it is a huge deal and I totally understand the stressing and all that but I HOPE to keep myself calm for a least the first few months of trying.
I feel like we are cheated out of so many things with PCOS or have to work harder for them and instead of celebrating the decision to start a family, I am keeping it pretty hush hush and the only family person who knows is my mom. I have told a couple of close friends as well but for the most part no one will know until we have a pretty solid viable pregnancy

So positive things about Clomid? Anything positive please!!! I should feel so happy and upbeat about this new chapter in our lives but I am just not feeling it like I should. Hubby and I would like to have 2..maybe 3 kids. I have already warned him that I want 2 pretty close together if we can pull it off. I have always wanted kids but now, probably since the beginning of meeting my husband I have never wanted them more. I am crazy in love with this man and guess I am kind of old fashion in feeling like creating a little person out of that love is the ultimate way to show the world that love. Sappy..I know, but everytime I look at my husband I just want to make little versions of him LOL.

Anyway, here I am...in the TTC club...the sooner AF shows the better because I am so ready to get this show on the road!!!

[defygravity]

I have taken clomid twice, 50mg each time, and responded both months. There's no reason to automatically assume you won't respond. The response varies by woman though so don't get discouraged right away if you don't respond the first time - I responded differently to the same dose each month so if the 50 doesn't work for you don't get frustrated, give the 100 a try. Also, remember that clomid's objective is to get you to grow a follicle and ovulate. Miscarriage is common for all women, not just PCOS women, and personally I believe the m/c rate is higher for PCOS women because we're paying attention earlier in the cycle. We tend to know much earlier that we're pregnant and the catch there is that most miscarriages are very early. Something like a chemical pregnancy would be noticed by someone in this arena because we're POAS earlier, whereas someone who wasn't monitoring their cycle may not even know it happened.

As far as self-monitoring... I don't track CP and CM, but I firmly believe temping is important. Since women can ovulate later on clomid (or later than CD14 anyway) it's good to know when you do ovulate, especially if your doctor doesn't do any mid-cycle monitoring. You don't want to be sitting at CD21 with a blood test telling you that you didn't ovulate and starting Provera on CD28 when you ovulated on CD23 and didn't even get a chance. You're right about the stress, sometimes charting is sometimes stressful. But honestly I would find not-knowing even more stressful. It's just my .02 FWIW, I've just seen quite a few women who didn't temp cursing themselves mid-cycle because they have no idea what's going on. The choice is entirely up to you.

The first cycle was very exciting for me, and it's good to go into it realistically and practically. Each ovulatory cycle, for ALL women regardless of PCOS or not, gives a 20-25% chance of pregnancy. The goal with the medication is to ovulate, so if that happens in your cycle it's a victory whether you get pregnant or not. Good luck, and please keep us posted!

[vancouverNicole]

Clomid worked for me too, though I do feel lucky that it did. OPKs didn't work for me though, even though I ovulated, only the blood test would confirm ovulation for some reason (I've heard of them not working for others with PCOS too, not sure what is going on with that).

[defygravity]

I didn't have much luck with OPKs either - I never got a positive and ended up triggering both times. They do work for some women though.

Nicole, you're getting close... I'm sure you're excited.

[jazzistar79]

I have taken clomid twice, 50mg each time, and responded both months. There's no reason to automatically assume you won't respond. The response varies by woman though so don't get discouraged right away if you don't respond the first time - I responded differently to the same dose each month so if the 50 doesn't work for you don't get frustrated, give the 100 a try. Also, remember that clomid's objective is to get you to grow a follicle and ovulate. Miscarriage is common for all women, not just PCOS women, and personally I believe the m/c rate is higher for PCOS women because we're paying attention earlier in the cycle. We tend to know much earlier that we're pregnant and the catch there is that most miscarriages are very early. Something like a chemical pregnancy would be noticed by someone in this arena because we're POAS earlier, whereas someone who wasn't monitoring their cycle may not even know it happened.

