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femera v. clomid - plus a few other questions! (total newbie!)

Forum: Trying to Conceive with Medical Assistance


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January 3rd, 2011, 07:35 PM
Platinum Supermommy
Join Date: Oct 2004
Location: *queen city* of North Carolina
Posts: 9,497
(1) I'm kind of confused. When I talked to my OB before Christmas she said CLomid from CD 3-7. Well, I was at the office today for Day "3" (Really CD 4 - but closed on Sunday's) and the OB wrote out scripts for all my medicines this month! The script was for Femera. I guess both do the same thing, but some studies suggest Femera give better results. Some studies say the same results and Clomid minus some of the side effects related to CM. I just was expecting Clomid and know it is given more often and more common.
Also, I figured since I was on CD 4 I'd start it tonight, but the OB said to start it tomorrow on CD 5 (Tuesday) and take it for 5 days (until CD 9). Then of course the trigger and progestrone on CD 14 and CD 21. How much does timing of taking Femera or Clomid matter in relation to O or egg quality?

(2) I did lab work on CD 21 for my pregestrone level. However, our insurance denied the claim because they don't cover infertility (which is BS IMO, its like saying we wont cover depression or a broken bone). Is there a way the doctor can change the coding (IE: hormone imbalance) or something? None of our other claims have been denied, so I'm curious why this particular one was.

(3) speaking of appt's and lab work - how often do you have to go into the office and continue with u/s and bloodwork? My poor veins are a mess from having blood drawn. We're going to take Feb and March "off" if this doesn't work for financial reasons but also because my veins from doing blood work are just awful! I mean, I have constant bruises on them despite switching arms each time they draw blood. Do they always require the day 3, day 14, and day 21 stuff? I mean, I get doing an u/s to check for mature follicule and monitoring progestrone levels when doing the suppliments. I'm just not sure what to expect going into the future with all of this.

(4) OPK's - when do you start them? I got a box, but I didn't check the date and they are expired so I have to return it. My "normal" cycle is around 35 days. However, I imagine since we'll be basically "forcing" a 28 day cycle by doing the trigger, etc - I should start doing the OPK based on a 28 day cycle right?

I'm just praying that doing all of this will result in a strong, sticky BFP! I'm crossing my fingers!
Proud Mommy To My Princess (5)
Watching over us -- August 2005, March 2010, October 2010, July 2011
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January 3rd, 2011, 09:09 PM
Hoping To Be A Mommy
Join Date: Aug 2010
Location: TEXAS
Posts: 3,638
Good luck with it all!
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January 4th, 2011, 08:29 AM
MommaLee's Avatar Platinum Supermommy
Join Date: Mar 2009
Location: Texas
Posts: 8,986
Clomid and Femara do essentially the same thing. Clomid tends to produce more eggs while Femara does not - it usually only produces 1 egg unless you are on the highest dose of (7.5mg). I was given 2.5 mg for 5 days which is the lowest dose. I don't know what the effect would be if you take it CD5-9 but it really depends on your doctors orders. I took mine CD3-7 but I know of other ladies on here who take theirs on CD5-9. Personally, I'm not sure if really matters all that much. Femara is also said to produce a better quality egg than clomid would. For me, Femara was $60 and Clomid was $4. My doctor recommended the Femara because she wanted to lower the possibility of multiple births and the better egg quality so that is what we went with.

You can ask the office staff if they will change the coding but don't expect that they will. My doctors office flat out told me that they file everything correctly...all of my stuff they billed was labeled infertility but I was lucky that my insurance covered it although I'm not sure why since they blantantly told me on the phone they would not. I really think it is because she was a gyno and not affiliated with anything that represents infertility. There is no harm in asking - all they can tell you is no.

I'm a little different. We were unexplained and all my tests came back looking great, so I did not have to do the lab work associated with fertility treatments (iui is what I had). But I guess it depends on your doc. I went in for a CD3 u/s to make sure there were no remaining cysts and then I would go back around CD10-12 to check my lining and follies. Usually I had a pretty good sized follie by that time and so I would start using opk's then. I would highly suggest the digital. If you are paying hundreds for infertility - do not skimp on the opks - get that you can easily read so you have no doubt in your mind if it is positive or negative. When my opk was positive I would call my doctors office and come in the next morning. My doctor would check for ovulation (her practice did not do the iui until ovulation has occurred..they have had good results doing it this way) and if I ovulated then I would go home, have my dh give a sample and return with it to her office and the iui was done about 1 hour afterwards (they have to spin the sample to separate the seminal fluid/sperm).

That is basically how mine went. Hopefully I answered most of your questions...I have no experience with triggers or ovidrel because I did not use them. I ovulate on my own anyways so the doctor didn't see the need for them and I agreed.

Good luck
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January 4th, 2011, 03:44 PM
Platinum Supermommy
Join Date: Oct 2004
Location: *queen city* of North Carolina
Posts: 9,497
Thanks! That does Answer alot!! We got the digital but have to return but I'm not skimping lol!! I agree this much money might as well go all the way! Hopefully I was a lab coding error with insurance. Bc that bill was a lot!
Proud Mommy To My Princess (5)
Watching over us -- August 2005, March 2010, October 2010, July 2011
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