Those who no O on clomid, what next?

iwantbabies · 06-13-2005, 05:21 PM

I need help, I'm getting really frustrated. I'm on round two of clomid and I still haven't Oed. When I asked my ob/gyn about it she gave me no advice and told me that she is dropping me as a patient and refered me to an RE of which my insurance won't cover.(Ironic that I work in the healthcare industry, and yet my insurance won't cover infertility). Anyway, I feel asking for advice/help from a Dr. is out, so I'm turning to you.

Here are a couple of questions for those clomid users who didn't O:
At what point do you give up on on waiting to O and call it quits, I'm on cd27 and no O, no +OPK and no thermal shift, should I assume no O and that this cycle is up?

If you didn't O on clomid did you still get AF on your own or did you have to use provera?

If you didn't O, what did you do for your next cycle? Did you take a clomid break? For how long? Or did you up your clomid dose?

RunnerDuck · 06-13-2005, 05:46 PM

I don't have infertility coverage either. I ordered clomid from mexico but it didn't work for me... just made my blood work worse. I think if your hormones are whacky to start the clomid might just make them wackier.

Anyway my current plan is this. I am on 2000mg/day of glucophage (metformin) and 4mg of Avandia. The Avandia is new (ish) - I have only been taking that a few months. And I am doing 9 weeks solid of BCPs (Yasmin) and I am hoping that that will quiet my ovaries down enough that when i go off, the insulin meds will allow them to function normally for a bit, I will ovulate, and get preg. And in the mean time of course I am being good about diet and exercise. Better than I have ever been in my life at that! Usually my exercise is good but my diet is lousy.

So maybe you could up your met, add or switch to avandia, ,do a BCP break before doing clomid again or hoping just to let you work normally... it *can* take 6 months to a year to see results from met so maybe you just haven't given it long enough, or maybe you need a higher dose... and are you being good about diet and exercise? These are some things you can try yet without dipping into infertility treatments...

The BCPs before clomid really might help. In my case I wasn't cycling, I induced a bleed with Natural Progesterone Cream... then started the clomid. But I suspect I may have just really confused my body by doing that. I gave up thinking I would O after, I don't know, 3 weeks... I never did get a period. I did a pregnancy test (Ha ha, just to be sure, there's always that dilusional hope) and went on the BCPs.

Peyton's Momma · 06-13-2005, 06:40 PM

I just finished my first round of Clomid and I didn't 0 either. My doctor had me get CD24 progesterone test, which is a way to tell whether or not you ovulated. I didn't, so she gave me a new prescription for Provera to induce my period, and 100mg of Clomid. I could never go back on birth control pills - I hated every minute of it.

~Traci~ · 06-22-2005, 10:56 PM

I would find a new OB if you don't want to go to an RE. That's rediculous that she's refusing to treat you after only 2 cycles! There is also Femera that's worked for my cysters when Clomid doesn't. If none of that works (you can only take Clomid for 6x's @ a time and then a break) then you would have to go to an RE for injectible meds if that's the route you want to take.

Good Luck!
Traci

optima1 · 06-26-2005, 04:59 PM

RunnerDuck, could you please send me info on where in Mexico you ordered your clomid. I am really concerned about finding a trusted site to use.

RunnerDuck · 06-26-2005, 05:50 PM

Optima -

I ordered from www.medsmex.com but seriously... I don't know that I would reccomend it. I didn't have a problem getting the meds and I don't think they are fake based on the fact that they made my blood work SOOOOO bad, obviously they had some effect on my hormones... but there have been reports of one woman in the TTC board not getting her meds and instead getting a letter from customs saying the drugs had been seized... and another woman who it just took a LONG time for them to arrive, and personally had I gone through that I would have been sweating bullets the whole time.

Of course, it's your call...

