Clomid dosage after DS

Bonnie R.
on 9/15/11 1:29 am - Stratford, CT
Hi All.  Wondering if any of you have experience with taking Clomid (a fertility drug) after your DS.  I'll need to take it to try and conceive.  My doctor insisted yesterday that it won't malabsorb (even though he tells me it absorbs in the intestines).   Of course I know he's got to be wrong.  And I'd hate to have to keep upping the dosage for months before it works.  We have no healthcare covereage for infertility meds or procedures. 

Not even sure he'd listen to me, but I'd at least like some input from you all.

Thanks! Bonnie
beemerbeeper
on 9/15/11 4:38 am - AL
Bonnie,

I wish I had an answer for you.  I'm sorry you have to take fertility drugs but I can't wait to see what a beautiful baby you will have.  I hope someone comes along who knows how it is absorbed.

~Becky




RainyDayWoman
on 9/15/11 4:47 am - Fridley, MN
 Can you get in touch with a pharmacist and your DS surgeon?  I have no idea how much Clomid would get malabsorbed.  I can tell you I needed it to conceive my pre-DS daughter but got pregnant without it after my DS.  If you have already been TTC sans meds and it's not working, forgive me, I don't mean to be insensitive.  

Did you use it to get pregnant pre-DS?  Could you just start at the dosage that worked or 50 mg under that and increase from there?  I know that when I got pregnant on Clomid, I only needed 50 mg days 3-7 and I was quite heavy at the time and my PCOS was bad.  Hope you don't have to do the meds shuffle for too long.
Nissa_M
on 9/15/11 4:54 am - TX
I only used it pre-DS. Wish I had an answer for you. I'm hoping I won't need it post DS to concieve, but hadn't thought that I might. Food for thought. I hope you'll post an update on how it worked for you. 50mg was my magic number, first cycle and we were pregnant.
newyorkbitch
on 9/15/11 5:01 am, edited 9/15/11 5:28 am
Bonnie why are you being prescribed Clomid?  How old are you? what is your infertility diagnosis?  What is your FSH level?  Are you doing an IUI or IVF in conjunction with the Clomid?

Who is prescribing the clomid - a regular ob/gyn or are you seeing  a reproductive endorinologist?

Clomid will MAYBE help you produce more eggs but it does NOT help you get pregnant if your issue is anything else.

If you are going to take Clomid and just do timed intercourse....PLEASE consider having an ultrasound just before you ovulate to make sure you don't have too many embryos that could fertilize.

The only way you are going to know if the Clomid is working is by BLOOD TESTS and ULTRASOUNDS.

And you cannot keep upping the dosage - because every cycle is different.

I will help you figure it out - just give me some more info.

I work in this field,  and I have a healthy baby after a lot of treatment - my issue was only age.

CT has an infertility insurance coverage mandate.  Are you sure you don't qualify???


ETA:  Bonnie  l looked at earlier posts...I see you are 38.  Have you been fully worked up as to why you are not conceiving?  Clomid is NOT a "throw it at you because you haven't gotten pregnant while trying for 6 months" drug.    This would put you at risk for multiples - you have to get certain diagnostics done before proceeding with ANY drug or treatment.

Has the sperm been tested???





Bonnie R.
on 9/15/11 6:49 am - Stratford, CT
 I'm 37 and trying to have my first child (have been trying for quite some time with a year off in the middle to have the surgery and waiting time). I have been entirely worked up with many tests including a hysterosalpingogram, sonohysterogram, baseline hormones, follicle monitoring and hormones during ovulation.  Prior to the extremely thorough endo fertility specialist who performed all these tests, I was at a different fertility doctor who was not as current with today's procedures and had 2 post-coital tests with him along with some blood work etc.  My husband's semen has been checked and he is fine.

My left fallopian tube is blocked.  The clomid is to try and get my right ovary to produce a follicle each month rather than the typical every other.  I do not want to have multiples if it can be avoided and the ultrasound and blood work prior to IUI is planned (and part of normal procedure at this practice).  Given my age, I would like to give myself as high a chance of getting pregnant (save from IVF at this time). I think timing intercourse will not do that for me--putting the sperm as close to the fallopian tube, as with IUI, sounds the better way to go.  However, I will talk to my husband about this--it may be an option for a cycle or two.

Although CT has a mandate for infertility coverage, my husband's company is "self insured" and sadly does not have to follow the mandates. I've talked to him about submitting a letter and asking for fertility coverage, but he is nervous to bring negative attention to himself.  He generally doesn't like conflict so this is not surprising.


Now that you have a little history on me, please assume I am moving forward carefully and intelligently.  Thank you for your input.  I'm concerned if I don't have follicles each month from my right ovary taking the dose he recommends, and each cycle is different, how will I know if it is the dose malabsorbed because of the DS or just normal fluctuations?  I don't know that anyone can answer that question.  I'll keep you posted.  



newyorkbitch
on 9/15/11 7:08 am
I understand Bonnie.  But it is not true that each ovary only works every other month.  You don't know which ovary will respond in any given month.  It may be that your right ovary might only produce once in a while,  or not at all,  or every month.  You just don't know.

If it was only an issue of getting an egg out every month,  and you have been doing timed intercourse for a while now....the issue may be that due to age your eggs are abnormal,  at least during some cycles.  Unfortunately that is normal for your age.

I would really urge you NOT to go through with an IUI (or timed intercourse) if an ultrasound shows multiple mature follicles likely to ovulate (if your right ovary does respond to the Clomid).  Even though the odds are small that your right ovary will produce two viable eggs,  the risk is still there for multiples.

The other issue is that Clomid thins the uterine lining in many women.  That can prevent implantation.

I know it's expensive....but time is of the essence for you...and IVF is your best bet.   It would greatly improve your chances (although no guarantee due to possible egg quality issues).

What is your baseline FSH?

I hope you are not at RMA.

If you are going to go ahead with Clomid and IUI...make sure you have an ultrasound a day or two before you ovulate.    In well monitoried cycles,  you would have multiple ultrasounds - if there is nothing going on in your right ovary,  then you would know early to just stop the clomid and skip that cycle.

You need to know if your right ovary is producing mature follicles.  If not,  that's one set of decisions.  If it is,  that's another set of decisions - if it is,  you might want to consider an IVF cycle sooner rather than later.  Time is not on your side.

Go see Dr Drew Tortoriello at SIRM-NYC for a consult.  The best of the best at treating women in your age group.   Without regard for his stats.






Bonnie R.
on 9/15/11 6:52 am - Stratford, CT
Justin K.
on 9/15/11 6:54 am - Grand Island, NE
Bonnie, to a certain extent I can appreciate what you're going through.. my wife and I have been trying to have a child for abot 6 years now.  We've tried a multitude of drugs, and ****tails of said drugs.. the only thing that worked was injections of medicine called Menipur (I think that's how it's spelled).  Anyway, it would get around the malabsorption, if the Clomid didn't work.

Justin

P.S. Menipur is pretty expensive :(
Bonnie R.
on 9/15/11 7:00 am - Stratford, CT
 Thanks Justin.  The injectable is a later option if necessary.  Doc says it is much stronger and I worry about producing too many eggs.  I'm high risk (I have epilepsy) so everything gets more complicated if I am pregnant with more than one, and more than two would probably make my high risk doctor's head pop off!
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