This makes so much sense to me and I think you are absolutely correct about that. I know when talking to my close friends who do not have PCOS and DO have kids I usually know so much more about things pertaining to a woman's cycle...that comes from a lot of obsessing over it. You should see the faces I get when I talk about CM...LOL it's priceless.

I will have to look more into temping, what I do know about it is very little, take temp first thing after several solid hours of sleep. We keep such a weird schedule around here so I don't know how accurate that would be. My husband works ridiculous hours.. sometimes day shift, sometimes night shift. I am on 1st shift right now but will eventually go to 2nd or 3rd, it's up in the air, but he either wakes me up coming in or I wake up to make sure he gets up...I am a light sleeper so sometimes something as simple as the dog snoring will wake me up. So if you have any suggestions I will gladly take them. I have attempted to temp in the last couple of months...even had an alarm on my phone set but my sleeping patterns were out of wack. I may try this again after I get a new thermometer. The one I have is just a regular digital, not basil..it has one decimal place but I think the basil has 2 decimal places?

I won't see my doc mid cycle but I will see her in between rounds. After AF and the OPKs (which I am a little skeptical about myself) I am supposed to do a pregnancy test on day 35. If AF shows up before then, I am supposed to get in to see her before day 5 to get a clomid refill. If BFN and no AF I will also get in and she will test/exam to see what is going on and if I ovulated or if anything is happening etc. and do the next round with provera again if need be. I think as we go through this process she will see me more often to check things out the further we get into it..I hope.

Today, hubz said, wouldn't it be crazy if this happened the first month...I didn't say it, but I thought to myself yeah so crazy you would have to have me committed or I would die of shock LOL.

Thank you sooo much for all your feedback! I am told on a regular basis by my doc to stay away from Dr Google, so I have, but I definitely seek out this forum a lot!!

[jazzistar79]

Clomid worked for me too, though I do feel lucky that it did. OPKs didn't work for me though, even though I ovulated, only the blood test would confirm ovulation for some reason (I've heard of them not working for others with PCOS too, not sure what is going on with that).

Looking at your stats, looks like you did a total of 5 rounds on Clomid..my doc only wants to do 3 before moving on to another drug....maybe she means if I don't ovulate on it...if I ovulate then I would think she would stick with the dose I am ovulating on and have us keep trying. I didn't even really think about that until now so that is a positive thought...I had kind of had this idea that basically it was 6 months (3 rounds of both drugs) or bust and I would be sent off to the specialist. That wouldn't make sense if I was responding to the drug. That's kind of a relief there!

Congrats on your baby! That really is right around the corner!

[jazzistar79]

Okay, I actually have another question that I keep forgetting to ask everybody, including my doctor. I am super super prone to UTIs. I was taking cranberry daily but then I read a couple of contradicting things about TTC and taking cranberry supplements. I think I will be okay as long as I don't fall asleep before I go to the bathroom, that seems to be a major culprit so I try to avoid that at all costs. If I do wake up with that funny twingy tingle that I normally feel in the very beginning I have found that if I take just 1 of the over the counter cystex capsules it usually clears it right up. Obviously until I ask my doc about this I am nixing both the cranberry and the cystex until she okays it.

My question is how long should I elevate, lay still, stand on my head, etc. to keep things flowing in the right direction? I don't want to overdo it and risk infection but I also don't want to to make a beeline for the toilet either, although thanks to metformin it is like my 2nd home...seriously.

[defygravity]

I usually try to stay flat or hips elevated for 15-20 minutes. You could try a Softcup, which is basically a diaphragm looking thing that you insert after sex. It's typically used for menstrual blood, but several women have had success with it because it doesn't let as much semen leak out. It's something to think about, if you need to urinate frequently and you're concerned. Certainly not a requirement, just something to keep in the back of your mind.

Temping really only requires 3 hours of sleep each night. I rouse frequently as well to turn over, flip the pillow, because I kicked the cat, DH snoring, etc. As long as I fall right back asleep, it's not an issue. I do have problems on the nights I fully wake up or get up to pee in the middle of the night. I normally take my temp at 8. If I wake up between 1am and 5am, I take my temp as normal at 8. If I wake up between 6 and 7:30 (and don't fall right back asleep) I take my temp when I wake up and adjust it later. If I wake up between 7:30 and 8 I just take it as normal and leave it be. I started tracking how often I adjust it and actually learned I need to start taking it earlier - I wake up at 6:45 too often, apparently. I do recommend a BBT thermometer. I've seen women do it with a regular therm, but I think the BBT helps see the shift better. Fertilityfriend.com has fantastic training videos and FAQs, and they actually address the questions about shift work. More or less, it's a do the best you can kind of thing.

It's good that your doc waits until CD35 - I always get nervous when I see the CD28 blood test/Provera routine because there's nothing more frustrating than going through all of the legwork and medication and then wiping out your chance. I'm very excited for you - good luck and certainly keep us posted.

[vancouverNicole]

Looking at your stats, looks like you did a total of 5 rounds on Clomid..my doc only wants to do 3 before moving on to another drug....maybe she means if I don't ovulate on it...if I ovulate then I would think she would stick with the dose I am ovulating on and have us keep trying. I didn't even really think about that until now so that is a positive thought...I had kind of had this idea that basically it was 6 months (3 rounds of both drugs) or bust and I would be sent off to the specialist. That wouldn't make sense if I was responding to the drug. That's kind of a relief there!

Congrats on your baby! That really is right around the corner!

Thanks!
Yah even if you are ovulating, it sometimes takes a few months to get pregnant, as long as you're ovulating on clomid I'm not sure why they would change meds that fast.

I did the elevated butt thing for 20-30 mins after.

[DiamondInTheRough]

Are you staying on the Metformin?

I conceived twice using clomid. Each time was on the second or third try I think, can't recall for sure. I conceived once with Metformin, and it took about 5 months.

[jazzistar79]

Are you staying on the Metformin?

I conceived twice using clomid. Each time was on the second or third try I think, can't recall for sure. I conceived once with Metformin, and it took about 5 months.

Oh yeah...definitely staying on the metformin. My doc has always encouraged me to use it and my dose has always been 2000 but I had always had such a hard time with the side effects, even with XL version that I would go on and off a lot of take a lower dose but I have been set right at 2000 mg religiously since January 1 and have just learned to live with the inconveniences in hopes that it would be worth it in the end. I plan to push to stay on it during pregnancy as well...she may recommend staying on it anyway, we obviously havent gotten that far but I hope that is something she wants me to do as well. How long did you try with Clomid before you got your BFP?

[Stormy77]

I have a very good friend from church that tried 50mg of clomid after TTc for 7 yrs. got pregnant the 1st mth and carried her DD to term. 2 yrs later did 50mg of clomid and got pregnant 1st mth. carried her DS to term. 3 yrs later got a surprise lol. Some women (like me ) dont respond to clomid or femera. I created more eggs just werent good eggs. nothing to do with the drugs. Dont give up hope before you start.

Some drs will only try 6 mths of the drugs due to the fact they dont want to dea with it. they just send you someplace else. I think if the drug is working on that mg then to stick with it a few mths. if not them move up.

[jazzistar79]

AF finally made it! I am so excited about starting the clomid in a couple of more days. I am supposed to take it days 5-9....even if I am bleeding on day 5? I think I read on this forum somewhere that you do still take it even if you are bleeding. I have no idea how long the bleeding will last but surely it will be gone by the time I start OPKs on day 10...right? Does provera ever make you bleed for an insane amount of time and if so how does that affect ovulation?

[defygravity]

Yes - take the clomid even if you're still bleeding.

I've never bled more than a week on provera - usually 4-5 days. I'm sure there's variance, but since you had a period earlier this year I wouldn't expect anything going on for 10 days. Good luck!

[jazzistar79]

I think things are winding down...it has lightened up quite a bit so hopefully in the next day or two it will be gone. I took my first Clomid this morning....I assume the time of day you take it does not matter as long as you are consistent about the time. The doc said we should BD every day..once and only once after/if I get a positive OPK. I have seen many people say to BD every other day not everyday. Any thoughts on that?