[Shadeauxe]

Ok, so I had my follow up appointment yesterday with the RE and now that I am on a real keyboard, I can type everything up. I thought some of the information was very interesting. Some of what she said contradicts what other people and their doctors have said, so keep in mind that I am merely transcribing what was told to me. I am not trying to discredit anyone's experience or doctor.

I got tested for STDs, FSH, estrogen and other random things like rubella (why?). Everything came back normal except the estrogen, which was 83 and they want less than 70.

She gave me a lot of numbers which would be a lot easier to read in a table, but since tables are not allowed in here, I'll do what I can. All of these % are based on my age. So, if I was younger, everything would be higher. For example, the % chance of pregnancy at age 20 is 20%. Each % is a per cycle chance. My miscarriage percent is 30%.

Normal Conception Rates (for my age)

• Getting Pregnant - 5%
• Twins - 2%
• HOM (High Order Multiples) - <1%

Oral Medicine (Clomid/Letrazole)

• Getting Pregnant - 8%
• Twins - 8%
• HOM - <1%

Oral Medicine (Clomid/Letrazole) with IUI

• Getting Pregnant - 10-15%
• Twins - 8%
• HOM - <1%

Injectible Medicine (FSH) with IUI

• Getting Pregnant - 15-20%
• Twins - 15%
• HOM - <1%

IVF

• Getting Pregnant - 40%
• Twins - 20-25%
• HOM - 1-2%

I asked her about blood clotting and progesterone and she said that there is no evidence to support blood clotting being the cause of first trimester losses and that the whole baby aspirin thing had been debunked.

With the progesterone, she said that people aren't usually tested for it unless they have had multiple losses and there's also no data to support that taking progesterone keeps a pregnancy viable. I've heard that mentioned in here before as a chicken/egg type thing where the question is if the progesterone is low because there's going to be a miscarriage or that there is a miscarriage because the progesterone is low. She believes it is the former.

I also asked about the Clomid vs Femara thing because I know Katie said she didn't like the Clomid at all and had worse reactions to it. I also asked about it thinning the lining. She said it does thin the lining, but for the amount of time that I will be on it (2 months), it's won't be an issue. She said doctors go to it first because it has been around longer and has a larger group of use cases. I am not wording that properly, but basically more people have used it and therefore tested it and they like that better than a newer drug. She also said that after three months of using Clomid or Femara, you've plateaued and it continuing to take it probably won't be successful since most people who use it get pregnant within three months.

So, she is going to have me take Clmoid for a couple of months and if that doesn't work, then we'll switch to Femara with IUI which is fairly inexpensive. If that doesn't work, I'll decide what to do next. I have good health insurance, so it's all covered. If I think of any more information, I'll post it as an update.

[*SamF*]

Sounds like a good appointment! It's weird how they all have differing opinions on things like progesterone. Hope the Clomid works for you, and you don't have to move on to any of the other stuff!

[Shadeauxe]

Originally Posted by *SamF*

Sounds like a good appointment! It's weird how they all have differing opinions on things like progesterone. Hope the Clomid works for you, and you don't have to move on to any of the other stuff!

Yeah, I thought it was interesting to. She seems logical and rational to me, so I am going to trust in what she says. Obviously no one has all the answers. In the end, you just have to go with what feels right to you. I hope I don't have to use any of the other procedures also.

[acchickpea]

What a great visit! Your Doctor seems very knowlegable and I hope that Clomid is the answer for you!

[pepper73]

Sounds like a very informative appointment. Those percentages terrify me (being one of advanced maternal age) but I think it's great that she laid everything out for you and now you are well armed with information. I hope the Clomid works for you!!

P.S. Massachusetts must have a thing about Rubella. When I got married, it was in MA and I had to get my blood tested specifically for that, even though it is basically obsolete. Weird.

[melissalaw]

Sounds like you had a good appointment. Your doctor sounds like a good knowledgeable doctor. I really hope that the clomid works for you and you don't have to try the others.

[.:Shortcake:.]

Sounds like you had a good appointment! I hope the Clomid works for you and just wanted to say take it before you go to sleep just in case you have symptoms from it you sleep through most of it I learned that the hard way!

[lindsey2000k]

Good luck.
I also think its weird how they all have there own opinons on meds and stuff.
My DR agrees about the baby asprin he calls it voodoo but then in the same breath told me to give it a try because for some reason its worked with some women.
My DR says that because I have MTHFR I need Lovenox but my mom asked her GYN about it and he said he would not give it, and he said when a woman has MTHFR getting pregnant and staying pregnant is just a numbers game and you have a 1 in 20 pregnancy chance of not miscarring. But he is just a GYN not a OB.

I am doing the baby asprin and lovenox because in my head I feel like I am at least doing something.

[Shadeauxe]

Thanks everyone!

Originally Posted by pepper73

Sounds like a very informative appointment. Those percentages terrify me (being one of advanced maternal age) but I think it's great that she laid everything out for you and now you are well armed with information. I hope the Clomid works for you!!

P.S. Massachusetts must have a thing about Rubella. When I got married, it was in MA and I had to get my blood tested specifically for that, even though it is basically obsolete. Weird.

I don't know how old you are, but I am 38. I had no idea that numbers dropped so drastically. I also thought the percentage would be higher for a 20 year old, so I guess it's good that I am not dispensing obstetric advice to anyone, haha. I also had to have a rubella test for my marriage license, and I was pissed because I already knew I was immune and they charged me $90. They (the fertility folks) also wanted to test me for chicken pox for some reason.

Originally Posted by .:Shortcake:.

Sounds like you had a good appointment! I hope the Clomid works for you and just wanted to say take it before you go to sleep just in case you have symptoms from it you sleep through most of it I learned that the hard way!

Thanks Katie! The doctor did tell me to take it at night and I remembered that a lot of you take all of your medicines at night to avoid the side effects. It's a very clever idea and I don't think it would have occurred to me. I start tomorrow, CD5.

[.:Shortcake:.]

Thanks Katie! The doctor did tell me to take it at night and I remembered that a lot of you take all of your medicines at night to avoid the side effects. It's a very clever idea and I don't think it would have occurred to me. I start tomorrow, CD5.

I forget who told me to take it at night. I still had side effects and you might want to warn your DH that if your not yourself it's the meds fault DH said I was crazy on it and I agree. It made me feel unlike myself. But some women don't mind it and I hope your one of them.

[EJsMommy]

Sounds like you had a good appointment. I hope that the clomid will do the trick for you. My OBGyn doc over did it with me so my RE will not give that to me. She will do shots instead.

[pepper73]

Originally Posted by Shadeauxe

I don't know how old you are, but I am 38. I had no idea that numbers dropped so drastically. I also thought the percentage would be higher for a 20 year old, so I guess it's good that I am not dispensing obstetric advice to anyone, haha. I also had to have a rubella test for my marriage license, and I was pissed because I already knew I was immune and they charged me $90. They (the fertility folks) also wanted to test me for chicken pox for some reason.

I am 37 (just shy of 2 months away from 38) so I'm in the same percentile as you. I knew the numbers dropped but I definitely thought they were better than that. Scary! But, we still do have time and hope so I'll cling to that.

That is weird about the chicken pox test. I assume you have already had it and are immune so that makes no sense at all...unless you were recently exposed and they just wanted to be extra cautious. Sometimes I just don't understand what doctors are thinking!

[*SamF*]

Advice I got from my RE- Numbers do drop radically as you get older, BUT there are also less women TRYING to get pregnant, so the overall base numbers are smaller. Also just on the logical side, you have to take into consideration why women are having children at an older age (not really why for me, but it makes sense) that if they just didn't accidentally get pregnant younger, and they decide that they really want children that they may have fertility issues to start with.
Did that make sense or is it my old brain running circles?
Listening to the numbers sometimes, you wonder how there are so many people in the world.

[StaceygirlPa]

Sounds like you had a great appt. Good luck this cycle.

[owensmom]

Glad to hear you had a good appointment. My Dr told me some of the same things yours did - that baby asprin and progesterone suppliments aren't known to help, but they can't hurt, so she has me on both of them. I got prego with my m/c the first month on progesterone, so I can't say if it really helped or not.

[pepper73]

Originally Posted by *SamF*

Advice I got from my RE- Numbers do drop radically as you get older, BUT there are also less women TRYING to get pregnant, so the overall base numbers are smaller. Also just on the logical side, you have to take into consideration why women are having children at an older age (not really why for me, but it makes sense) that if they just didn't accidentally get pregnant younger, and they decide that they really want children that they may have fertility issues to start with.
Did that make sense or is it my old brain running circles?
Listening to the numbers sometimes, you wonder how there are so many people in the world.

Sam, that makes total sense. I'm glad to hear it from a perspective like that. Thanks!!

[missy123]

My Chances were actually MUCH LOWER than yours and given my high FSH and low ovarian reserve the doctors told me NO WAY would I get pregnant without donor eggs. I got pregnant 3 times after they said that!!! Do not give up hope based on statistics. I know how much you love charts and graphs

I asked her about blood clotting and progesterone and she said that there is no evidence to support blood clotting being the cause of first trimester losses and that the whole baby aspirin thing had been debunked.

I am going to pull KaryRN into this conversation as she is not only a nurse but an expert on this topic.


