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Meds to expect ?


Forum: Trying to Conceive with Medical Assistance

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  #1  
December 10th, 2009, 05:00 AM
Mega Super Mommy
Join Date: May 2009
Posts: 2,464
Since we'll be meeting with the RE for the 1st time in just 5 days( ) I'm wondering what meds he may suggest us trying next ..... I'm currently on round 3 of Clomid 50mg. Its not doing the trick on its own ... so do you think he'll go right to another pill or will he suggest injectables ?? I've been trying to read lots of different posts to find out what you ladies have tried. I still feel a little confused about all the different meds & combinations there are ???
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  #2  
December 10th, 2009, 06:45 AM
Mega Super Mommy
Join Date: Dec 2007
Posts: 1,292
A lot depends on the results of your bloodwork and other initial testing. Have you had an HSG exam?

If there are no apparent underlying factors (ie--tubal blockage, low sperm count or motility/morph issues w/DH, etc.) then you can probably do whatrever you want to do and be as aggressive/laidback as you want.

I personally never had success w/multiple follies and Clomid. I O on my own, but the Clomid was *supposed* to give me more follices for more targets. I did it for 3 months and the last 2 months I was up to 150 mg---still I only had 1 follie each time.

So personally--if I were in your shoes--I would probably want to move onto something more aggressive, like Follistim or Gonal-F (they are basically the same thing if I'm not mistaken.) Femara is a pill that (I think?) is kind of in between Clomid and injects. So that could also be a next step for you.
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  #3  
December 10th, 2009, 06:51 AM
redbirds's Avatar Blessed Again!
Join Date: Jul 2007
Location: CO
Posts: 18,447
For my next step after clomid, I had femara (2.5 mg, but wish I started with 5) and then 3 days of gonal F (75 IU). It still only led to 1 follie with me, so we've moved on to full injectibles.

That could be a new step: a combination of femara and injectibles.

You may also have an HSG and DH's SA done this cycle to check out the basics (bloodwork too!) All this can easily be done during a TTC cycle, so that could also be what's ordered.

FX that whatever your protocol is, it works the first time!
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  #4  
December 10th, 2009, 10:23 AM
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Join Date: May 2009
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Hmmm, this morning I posted tests we've had done but now I see it didnt show up ... I have had a sonohysterogram & some bloodwork already (prolactin & TSH) All of these were normal. My abnormal was progesterone done at 7DPO, it was only 6 so that's why my doc started me on the 50mg of Clomid. I will have another 7DPO progesterone done this cycle, although with it being my 3rd round I just dont see it doing the trick. As far as DH goes, he had an SA done back in Oct. Had 2 abnormals there: morph 26% (norm >30%) and viability 50% (norm >75%).
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  #5  
December 10th, 2009, 10:48 AM
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Join Date: Dec 2007
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If your progesterone at 7 dpo was only 6, I kind of think that you should have been put on progesterone supplements--something like prometrium. Correct me if I am wrong, ladies?

I think your dr put you on the Clomid so you'd have a stronger O... have you had any 7dpo bloodwork done since being on the Clomid?

If it's your 3rd month on Clomid, I would probably move onto something else when you see your RE. I've always heard the rule of "threes," that if something is going to work it's generally within the first three tries. After that, it's time to swtich things up.

Personally--if you are comfortable doing so---I'd skip Femara or a femara/inject combo and just go straight to injects. But of course, injects gave me my first in two yrs, so I am kind of biased!

Given that you've got some minor male issues going on, too, an IUI would probably be a good option for you.
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Married with two awesome 7 year olds, we're TTC with unexplained infertility.
Thank you sophiasmomma for my beautiful siggy!
Nov/Dec Follistim cycle = BFP, chemical pregnancy
Dec/Jan TTC naturally after m/c, BFN
Jan 2010 2nd round of Follistim


Last edited by TTCagain; December 10th, 2009 at 10:53 AM.
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  #6  
December 10th, 2009, 10:58 AM
Sarah:Marie:IVF:Mommy's Avatar Proud mom of Leiland
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clomid did absolutely NOTHING for me, so my RE suggested I start on Injectibles. but we were military then and they wouldn't allow an injectible with timed intercourse, so we paid for the IUI.
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  #7  
December 10th, 2009, 03:27 PM
Mega Super Mommy
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Quote:
Originally Posted by TTCagain View Post
If your progesterone at 7 dpo was only 6, I kind of think that you should have been put on progesterone supplements--something like prometrium. Correct me if I am wrong, ladies?

I think your dr put you on the Clomid so you'd have a stronger O... have you had any 7dpo bloodwork done since being on the Clomid?

If it's your 3rd month on Clomid, I would probably move onto something else when you see your RE. I've always heard the rule of "threes," that if something is going to work it's generally within the first three tries. After that, it's time to swtich things up.

Personally--if you are comfortable doing so---I'd skip Femara or a femara/inject combo and just go straight to injects. But of course, injects gave me my first in two yrs, so I am kind of biased!

