Medicated protocol if you ovulate on your own


#1

Hi guys, so this cycle is about to be a bust for me, so I am preparing for next since I will most likely need to get a pre-auth from my insurance company to get the drugs covered. In any case, I have a call into my doc to get his protocol… but curious, how did you decide to do injectibles over Clomid? Or are you supposed to start with Clomid and go from there? My last one was unmedicated w/ an HCG trigger and progesterone. I ovulate on my own, and had 1 20mm follie prior to triggering this cycle.

I have used injectibles in the past, as I was an egg donor and the response was really well (but to the point of near hyperstimulation). Obviously, I do not want to produce TONs of follicles because the cycle will be cancelled. So, just curious on your protocols (esp if you ovulate on your own).

Thanks!


#2

[SIZE=3][FONT=Calibri]Most RE’s will start with clomid (mine did) and see how you respond. If you need a more aggressive protocol they will add in injectables. Most likely a low dose (75 units) for 3 days or so. Then give you an u/s to verify the status. Most RE’s like to see no more than 3 mature follies before trigger/IUI. Best wishes! [/FONT][/SIZE]


#3

[QUOTE=Webelieveinmiracles][SIZE=3][FONT=Calibri]Most RE’s will start with clomid (mine did) and see how you respond. If you need a more aggressive protocol they will add in injectables. Most likely a low dose (75 units) for 3 days or so. Then give you an u/s to verify the status. Most RE’s like to see no more than 3 mature follies before trigger/IUI. Best wishes! [/FONT][/SIZE][/QUOTE]

Thanks for the info! Makes sense.


#4

For my my RE started me on 100mg clomid for my first IUI. Had 3 mature follies and got pregnant with triplets. We lost them, so for IUI #2 and 3 we did 100mg clomid again. But my body didn’t respond the 3rd IUI so he added follistim. After that we never used clomid again. When i moved to another IUI he tried femara and a very low dose of follistim. Got one mature follie. Then we moved to yet another RE and he only used follistim on me.

So personally, i would do a cycle or 2 of clomid before doing injections.


#5

I ovulate on my own so we started with three unmedicated IUIs…they didn’t work. I then moved on to Clomid 100mg, CD 3-7. I still just used OPKs and then did IUI 24 hours later. I got pregnant with my son on the 2nd Clomid IUI (5th IUI). TTC#2 was a bit more interesting. We started with Clomid 100 mg since that worked the last time and I could tell I wasn’t responding as well. I had them do u/s this time a couple of times and I was only getting one mature follie (had two with my son). Even so, I did get pregnant on my 4th Clomid IUI, but had a chemical pregnancy. Decided that we didn’t want to use Clomid beyond the point of being beneficial so switched to Femara for my 5th IUI. That was a BFN so we decided to be more aggressive and try Follistim 150IU. Another BFN. In the meantime, they ran bloodwork on me and discovered that both my FSH and LH were low so they determined that Repronex would be a better option for me since it’s half FSH and half LH, unlike Follistim that is only FSH. I used Repronex twice and got pregnant both times. As you can see, sometimes it just takes a while to find the right fit…and even if you ovulate on your own, it sometimes still is worthwhile to use meds. I may ovulate on my own but I wonder if the meds just helped improve the quality of my eggs a bit. Hard to know, but it seems to have worked.


#6

Thanks gals! I spoke w/ my doc, and should my beta come back neg this afternoon, we will be proceeding with Clomid (not sure of dosage) Days 5-9. Am hoping to get maybe one more follie to up my odds a little. Thanks for all of the great info!


#7

[quote=timetotest]Hi guys, so this cycle is about to be a bust for me, so I am preparing for next since I will most likely need to get a pre-auth from my insurance company to get the drugs covered. In any case, I have a call into my doc to get his protocol… but curious, how did you decide to do injectibles over Clomid? Or are you supposed to start with Clomid and go from there? My last one was unmedicated w/ an HCG trigger and progesterone. I ovulate on my own, and had 1 20mm follie prior to triggering this cycle.

I have used injectibles in the past, as I was an egg donor and the response was really well (but to the point of near hyperstimulation). Obviously, I do not want to produce TONs of follicles because the cycle will be cancelled. So, just curious on your protocols (esp if you ovulate on your own).

Thanks![/quote]

I know you’ve already gotten several replies but just wanted to share with you what my RE does…They do not prescribe Clomid because, according to her, Clomid stays in your system for much longer and can adversly affect a fetus should you become pregnant. There are limited studies on this and the negative side effects are slim but do exist. Also, Clomid decreases your lining and can cause more problems for you. My RE prescribed Femera (letrozole) because it has a super short half life and does not affect your lining. I have no known fertility issues and I actually produced two of my own follies when I was first checked out, so, they started me on a very low dose of Femera for my very first IUI cycle, I responded well, I believe I had two good size follies. Because we have MF and decided to move on to using his frozen sample (from 2005), the RE wanted to give it as many “targets” as possible to maximize our chances, so they upped my Femera and added injectibles. She said it was almost like an insurance for the cycle. I responded extremely well that cycle and produced 4 extremely large follies (on cd11 4 of them were over 17!). I was very concerned about this but no one ever mentioned multiples or canceling my cycle. My RE told me (after we got the BFN) that the more targets the better. Only if I were to have around 6 good size follies would they consider canceling. For my 3rd cycle, they upped my dose of injectibles, again I questioned this, if I have no problems, O on my own, etc, why are we upping the dose again? Same answer - more targets the better - and she also said that sometimes your body can “get used to” the meds it’s taking and what worked last cycle won’t this cycle. So, even though they have never found anything at all wrong with me (in fact they said I was one fertile mertile) they have still give me a pretty high dose of medications, trying to give me the best possible chance of success. You can see by my signature that even having 4 possible more mature follicles, it still has not worked! Every RE will have a different set of “guidelines” they use to determine your treatment plan, so def. follow what they say. And if you have any questions/concerns/suggestions, always discuss with your RE. You are paying for it so you should be able to dictate how things go!


#8

[B]Hopeful4Baby23 [/B]thanks for sharing! Good luck in your TWW! :cross: