Trying to Conceive Forum

by **dma2009** » Wed Feb 01, 2012 8:40 am

Hope you guys don't mind a newbie!

I ovulate on my own based on bbt and opks, but my gyn just referred me to a specialist b/c she's not sure why we haven't had any luck. All my blood tests came back normal, HSG was clear, and my husband's SA was normal. We've been actively trying for 6 cycles, but I've been off the pill for about a year. I do have symptoms of PCOS- acne, dark facial hair, recent weight gain, but my gyn insists that I ovulate and wanted the specialist to see me first before clomid.

I also have a short LP- it used to be 9-10 days and since I've been taking Vit B6 it's up to 12 days. But, with the B6 I've gotten a lot of progesterone-like symptoms, which I think hid a potential progesterone problem in the blood work.

So, I have an appointment with the RE tomorrow, and I wanted to know what sort of questions I need to ask and/or what I should ask for. Do people typically just start on clomid un-monitored first before going through the clomid challenge and/or triggers?

Thanks for your help!

by **miaowington** » Wed Feb 01, 2012 9:47 am

dma, we are pretty much in the exact same situation. The only difference is that I don't really have any PCOS symptoms (that I know of). This is my seventh cycle trying, I've been using OPKs & charting to confirm O every cycle, but despite pretty good BD timing, I'm not getting pregnant. My LP is consistently only 9-10 days. My BF got a SA & it came back pretty normal across the board. Nothing to write home about, but no real problems either. I've been off BC since October 2010 & haven't had an HSG done (waiting to see if Clomid works its magic first).

My ob-gyn does fertility counseling as well, & she started me off on 50mg of Clomid, days 5-9, no monitoring (aside from pre-Clomid bloodwork to rule out other issues, like elevated prolactin, etc). She also put me on progesterone supplements, which I started on CD17 (the day after I O'ed). I think the idea is that the Clomid/prog combo will give me a stronger O & the hormone boost I need to allow a fertilized egg to implant. I guess the idea is that I'm releasing eggs, maybe they are even getting fertilized, but they can't implant because the short LP means the endometrium is breaking down when the egg is ready to make itself cozy.

So right now I'm 7DPO on my first try with all this stuff.

Quick question: do you know what bloodwork you've already had done? It sounds like you might indeed have a prog issue, but that can only really be ruled out by bloodwork during your LP or via ultrasound to check out the endometrium (also during your LP). Has you doc done that? If you've only had FSH & prolactin & all that checked...well, that doesn't give any definite info on prog.

I think every RE has their own style that makes them feel comfortable. Some seem to be all about monitoring the follicles even if the patient isn't doing IUI. I mean, go for it if your insurance covers it, but it kind of seems like a waste to me. The only thing I'd press with the RE is that 1) you're ready to try medication, 2) you're concerned about your LP, & 3) ask about prog supplements. & double-check your prescription drug coverage because the go-to prog docs seem to like to prescribe is crazy expensive. There are generics that work just as well.

by **dma2009** » Wed Feb 01, 2012 10:59 am

Mia- Thanks for your response! What day did you start taking Clomid? Any symptoms? I read that it can cause EWCM to dry up, but we've been using pre-seed the last 2 cycles, so I figure I'd continue it.

I just looked at my blood work and noticed I never had my prolactin checked?! I'll definitely ask about that tomorrow. I had Testosterone, Thyroid, LH, FSH (all done around day 7) and progesterone (done 7 dpo). But, my progesterone was checked the same month I started the Vitamin B6- which definitely did something with my hormones, as I've never had sore bbs before ovulation in my life and they felt like they were on fire that month. I haven't had any ultrasounds. But my periods only last about 2 days, so I am worried about my lining. My doctor seems to think that my short period is normal, but I''m concerned that my lining may not be thick enough?

Thanks for your help, and I'll keep you posted on what the doctor says tomorrow.

by **dma2009** » Wed Feb 01, 2012 11:01 am

PS- Your chart looks great!! Good luck!

by **miaowington** » Wed Feb 01, 2012 12:26 pm

Thanks for the compliment on the chart! My temps are WAY higher & more consistent than they usually are during my LP, so I am wicked hopeful! But you know...prog supplements can raise your temps too...so who knows? Must be patient.

I did Clomid days 5-9 & O'ed on day 16 (pretty typical for me). My only side effect was hot flashes. I'd heard that some ladies have bad headaches & nausea & all kinds of awfulness, so they suggested taking it at night with the idea that you can sleep through the worst of it. So I tried that but it just meant I got horrible hot flashes in the middle of the night, which would wake me up & mess up my schedule. No fun. But my side effects could have been way worse, so I won't complain too much.

Personally I didn't notice any CM changes. But I used Preseed every day during my fertile window just to be on the safe side. Can't hurt, right?

by **dma2009** » Wed Feb 01, 2012 1:27 pm

So exciting! Do you take the progesterone supplements orally? Did you find that your OPKs worked normally when on the clomid? When are you going to start testing?!

I'm a little anxious b/c I just found out that my insurance company has been putting a hold on recent claims b/c they need a letter from my old insurance company to prove I never had a lapse in coverage and didn't have a pre-existing condition. I switched jobs halfway through last year, so I hope everything works out. I don't anticipate a problem with my office visit tomorrow, but I hope they'll pay for the clomid (if I get an Rx) at the pharmacy.

by **miaowington** » Wed Feb 01, 2012 2:29 pm

I pay for all my prescription drugs in full out of pocket (no drug coverage) & thankfully Clomid is dirt cheap. Nine bucks for five 50mg pills. I was pleased, especially considering that I'm paying over $250 for half a month or progesterone. (I'm starting on a generic after I'm out of the expensive stuff. My doc didn't realize I didn't have drug coverage when she wrote the prescription & I didn't think to mention it.)

The prog I'm doing right now is Crinone 8%. It's a vaginal supplement. I know there are orals out there but I don't know anything about them. This is my first (hopefully only!) time with any of this stuff.

I took my last Clomid on CD9 & my first OPK on CD11. I got my first (& only) +OPK on CD16. So the Clomid didn't interfere with the OPKs. I was doing the Clearblue Digital OPKs.

When am I going to start testing...that's the big question. Probably earlier than is smart. I went to Dollar Tree today & stocked up on cheapie tests. Usually I force myself to use the more expensive tests so I won't be tempted to test ten times a day or start testing on, like, 4DPO, but I buckled. I haven't taken any yet...but the day is young...

by **dma2009** » Wed Feb 01, 2012 6:36 pm

Thank God the drugs aren't ridiculously expensive!

I'm getting nervous for my appointment tomorrow. I typed up a list of my history, concerns, and questions. Im sure doctors hate that, but I always end up forgetting questions and figured it be would be easier if it was on paper.

Best of luck testing! Hopefully one month is all it took!

by **dma2009** » Thu Feb 02, 2012 4:50 pm

Glad to see your chart still looks good! Any testing?

I just got back from the doctor, and he recommended clomid + progesterone. Problem is that I just started taking vitex 3 days ago. I know I can't take both, and I'm not sure if I should finish out the month with vitex and then start clomid next cycle?

The doctor says I'm ovulating, but I'm not producing progesterone for a long enough time. He said I could do either clomid or progesterone, but I elected to do both.

Any advice? He wants me to start the clomid tomorrow, day 5.