Please bear with me through this story, I need advice and help badly and have no where else to turn!
So I've been living with PCOS for over 10 years and don't believe I have ever ovulated in my life. My periods are virtually non-existent (have gone years without having one) but seem to have no problem forcing one by use of medroxyprogesterone drugs like Provera.
The story is this: TTC and went to see an RE about my problem. Ultrasound showed polycystic ovaries and blood tests were normal apart from testosterone which was VERY high (214ng). He prescribed me 100mg of Clomid to be taken on day 5 of my cycle for 7 days total. I took my LAST dose this last Wednesday (July 9) and went in for a follow-up ultrasound TODAY (July 11, CD13). Ultrasound was performed by a nurse practitioner who quickly scanned my ovaries and commented that there were several eggs but none that developed. Not even sure if there were any follicles at all as sizes were never mentioned. Ultrasound took less than 2 minutes and began crying immediately as I had so much hope for good news, but got none.
The nurse then suggested that I start taking 5mg Letrozole (aka Femara) instead of the Clomid (of which I only took it for this one cycle). Although today is CD13, she said we are going to start over and count today as CD1 instead; no need to bring on another period as my endometrial lining is pretty thin right now. So this Sunday would be CD3 and I should start taking the Letrozole.
My concerns are these:
1.) Is 2 days post last dosage of Clomid TOO early to detect mature follicles? How long does it normally take after your last pill for there to be some real evidence?
2.) Is it normal to be prescribed a totally different drug and be told to take it just five days after finishing Clomid?
3.) Is it possible that I already ovulated and it was not detected during the ultrasound (eg. I already released an egg, therefore not showing mature follicles on US). OPK's have been showing negative last three days.
I was really annoyed that a NURSE decided to change my fertility plan without consulting my RE first. I know nurses know what they are talking about, etc, but they are NOT doctors... how could this nurse even have the authority to prescribe me anything at all? After the appointment I called the doctor and told him what happened. He agrees that I should not start taking the Letrozole this weekend and suggested that I wait 2 weeks and then come in for a blood test to (I guess) measure my progesterone levels to see if I ovulated. He seems doubtful that based on today's results I would ovulate.
I feel so hopeless after today that I didn't respond AT ALL to Clomid. I've read that Letrozole is better anyway as it doesn't thicken the CM or cause thin uterine lining so I'm happy about that. I just want my body to ovulate and not sure if I ever will; today was not a good day.
PLEASE HELP! With my grossly high testosterone, and no sign of my ovaries doing anything, it makes me feel alone and totally unable to conceive. Depression isn't even a strong enough word for how I'm feeling.
Last edited by Concertina4321; 07-11-2008 at 08:13 PM.
Just called the doctor back and requested another appointment on Monday (which would be CD16) for an ultrasound with a different nurse for a second opinion. Do you think this was pointless of me to do? There's probably no chance I'll grow any follicles in the next three days. Just want to make sure today's nurse knew what she was looking at after 2 seconds of looking at my ovaries on ultrasound and dismissing any follicular growth.
I know every practice is different, but my dr has me go for blood work on day 21-22 of my cycle to determine if I've ovulated that month. What day of your cycle did they do the ultrasound? I'm not a clinician so I don't know if they can tell only from that and during the time of month they did it. But I would want a second opinion as well. Go with your gut and trust your instincts. YOu need to be in charge of your health. Good Luck!
The ultrasound was done today which is my CD13. I stopped taking the Clomid on CD11. My gut feeling is that it was too early to get a proper diagnosis, but I'm not a doctor. I've read on other websites that you're typically supposed to get an ultrasound 4-6 days after your last Clomid pill. I booked my second opinion u/s on what will be CD16. Not sure if this will make any difference at all.
Another thing to ask your dr, since you have high androgen (testosterone) levels, is if you wind up being Clomid resistant (just not responding to the Clomid), would he recommend you be put on dexamethasone along with the fertility meds to help lower your testosterone levels so your body can react to the Clomid or Femara?
I've heard that some women with PCOs are clomid resistant and Femara(letrozol) works much better. If the "nurse" was prescribing meds then she probably was a nurse practioner, which is more training than a nurse. glad you got a second opinion though if your gut told you something wasn't right. If the femara doesn't get those eggs ready than there's injectibles too. Will you be taking a trigger shot after the femara this cycle?
__________________ Leigh(29)DH(35) Married 12-28-07 TTC#1-June 2008 Cycle 1-Natural cycle, No O, BFN Cycle 2-Femara, trigger, O, BFN Cycle 3-Natural cycle, O, BFN Cycle 4-Natural cycle, O, BFP, didn't know/m/c 9 month break for testing, laproscopy (all normal) Cycle 5-Femara, trigger, O, BFP! 8/17 (m/c) 8/27 Cycle 6-Natural cycle, O, BFN Cycle 7-Femara, trigger, O, BFN Cycle 8-Femara, To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Thanks to everyone who responded. Just wanted to let you know that I did go in this morning for a second opinion and ultrasound. And guess what?! They found a 15mm follicle! Going back in again on Wednesday to see if it grows any more and if it does, I'll have the HCG trigger shot.
TRUST YOUR GUT FEELING! On Friday they found nothing, and I was worried it was too soon, turns out I was right! If I did not go in for a second opinion today I would have just assumed the Clomid didn't work. Obviously this was wrong and I am so glad I went in today. I am so happy I don't even know what to do with myself. Now I just have to work on getting pregnant once this egg is ready to go!
We women are pretty good at "just knowing" something isn't right. Good for you for following your gut! I hope this cycle is a success for you!
__________________ Leigh(29)DH(35) Married 12-28-07 TTC#1-June 2008 Cycle 1-Natural cycle, No O, BFN Cycle 2-Femara, trigger, O, BFN Cycle 3-Natural cycle, O, BFN Cycle 4-Natural cycle, O, BFP, didn't know/m/c 9 month break for testing, laproscopy (all normal) Cycle 5-Femara, trigger, O, BFP! 8/17 (m/c) 8/27 Cycle 6-Natural cycle, O, BFN Cycle 7-Femara, trigger, O, BFN Cycle 8-Femara, To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
I'm so glad you trusted your feeling. On the cycles I did have follies with clomid, they did not start to grow until like cd17 or after. 2 Days after last pill is way too early and congratulations on your follie! Triggers are great...basically guaranteed ovulation and you'll know EXACTLY when to do the deed!! Good luck!
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