What next after Clomid?

Hi all,

Just wondering what is the next step after clomid and can we go straight to IVF?

Short story about us, I have PCOS and have always had irregular period from 32 days to 125 days.

Been TTC since Jan 2010.

Went on clomid for two rounds last Oct/Nov but wanted to try natural cycle after.

Then AF came once and never came since Feb 2011.

Since then until now i had irregular spotting which ultrasound found nothing wrong.

Currently on Metformin, started about a month ago.

I did ovulate this month though so waiting for AF now.

So, how do I go about with the next step? and can I go straight to IVF?

Thanks all

hi hun,

i have just finished my last cycle of clomid, from here im planning on going onto injections (so along the lines of clomid, its "ovulation induction" but still dtd at home, will have some blood tests and ultrasound monitoring throughout the cycle to check for ovulation.

there is also iui we could do before "full" ivf but im not keen on that. one clinic said i could go straight to ivf from here but im now going through another clinic and they are happy for my to try the other options first.

so to answer your question you can really do whatever you want !

did you have help conceiving DD ?

Heya minnie

DD was an absolute miracle. I had no clues on cycles and charting and all that and she was conceived 1.5mths of us deciding, so she sure was a miracle.

Ive asked DH to do some research on IVF. We are thinking of trying naturally until end of this year before IVF.

Ive heard you ladies talk about IUI and FSH etc but will have to read up on it a bit mroe as I have no idea what they mean lol

hopefully metformin will help things, i have been on it for many years because of pcos

not sure where you live but i can give you some info if you are in sydney (or even if in nsw) pm if you like

I'm not definite but I would have thought if you Are ovulating maybe IUI? It's just where the sperm is directly inseminated into you at ovulation. IT's cheaper than IVF but that's all I really know about it not much help sorry.

Have you thought of ovarian drilling at all? That was my next step after clomid didn't work for me.. We ended up doing IVF in the end but if you have ovulated on clomid I would definately think you'd be a good candidate for it providing your FS is keen on it... After that I did FSH and DTD at home that cycle ended in OHSS and then after that my FS said are you sick of this I obvioulsy was like YES so IVF we went wish I'd done it in the first place but in saying that I was thankful for her trying all this first :) I forgot to mention I was diagnosed with PCOS when I was 12 and NEVER had a cycle unless medically made!

If you need to know anything feel free to pm me

Thanks ladies

When i was on clomid I did ovulate. Also I ovulated 2 weeks ago as well. I mean i am going based on hormonal measurements (ie blood test for clomid) and fertility monitor for this cycle.

So do you think there is a chance that I ovulated but no egg was released? Ie just hormone changes?

Reason i ask is i dont get how my egg is not getting fertilised when it feels like weve done everything right this cycle =(

It's up to you really. IUI may be an option - it's less invasive and cheaper but also has a lower success rate. We had the option of trying IUI first as DH's sperm was 'borderline', but went straight to IVF as we hoped it would be quicker.

ETA - if you ovulate, the there has to be an egg. It is possible that your ovaries aren't doing quite what they should in the luteal phase, however, hormone-wise. Clomid or OI can help with this.

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Thanks ladies

When i was on clomid I did ovulate. Also I ovulated 2 weeks ago as well. I mean i am going based on hormonal measurements (ie blood test for clomid) and fertility monitor for this cycle.

So do you think there is a chance that I ovulated but no egg was released? Ie just hormone changes?

Reason i ask is i dont get how my egg is not getting fertilised when it feels like weve done everything right this cycle =(

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Hiya

Could be quite a few reasons!
- Not sure how old you are, or if you have had your FSH and AMH tested, but it could be the quality of your eggs or low ovarian reserve???
- Has your DH had a sperm analysis? It could be that he is not producing enough good quality sperm. If he hasnt been tested, get his swimmers looked at ASAP!!
- Even young, fertile couples only have a 20-25 per cent each cycle of getting UTD naturally. This diminishes with age. Your month may not have come yet IYKWIM!!


You can go straight to IVF from Clomid (I did) but it would be up to your FS if they recommend it or not. You will have to do a gazillion tests first too!

Good luck x

Im 32 yrs old (forgot if i was turning 33 or 32 to be honest LOL)

Just read up a bit on the ivf website, the procedures look scary!!!!!!!!! im not really a fan of needles either but of all things i would definitey do it for another bub.

Nah, not scary! The scariest thing is the cost!!

And you get used to the needles very quickly!

I think we will redraw from our home loan for that LOL

I cant believe it ... last year my friend asked if i could be her bridesmaid and i turned her down saying that i possibly could be pregnant and huge so wont be able to do it ... and she is getting married on the weekend argh

no idea why i had to add this.

Argh! That sort of 'milestone' really hurts
Yeah, the needles are the easy part, honestly

Firstly, just want to give you big squishy hugs. I too have put things on hold for over 2.5 years 'in case' I fall pg, so I can understand how you are feeling atm.

My story: I did Clomid for approx. 6 rounds, with no success. I only had bloods to confirm O on CD 21 - no other monitoring. I then had a lap & dye study which revealed nothing - all clear. DH then had his sperm tested & in the meantime I fell pg but m/c. Since all was OK with DH sperm test & I was Oing on Clomid, I got referred to a FS & he suggested IUI/superovulation. We did 3 rounds, which were unsuccessful & we decided not to bother with a 4th round & have been referred onwards to IVF, which we are yet to commence.

I'll give you a breakdown on MY experience with IUI.
- Pg test to confirm not pg on CD3
- CD3 start injections (puregon/FSH) to grow eggs (same time each day/night)
- Monitoring via u/s & blood tests to see how big eggs are
- Once eggs are around 14-16mm I do the trigger injection (pregnyl) to release the egg
- No DTD roughly 3 days prior to AI
- DH produces sperm sample in the morning & they do the artificial insemination (AI) later that day (which is like a pap smear, no anesthetic)
- DTD for three days after AI
- Blood test 4-5 days after IUI to measure progesterone levels
- I was advised to do extra pregnyl injection to boost progesterone
- Beta HCG 2 weeks after AI if no AF

I agree with MadB - the injections were the easiest once you do the first one. It's all the other stuff inbetween that I found the hardest & I haven't even done IVF, only IUI