Clomid unmonitored

[Anonymous]

I've read through the archives as I know there is a lot of info on clomid here, but just want an answer to this question. I am 35, been trying for over 7 months and tests have shown low progesterone. I went for CD 3 FSH and estradiol test today with pelvic sonogram. OB/GYN put me on Clomid to take days 5-9, start OPK'ing on day 14 and then come in for progesterone test 7 dpo. Is there anyone else who did this? I have also been to see an RE who wants to hold off on treatment until she runs all the batteries of tests, including an HSG. Part of me just wants to try the Clomid for three cycles to see if it works before going on to more invasive tests with RE. That being said, I read this board and people seem to freak out about going through "unmonitored" clomid cycles. So can I get some info from people with experience? And we are testing husband this week -- though Ob/gyn wants to run an antibody test which involves taking my blood at the same time they test the semen; RE said nothing about this. So also trying to decide where to take the semen for analysis. I am confused to say the least.

[Anonymous]

Is your OB going to do another ultrasound before you O? If not, I'd worry that you are one of the people who respond REALLY well to Clomid (esp risky if you don't know your diagnosis - I believe women PCOS have very responsive ovaries?). Are you willing to accept the risks that go along with becoming pregnant with multiples?

Personally I'd go with the RE (who specializes in IF - very rare for an OB to have the training/experience) and stop wasting time with your OB.

At a minimum, I'd push the OB to do at least one more ultrasound right before you O...

And you have unusually long cycles? starting OPKs on CD14 sounds very late...

Good luck with whatever you decide!

[Anonymous]

p.s. OPKs pick up your LH surge which is usually 1-2 days prior to Oing... I'd start on CD10 unless you've been charting/OPKing in the past and know when you usually surge/O...

[Anonymous]

I was an over-responder to clomid- would produce 20+ follicles at a shot. Can't imagine what would have happened if we had triggered and gone on to inseminate. Then again, I'm no RE, and my doc never suggested going without monitoring, but I just don't know how they can figure out how a particular person will respond.

[Anonymous]

Stick with the RE. They are the specialists.

[Anonymous]

Yeah well I called my RE today and she is apparently on vacation until the middle of June. Thanks for telling me. Ob/gyn it is....

[Anonymous]

Yeah well I called my RE today and she is apparently on vacation until the middle of June. Thanks for telling me. Ob/gyn it is....

Really? Personally, I think it's worth waiting a month rather than risking high-order multiples. There's a reason people freak out about unmonitored clomid cycles. How old are you? If you are younger, there's a good chance that all or most of the eggs that Clomid causes you to produce will be of fertilizable quality.

The way that one RE put it to me, when I was very upset to have my first Clomid cycle cancelled because I produced way too many follicles (which I never would have known if I wasn't monitored) was, "I know it seems like a disaster to lose one month when you have a cycle cancelled, but can you imagine how much bigger of a disaster it would be if you got pregnant with quads or quints?"

As much as I would not want to lose a month, I would not take that risk. I'd wait to work with the RE. OBs generally don't know what they're doing when it comes to fertility treatments, and the use of Clomid without monitoring, in a patient who has never taken Clomid before, is irresponsible, IMO.

REs generally don't run a whole lot of invasive tests in the initial workup - it's baseline bloodwork and ultrasound, an HSG (which is invasive, yes) and a semen analysis. You can get all of that done in the first month and start treatment the 2nd month.

[Anonymous]

I know a woman at work who recently did unmonitored clomid cycles.....she now has triplets!

[Anonymous]

at least press for an u/s right before you O...IMO it's irresponsible (for you and especially the OB) not to know what is going on in there...

and if the OB said to start OPKs on CD14 and you don't have long cycles then I really think the OB is clueless!!

if you've already had your initial consult with the RE, can the nurses help get you started with the testing? or is there another RE in the practice who can cover while she's out?

[Anonymous]

and unfortunately if you are entering the ugly world of IF don't be surprised if you have more waiting ahead - it can be horrible & painful to wait, but seems to happen nevertheless...

[Anonymous]

I am 35, I do have long cycles, from my research the risk of HOM is very low. I would be happy with twins. I will call ob/gyn about coming in for earlier u/s, but i've read that many people try clomid this way first. i am on the lowest dosage as well. but again, i see the concern. re: the RE, i think she should have told me that she was going to be out of town for a month considering i was in her office a week before she left. re my ob/gyn he said that he himself has been through infertility and almost half his patients have infertility issues. thanks for advice.

[Anonymous]

I am actually having this exact same problem/question this month! OB gave me a Px for clomid and everyone I told freaked out because I wasn't being monitored. Why are the OB's so quick to hand out the Px if there is so much concern?
I had an early miscarrage a few months ago and then didn't ovulate for 3 months, so the OB gave me clomid to ovulate, which worked...but I didn't get pregnant this month. I'm on cd1 now. I'm hesitant to go to an RE and do all testing when I know I can get pregnant...so I'm thinking about taking the clomid again this month.
I know it would be ideal to see an RE, but I also know people who have done clomid with an RE and still had multiples! Going to an RE and being monitored doesn't prevent multiples.

[Anonymous]

Anonymous wrote:I know it would be ideal to see an RE, but I also know people who have done clomid with an RE and still had multiples! Going to an RE and being monitored doesn't prevent multiples.

but at least you'd know how many follicles you have and it'd be an educated/calculated risk (e.g., maybe you go for it if you have 2-3, but hold off if you have 10)....

[Anonymous]

I'm on my second unmonitored cycle of clomid under ob/gyn's care (at lowest dose). At my doctor's recommendation, I'm starting with an RE next cycle if it doesn't take this month. My doctor's great and I completely trust his professional judgment. If your ob/gyn feels comfortable prescribing it in such a manner and you trust your doctor, then it sounds like a good idea to stick with your ob/gyn for now. You can always step it up down the road, at your doctor's advice.

[Anonymous]

Get a new RE. Really you don't mess around with this stuff. If you have never done Clomid before you really don't know how you will react.