With the progesterone, she said that people aren't usually tested for it unless they have had multiple losses and there's also no data to support that taking progesterone keeps a pregnancy viable. I've heard that mentioned in here before as a chicken/egg type thing where the question is if the progesterone is low because there's going to be a miscarriage or that there is a miscarriage because the progesterone is low. She believes it is the former.
NOT TRUE! they just have not done any studies on the usage of progesterone. My levels were high naturally and I still kept having miscarriages. I took the progesterone and look where I am now.

I also asked about the Clomid vs Femara thing because I know Katie said she didn't like the Clomid at all and had worse reactions to it. I also asked about it thinning the lining. She said it does thin the lining, but for the amount of time that I will be on it (2 months), it's won't be an issue. She said doctors go to it first because it has been around longer and has a larger group of use cases. I am not wording that properly, but basically more people have used it and therefore tested it and they like that better than a newer drug. She also said that after three months of using Clomid or Femara, you've plateaued and it continuing to take it probably won't be successful since most people who use it get pregnant within three months.
In the 2nd cycle of me taking 100mg of clomid my lining was so thin that it was only a 3 at 4dpo. They want to see at least an 8. It was all due to the clomid. So basically even though the clomid helped me produce more follies, it hindered any chance of a baby implanting. Of course every woman and situation is different. And the side effects?? Oh my.... I actually told my husband to move out because I knew he didn't like me anymore while I was crying uncontrollably. Totally not me!!

So, she is going to have me take Clmoid for a couple of months and if that doesn't work, then we'll switch to Femara with IUI which is fairly inexpensive. If that doesn't work, I'll decide what to do next. I have good health insurance, so it's all covered. If I think of any more information, I'll post it as an update.

I hope you get pregnant right away!!!!!!!!!!!!!!!!!!!!! xooxoxoxo

[luvmykids623]

It sounds like you had a great appointment! It's interesting how so many doctors have differing opinions. I agree with Missy on the Clomid! It destroyed my lining the two months that I was on it. When he checked my lining the cycle before I started it, it was a 12. The two months I was on it I had great follies, but my lining was a 3 and that made it impossible for an egg to implant. I did injectables this time around, my lining was at a 12.8, and I may just be looking at a BFP. I hope that the clomid works for you, and you are looking at a sticky BFP soon!!

[Kary♥RN]

First off let me say No matter what I say, or anyone for that matter.. YOU have to be comfortable with your Dr. But also have an open mind.. that is why Drs will tell their pts to seek a second opinion... since Dr's are just like everyone else, they have their own beliefs on different treatments. And while two people can have the same diagnosis... the same medications and/or treatments may or may not work with everyone. And it sounds like you had a great appt and trust your Dr, I pray that clomid will give you your sticky BFP!

Now as for what your Dr said... I have a big problem with just "Debunking" things that have not even had long term studies and investigations done. The truth is over 50% of "CONCEPTIONS" (Conception meaning egg meets sperm that may not get far enough to show a positive pregnancy test) will not become viable pregnancies. Many years ago you had to 4-5 months pregnant before you "knew" now it is 4-5 days BEFORE your missed period to know. And who knows in a few more years we may know at conception... but With the early knowing, will come even more m/c's.

With the new pregnancy test over the past few years telling women they are pregnant before their period, has put Dr in a whole new world of M/C's and what to do, when to test, and what direction to point women in. The standard is 3 m/c before they start testing. Now comes down to the testing. The clotting factor Panels, the MTHFR are newer issues.. and these DO NEED "blood Thinners" Baby Aspirin or Lovenox.

Before I even had my blood work back my Dr told me we will start on Baby Aspirin and Progesterone once I conceive, since it can't hurt only help...
But when my tests did come back, he told me to go see a Hematologist (Blood Dr) Since the MTHFR is a clotting disorder and COULD be the reason for my m/c.... I seen the hematologist and he is the specialist and HE even said this is such a NEW gray area. It is such a new diagnosis for m/c's. And the standard at this time is treat with (depending on what type of clotting MTHFR, Factor V, combination of different clotting factors) is baby Aspirin or lovenox. The reason, their has not been enough testing to rule in or out the effectiveness of the treatments.

Just like Thyroid issues and m/c... Fibromyolgia.. and so many others that "COULD" cause m/c's. Dr's and patients need to look into everything! If taking a baby aspirin or progesterone could save one woman from going through a m/c isn't it worth it? If you have no other medical condition to contradict the usage... what can it hurt?

Look at me and so many other ladies who have MTHFR once we started on a baby aspirin or Lovenox we carried our rainbow babies.. look at me after three m/c I carried twins!!! And I fully believe it was the baby Aspirin!

Also a good Dr will monitor your cycles on clomid... They will bring you in to see if the dosage you are on is producing follicles, and check your linning. If they are not bringing you in I would ask why not.

Good Luck!!!!!

[doremi]

GOOD LUCK! Sounds like you are well on your way to a future BFP!