Given that you've got some minor male issues going on, too, an IUI would probably be a good option for you.
I agree--- I think I should have been also put on progesterone as well. I asked for that with this 3rd round but she brushed it off & just said I need to get this 7DPO prog. level. Which yes, I agree with but at the same time feel like I might be just flushing another cycle down the toilet with no supplement !!! My LP is only like 10-12 days if I'm lucky....I am going to be stern with the RE & pretty much tell him I want to be done with Clomid. My choice is to just go straight to injectables if I can. So with that said, what can I expect to take ? I dont know the combo used for straight injectables. I believe like what you said, with the minor male issue we have, that's why the RE told my ob/gyn that IUI may be best for us.
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  #8  
December 10th, 2009, 08:48 PM
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Location: Minnesota
Posts: 8,103
There are a lot of RE's out there that don't believe in LP defect problems... so make sure that your RE is comfortable giving you some progesterone. From the sounds of it, you could benefit from it.

I would for sure move forward with an IUI, but if you are responding well to clomid and haven't tried femara, they might suggest you go that route first. If you want to move on, then make sure your RE knows that. They often will only be as aggressive as you are being, so you have to kind of show them how far you are willing to go and how quickly. My RE for one always says he wants to get women pregnant the cheapest and simplest way... but will move forward to a new protocol if asked.

Good luck!!!
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  #9  
December 11th, 2009, 03:25 AM
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I was kind of in the same situation. Did 3 rounds of 50mg of clomid with obgyn. Worked great, but didn't get preg. He wanted me to do more clomid and I was like no I want a reffereal to RE. Did HSG and bloodwork, have mild pcos. RE wanted me to do clomid with iui. I wasn't too sure about another round of 50mg clomid, but I did thinking maybe it is a cm issue and iui will do the trick. IUI failed and I had 3 follies. RE wanted to do the same thing again and I was like NO I want injects. Well we are doing 5mg femara for 5 days and 6 days of Follistim (next cycle, I had a cycst this cycle, I am assuming caused by ovidrel). If this doesn't work though I want full injects.

Also I would recommend IUI, if you can afford too, it is so much LESS stressfull than TI.
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  #10  
December 11th, 2009, 10:24 AM
Mega Super Mommy
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Quote:
Originally Posted by Penguin115 View Post
I was kind of in the same situation. Did 3 rounds of 50mg of clomid with obgyn. Worked great, but didn't get preg. He wanted me to do more clomid and I was like no I want a reffereal to RE. Did HSG and bloodwork, have mild pcos. RE wanted me to do clomid with iui. I wasn't too sure about another round of 50mg clomid, but I did thinking maybe it is a cm issue and iui will do the trick. IUI failed and I had 3 follies. RE wanted to do the same thing again and I was like NO I want injects. Well we are doing 5mg femara for 5 days and 6 days of Follistim (next cycle, I had a cycst this cycle, I am assuming caused by ovidrel). If this doesn't work though I want full injects.

Also I would recommend IUI, if you can afford too, it is so much LESS stressfull than TI.
When you said your IUI failed & you had 3 follies, I'm not sure what you mean by 3...is that good or bad ?? So it sounds like you are doing a little of both (pills & injectable) for the next cycle then. I was thinking its one or the other. See, I learn new things with everyones scenerio. One last question what is TI ? Was your round of IUI around $1000 ?? We'll be paying for everything out of pocket.
THANKS
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  #11  
December 11th, 2009, 12:37 PM
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Quote:
Originally Posted by jenisuzy View Post
When you said your IUI failed & you had 3 follies, I'm not sure what you mean by 3...is that good or bad ?? So it sounds like you are doing a little of both (pills & injectable) for the next cycle then. I was thinking its one or the other. See, I learn new things with everyones scenerio. One last question what is TI ? Was your round of IUI around $1000 ?? We'll be paying for everything out of pocket.
THANKS
TI is timed intercourse.

The IUI failed in that it was bfn. 3 mature follicles is pretty good, the nurse was impressed, most pcos patients don't respond that well. 1 is all you need though. I just think for me clomid = bad quality eggs.

Yeah I didn't know you could do a combo of pills and injects either until RE suggested it. He is worried that full injects will work to well because of my weight (or lack thereof), so I would end up with too many follicles and we would have to cancel or convert to ivf (can't afford right now). When af arrives and I go for my basline i plan on asking, how many follicles are too many, etc.

As far as cost goes ( i am assuming we are allowed to discuss that here, please remove if we aren't ). Insurance paid for more than I though. RE qouted typical $800, depends on how many u/s you need etc. But the break down was

Clomid $10, Ovidrel $45

3 u/s (1 baseline, 2 follie check, weren't big enough, 2nd follie check).
Each u/s was $150, insurance told me they didn't pay but then ended up paying so I just had $30 co-pay for each one.

Sperm wash was $180 and iui was $185. Bloodwork afterwards insurance paid for so I don't know how much that was. For a grand totoal of $510. But like i said insurance paid alot more than we expected.

Injects are going to cost more (thankfully just higher co-pay and not the full amount which is in the $1000 + range), Femara will as well and i doubt insurance will anything for femara since it is not FDA aprroved.
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