But even more importantly - honestly, here's my thoughts. Don't do it on your own. I'm not saying you need to have a doctor follow you on this one, but if at all possible, get a doctor to do blood work first. Find out where your hormones are first. Mine were NOT in a good place. LH was 11something, FSH was 1something, testosterone was low 50s. After taking the clomid, my LH was 17something, FSH was 3something, and testosterone was high 70s. Clomid works by raising both LH and FSH. I think that if you have PCOS and your levels are way out of kilter to begin with, clomid will not make you ovulate. It will simply raise those crazy levels even higher, but it will not bring them to where they need for you to ovulate - because the problem is not how high they are but rather how out of line they are with each other, if that makes sense.

Before we knew about metformin, avandia, etc, clomid very often did not work for women with PCOS. It's not cut and dried that it will never work, but I do believe some women are better candidates than others. And if you are a poor candidate, you're better off address WHY your levels are off than trying to raise them with clomid. Take your insulin meds, exercise, etc...

Honestly i wish I had NEVER taken clomid. I feel like I wanted a short cut to getting pregnant and it backfired. I should have just given the avandia a chance to work. Instead I ended up taking BCPs for 3 cycles because things were so messed up the the best course of action seemed to bring my ovaries to a screeching halt, wipe the slate clean, and start over.

I used to think it would be a very easy thing, if I am not ovulating, I will take clomid and get pregnant. But it doesn't work that way, it seems. There are women who do the clomid thing entirely on their own and it works for them. But surely for every one of them, there is also one like me... and you know what they say, if you can't be a good example, you'll have to serve as a terrible warning? Let me be your terrible warning.

So seriously consider going to a doctor. See where your PCOS is, see if clomid is even a reasonable treatment for you. There is no doubt in my mind that had I asked my doctor "So do you think clomid will help?" he would have said NO. But instead I had to be pigheaded and have the hubris to think I could take care of this myself. Blah!

I'm not saying the doc has to prescribe the clomid... or follow you on it... but he/she should at least give you input on your best option at the moment.

You are on a very low dose of metformin... I would see about raising that to 1500mg or more, or adding another med, if that isn't helping you to have cycles or ovulate. IMO you really need to work on that, the reason you're not ovulating, rather than just think you can make yourself ovulate.

Iwantbabies -

I just wanted to say that I tend to think your OB did a good thing in dropping you as a patient. I don't think she did it to be mean or because she thinks you're hopeless - she did it because she doesn't want to keep tinkering in an area that isn't her area of expertise. PCOS is not a gynecological problem, and I think most IF treatment most OBs know to use begin with the premise that they are treating a more or less normal woman who just needs a little help. PCOS makes things much more complex, and you are really better off finding a doctor who will adress this fact rather than give you more clomid. If you don't have IF coverage, why not try to see a regular endo? Personally, I have always had better luck with endocrinologists anyway. REs have never found me too interesting because my goal has most always been to address my PCOS rather than aggressively pursue pregnancy. BABIES are dramatic but I guess treating PCOS is just mundane.

Anyway I don't have IF coverage, either, aside from "diagnostic," (which pretty much = USELESS) but I am working with an endo for my PCOS and I think that this is ultimately going to help me. I have to hold on to the belief that it will, at any rate... and if it doesn't help, at least I'll know I haven't jumped to the extra cost of paying an RE out of pocket when I had another choice.

socalmomma · 06-26-2005, 06:47 PM

To treat any infertility issues , you would be better of seeing an RE. An OBGYN is just not qualified and I'm sure you want the most knowledgable team working for you (not sure how to overcome the insurance issue though)!

I am not a doctor, but this is my experience. As far as no O on Clomid- They should have taken a blood test to test your progesterone levels. The number will determine if you have O or not. I don't believe your menses will start if you have NOT O. I would wait until ATLEAST day 35 of your cycle-take a pg test- and then start provera to induce next cycle.

I didn't O on 50mg of Clomid so they raised my dose to 100. That worked for me, but no pg. Some women need a higher dosage, this is not uncommon. Clomid is almost always the first line of treatment for infertility. Some are lucky and have success right away. Others move on to stronger meds like injectibles/follitism.

