Another clomid question

[Anonymous]

I haven't ovulated since my miscarriage two months ago, though I have had two periods or period-like bleeding episodes, and am seeing my doctor tomorrow. Wondering...

do regular ob/gyns prescribe Clomid or just REs?

Anything in particular I should ask about in my appt tomorrow?

[Anonymous]

Some regular OBs provide clomid, but I'd go to an RE. Clomid can thin your lining and an RE is usually better about watching out for that, I think.

[Anonymous]

First, I'm sorry about your miscarriage.

If your body is still recovering, it may be normal not to ovulate for a cycle or two. I'm not sure I'd rush into clomid if there is no other need for it and you typically ovulate on your own. Is the fact that you've just had 2 anovulatory cycles the only reason you're looking into clomid?

But if you do decide to try it, I would go to an RE. Too many OB/GYNs prescribe clomid without doing any monitoring, putting you at risk for multiples. If you've never been on clomid before, you really don't know how you will respond. I produced a lot of follicles on it - RE was very surprised as I was 39.5 at the time and we did not expect that kind of response. The first cycle I had ~8 mature follicles; I can't imagine if I hadn't known and we had gone ahead with timed intercourse or IUI. But there's no way to know unless you are monitored by ultrasound. And at the monitoring u/s, the RE will also check your lining and prescribe estrogen if it's thin.

[Anonymous]

Thanks PP. That makes sense. I will not jump onto it and do want to go forward with at least one more cycle to see what happens.

Can an ob/gyn monitor clomid and what it does to you (yikes, 8 babies!) or not?

[Anonymous]

Can an ob/gyn monitor clomid and what it does to you (yikes, 8 babies!) or not?

The monitoring is done by ultrasound (counting follicles, looking for cysts, and measuring uterine lining) and bloodwork (checking estrogen levels b/c mature follicles give off estrogen). Typically OBs are not equipped or trained to do that type of monitoring. I suppose they could but I think you'd be in better hands with an RE where they do this stuff on a daily basis and have their own labs for the bloodwork.

[Anonymous]

I;m PP 17:21 -- while it is better to go see an RE when using clomid, I'd be hesitant to go to an RE unless there is some reason to suspect a problem. Going to an RE is a big step IMO and it can be hard to jump off the assisted reproduction track once you are on it. If there's no sign of a problem, it might be better to wait and see if your cycle comes back on its own.

So sorry about the m/c.

[Anonymous]

Thanks to those who replied.

My doctor basically said that it's too soon to get anxious about anything. She did take blood to test beta levels. She also said she's not a huge fan of charting.

I am admittedly impatient. I'm 35, have a 21 month old, and am eager to get going with #2....

[Anonymous]

My doctor basically said that it's too soon to get anxious about anything. She did take blood to test beta levels. She also said she's not a huge fan of charting.

I totally agree with her on the first two points, but why does she not support charting? Charting is a GREAT natural non-invasive way to know your cycles and what's going on with your body. If done properly, it's very accurate in pinpointing ovulation.

[Anonymous]

My Re is also against charting, I find it weird since I really like it and I can totally tell when I ovulate

[Anonymous]

I charted for a couple years (first trying to avoid and then TTC) and I'm not a fan of charting while undergoing ART treatments - the medications really throw everything off (at least they did for me). But if you're not taking any medications and you are TTC, I'd definitely continue charting.

Your body is still healing - but I'd guess that it'll be back to normal in another couple cycles assuming it was an early m/c. Maybe a little longer if it was a later m/c.

[Anonymous]

My ob-gyn prescribed clomid for me. I took one cycle, got pregnant and miscarried at 6 weeks. 6 weeks later I got my period and used another cycle and got pregnant again (fingers crossed this one sticks). She told me she usually refers after three failed cycles.

My insurance has lousy coverage for infertility, so I preferred to stay with her as long as I could - she was able to code me as PCOS, not sure if an RE could do the same.

[Anonymous]

I'm sure you've read the comments on this thread (& others), but I'd really avoid taking Clomid through an OB until you know how you respond to it. And even if you did, I'd still probably go to an RE anyway since they will properly monitor you.

[Anonymous]

I think it's really irresponsible for OBs to prescribe clomid with no monitoring. There is no way to know how someone will respond until you actually count the follicles.

I'm the PP who had 8 mature follicles on my first cycle of clomid. Thank goodness my RE was doing ultrasounds and cancelled the cycle when she saw how many there were. What if an OB had just given me clomid and sent me on my way? Not something I would want to roll the dice with. OBs are great for a lot of things, but if you are going to take fertility medications, then seek care from a fertility specialist. It's a shame that insurance sometimes drives these decisions.

[Anonymous]

OP here. My OB said that the reason she doesn't like charting is because you have to wake up at the exact same time, not move a muscle, to make it work. I don't know...seems like a lot of woman find it works well for them. I'm going to continue to do it, but try not to get overly obsessed...

[Anonymous]

OP here. My OB said that the reason she doesn't like charting is because you have to wake up at the exact same time, not move a muscle, to make it work.

It sounds like she thinks it would be a hassle, I guess? But you just have to wake up in the same 30-minute window each day, and once you get into the habit of popping the thermometer into your mouth immediately, it's really very easy.

To each her own, but I say if it's working for you, keep doing it. If it's a pain, if you can't remember to take your temp first thing, if you have inconsistent waking times, if it's stressing you out, whatever, then by all means don't bother with it. There are other ways to track fertiilty (OPKs, cervical fluid). But I have been charting it on and off for the past 10 years & I used it successfully to conceive 2 babies and also used it to avoid pregnancy for many, many months - so no one is going to convince me it's not worthwhile!