Our First Coin Flip
Remember how I said we had settled on 25 mg of Clomid, with u/s monitoring starting on day 14? Well, that's not the whole story. What really happened was that Dr. Quixotic was going to start me on 50 mg of Clomid, OPK only days 12-17, and then u/s on day 17 if I had no signs of ovulation having occurred. I voiced my concern about too many follicles or even OHSS, and also about wanting to gain knowledge from even an anovulatory cycle.
So he agreed to the monitoring starting on day 14. He then started to say something else but thought better of it. And, like an idiot, I piped up with, "No, what were you going to say?" He looked at me for a moment, then said, "Well, you seem to be rathe cautious, and I think you're patient enough, so how about we reduce this to 25 milligrams this cycle?"
Argh.
At the moment it seemed ok, but now we're worried that it's just far too low to do anything and we'll just be wasting our time. I'm pretty sure I can go back to the 50 mg dose if we want; I'll be calling into the clinic at least twice more before I have to start taking it. So I ask you, my dear readers, for your opinions, advice, and experiences...
Labels: Clomid Monster
posted by Robber Barren at 7:31 PM
comments (8)
Well, as you know 25 mg is lower than the typical lowest starting dose, and I don't have any idea whether it's a waste of time or a smart precaution. Does your doctor have any statistics on success at 25mg, or on OHSS with PCOS at 50mg? You might want to ask.
In the absence of anything useful to say, I googled it for you and found this page, which says 25 mg may be enough for thin patients... maybe this was his was of telling you you're thin? ;-) OK, then there was also where someone reported conceiving twins on 25 mg (and yet another page with success stories on 25 mg which I refuse to link to, because it was covered with shiny happy baby dust and probably includes people who were barely infertile in the first place anyway.) Oh, and also this blog, but I haven't read enough to discover why the low dose or what the outcome was.
Hoping somebody out there has more helpful input for you. In the absence of info I would just go with your gut on whether it will make you more insane to worry about no response, or to worry about overstim...
Gah! Maybe you can edit my html for me. :-D
I don't know about OHSS, but from my understanding, multiples isn't such a big issue on Clomid. Everything I read said that clomid raises your chances of having twins to 5-10% (not such a high chance, and twins aren't THAT high-risk), and that clomid doesn't raise your chances of higher order multiples at all. I think the monitering is probably more important than the low dosage, but that could be my own experience talking - I'm on 100 mg clomid with frequent monitering... good luck with whatever you decide for this month.
Before I was diagnosed with PCOS, I was on 50 mg of Clomid. Did nothing. Two cycles of 100 mg of Clomid--ovulated on d18 the first one, back to my normal d33 on the second. Clomid resistance is a hallmark of PCOS (which my first RE did not pick up on--a big reason why I switched).
This time around, I'm on Metformin (extended release, 850 mg twice a day). Ovulation was getting later and later--up to d29 right before the Clomid cycle. But I took 25 mg of Clomid and ovulated on d17--a personal best. Didn't get pregnant, but it certainly got me ovulating sooner.
If you're having trouble with the Metformin, a higher dose of Clomid might be a better choice (maybe 50). Hope that helps!
I didn't ovulate until I got to Clomid 100mg, so 50mg was too low for me and obviously 25mg would definitely have been too low as well. Based on my own personal experience, I think 50 mg might be a better starting point, unless you're really afraid of the possibility of multiples (I really don't think OHSS should be much of a concern on Clomid).
Also, do OPKs work for you? As a possible PCOS'er, I find that OPKs that check for LH in the urine are ineffective for me because my LH is already somewhat elevated.
Good luck with whatever choice you make!
I'm somewhat doubtful about the efficacy of the OPKs, but Dr. Quixotic said to use them, so I will. I'm also going to have ulrasound monitoring begining on Day 14, so that should give us a better idea of what's going on, right?
I've pretty much decided that I'm going to take the 50 mg dose, unless Dr. Q can give me a really, really good reason not to.
I started on 50 mg and it did nothing for me. My doctor said that even on 50 mg my chance of concieving twins was only 10%. I can live with that.
As for OPK's I took one every month for the first six months and they always showed a hormone surge around day 13. So, apparently I'm in that 1% unsuccess rate, because even though they showed a surge, I never ovulated.
hi, my doctor recommends 50mg clomid. this will be my first round. i think it will produce too many eggs. I want to cut them in half. I lost some weight about 7 months back and my period. I am on my second round of provera to get my period back.. what do you think?
Speak up!
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