You really need someone qualified to helf you through this-it sounds like your obgyn agrees!

Best of luck to you-your body wants to O and it WILL happen!!!!!

optima1 · 06-27-2005, 08:00 PM

Runner Duck
Thanks so much for your reply. I O, just very late. I guess I need to update my info. I am now on 1500 met. My doctor suggests that I try clomid. But for whatever reason she wants me to see another doctor to write the script. She believes it will be a good option, but said because it is not a fertility clinic and since I go through the hospital she can't write it. She has done all the blood work and is willing to write up any new info the doctor needs and run the test just not write the script. She it going to do an ultrasound on the 7th because she says he will need it. Other than that everything else seems to be ok. I don't have any cysts or other complications, just long heavy cycles and late ovulation and kinda hairy oh and IR

Twinmommy2008 · 06-29-2005, 04:21 AM

I have been told by my RE that you can take clomid up to 12 months in your lifetime as more may increase the risk of Ovarian cancer. I tried 50 mg-no O, now 100mg-waiting for blood test results. If no O then we will increase to 150 mg. I have heard of some women taking 200mg but I thhough 150 mg was the highest they would give you. If clomid doesn't work for me, I will try ovarian drilling b/c I have read that results are similar to that of injectables. I can't afford injectables or IVF so mayve govt adoption (free) may be an option.

tessabird · 06-29-2005, 11:07 AM

Khennager i'm in exactly the same boat as you. Just waiting for AF to start so I can start Round 2 of clomid. He increased it this time to 150 mg. Good luck to you.

fawn · 06-30-2005, 03:17 AM

what will happen if you take more than 150mg of clomid?

I'm not TTC, but my doctor prescribed me clomid to see if my ovaries will respond to eat (coz i'm having amenorrhea). 100mg didn't work. And i will have to try 150mg ( in less than a month after taking 100mg)

jdreams76 · 07-06-2005, 09:12 PM

The highest dose of clomid you can take it 200mgs. If i were you I would either go find a RE that does take your insurance and sometimes they will bill under pcos instead of infertility. And if they do have to do infertility as billing they can put d/x of infertility on there. My doc did that for me and all my baseline u/s's and my other u/s's. But I see a Infertility Obgyn. He is a great doc i just want him to prescribe me femara before moving onto more expensive treatments. Femara is another drug that induces ovulation. And has been known to work better for pcos patients. My ob i was seeing before this one told me to go see this doc because she cant go beyond the clomid and she never monitored me other then my p4 test on cd21. Now this doc i am seeing now has me go in on cd3 for a baseline u/s and then on cd 12-14 to checkmy follies. And then he wants me to do a trigger which we are thinking about doing when i start clomid again in either Aug or Sept. But the point i am getting at is my old regular ob who didnt do much monitoring and wouldntbring me past 50mgs of clomid for 4cycles i Oed 2times weak O's i might add. Now this doc who put me on 150mgs right away and monitored me an di took the clomid for 7days i had the strongest O ever according to my p4 which i didnt have done until cd 24 vs 21 because of how late i Oed So basically just try to find a new good doc that takes your insurance and explain to them your situation with insurance coverage and see what they can do for you. GL

tiggerlily5278 · 07-08-2005, 11:44 PM

I was being treated by my ob/gyn. We tried 2 months of Clomid. 1st month 50mg (cd-24 testosterone level 0.8) and 2nd month 100mg (cd-24 testosterone level, still 0.8)! Obviously, I did not ovulate with Clomid. My ob/gyn said that he would increase the dosage each month. The last month would be the 4th cycle at 200mg. He said if that did not work, then he would refer me to RE. He suspected PCOS, but like the others have said, PCOS & infertility are not ob/gyn's specialty. After the 2nd month, I decided to go to RE who specializes in PCOS. Right now I'm completing blood work tests she gave. I suspect the next step is Metformin. I've heard others say as soon as they went on Met, they got preg. So, I'm hoping to be so lucky. Good luck.