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What would you do?

So this past cycle was my first "assisted" one. I took 50mg Clomid days 3 - 7 resulting in only one mature follicle at a 19. I took the HCG shot and believe I ovulated on day 17. I unfortunately got AF yesterday morning (day 27). Fortunately though, it looks like a REAL period which I haven't seen for awhile, but it looks like I might have a luteal phase defect.

I will listen to what the RE advises, but am wondering if anyone has experienced anything similar and what you did. Oh, bloodwork and HSG and husband's SA are all normal.

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Asked by jen2100 at 12:59 PM on Dec. 20, 2009 in Trying to Conceive

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Answers (8)
  • Ah, okay. My insurance doesn't cover treatment, only testing. So that's probably why she didn't mention it. I apparently don't have PCOS based on my testosterone and FSH to LH levels, but I was having 39 - 46 day periods about 4 months after I went off of BC. So I thought I might have PCOS. For some reason, I guess I'm not ovulating properly. Luckily everything else looks "normal" though. Although in saying that, they DID find a pretty good sized fibroid, but it's on the outside of the uterus, so shouldn't affect conception I'm told.

    Answer by jen2100 at 8:05 PM on Dec. 20, 2009

  • You're welcome :) Gonal-f is one type of an injectible med, there are others, but there comes a lot more risks with the injectibles like ovarian hyperstimulation and a much higher chance of multiples. Plus, it requires more monitoring and is more expensive, may be a good idea to know what your insurance covers and what they don't! I have PCOS and my ovaries are stubborn, that's why the Clomid never worked for me, just wasn't strong enough I guess.

    It's definitely a plan B if Clomid is not successful after 3 cycles. I think Letrozole might be a good thing to try though since you did respond to the Clomid.

    Glad I could help you out some. Make a list of your questions next time you see the RE, I always forgot when I went...but I did A LOT of research online lol I could have probably monitored and done everything myself this past cycle but then there's the problem of needing a PhD to do that LOL

    Answer by all4mymarine at 7:43 PM on Dec. 20, 2009

  • Wow. Thanks for that advice! I've never heard of Gonal-f, but will mention this to my RE! Sounds like it really worked for you!

    Answer by jen2100 at 7:28 PM on Dec. 20, 2009

  • Oh, forgot to say that I've never tried Letrozole but I've heard the side effects on the lining and mucus are much more favorable than Clomid! But I think they work the same ways. They both are an anti estrogen. I did try Tamoxifen once (didn't work either) and I think that's like Letrozole and Femara which are drugs used for women who have (breast?) cancer.

    Answer by all4mymarine at 5:48 PM on Dec. 20, 2009

  • One good follicle on clomid is normal! If you are producing one good follicle by day 17 then I wouldn't recommend increasing the dosage much, if at all. But that's your RE's call.

    Sure, some women may have shorter luteal phases but it *can* make it harder to conceive.

    In my experience clomid didn't work at all. I ended up using Gonal-f the first time and conceived my first ds with 2 follicles. My second pregnancy was 2nd try with Gonal-f and had 2 follicles that time as well. This pregnancy, first Gonal-f cycle and 5 follies! Just gotta find what works for you! Hopefully clomid is it for you :)

    Answer by all4mymarine at 5:41 PM on Dec. 20, 2009

  • Thanks for those replies guys! I think I'm more concerned about the lack of good follicles part. Does increasing the dosage of Clomid help? I don't think I would have ovulated on my own without the HCG shot. Has anyone had any luck with Letrozole?

    Answer by jen2100 at 2:46 PM on Dec. 20, 2009

  • I never had any experience with fertility drugs or anything of that nature. I am fairly certain that I have a 10 day luteal phase. We are not all the same and a shorter luteal phase may just be your "normal" All normal really is in the grand scheme of things is what's normal for you. My only advice would be to remember that if you do in fact have a short lp then when you do get pregnant there is a higher chance you will get a false negative preg test result at first.

    Answer by Krysden at 1:49 PM on Dec. 20, 2009

  • Sounds like you need to ask the RE for prometrium suppositories (progesterone) to start taking after ovulation to extend your luteal phase. What was your progesterone 7 days after you ovulated?

    I don't have a luteal phase defect myself but my RE gives everyone prometrium after ovulation and if you conceive you take it till 12 weeks, no harm and it may actually help.

    Just an FYI on clomid, make sure you read up on the side effects and the recommended usage period! Some doc's have women take it WAAAY too long and they wonder why they aren't getting pregnant!

    Answer by all4mymarine at 1:48 PM on Dec. 20, 2009

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