Frustrated- Need Advice

[kaprovea]

Here is the problem... I am going to start my third round of clomid 50 mg today.  The first month I took the clomid at the first of the month and then took Provera days 27-31 to get my cycle started.  I had a period the next week and took the clomid on Feb. 5-9.  This month my temps didn't go up and stay up.  It went up one day but then came back down the next day and stayed between 97.5-97.9.  Im assuming that I didn't ovulate.  Well if I was going to stay on the same cycle as I had the first month my period would have started yesterday.  I am suppose to take Clomid 50 mg again March 5-9.  Since I hadn't started my period I called the doctors office and one of the nurses called back saying that the DR.  said to just take the Clomid like scheduled.  I have a doctors appointment at the end of the month but I don't want to just keep letting the months slip by.  The doctor said that I have to just let my body get used to it.  Im frustrated that they aren't doing more.  I see people on here saying that they are having ultrasounds and blood tests to see if they are ovulating.  Should I switch doctors?  I need some advice on what to do.  

[Sheri1972]

A reproductive endocrinologist has an OB/GYN degree, but they also have a specific specialty in infertility and the treatment thereof.  They usually do not deliver babies that I'm aware of.  Once you get pregnant, they typically will monitor the pregnancy very closely until maybe 8 weeks or so and then you'll go to a regular OB/GYN.

I'm not saying a regular OB/GYN can't be good at treating infertility... some are.  I've just heard of many of them that seem to watch patients a little less than they probably should when putting them on all these drugs that can do funny things to our ovaries.

Most reproductive endocrinologists will do exhaustive tests to determine exactly why you are having difficulty getting pregnant, and will monitor you closely through whatever treatment you are pursuing.  

The problem with not monitoring on clomid is though it is mild, you can still hyperstimulate on it, and if the doctor isn't looking to see how many follicles you are getting, or how big they are, you could either be risking OHSS (although rare) or you could be wasting your money entirely.

I took only 50 mg of clomid and got over 13 mature follicles the first time, so overstimulating is a definite possibility.  I think my concern for you would more be if you didn't have any mature follicles, it's sort of wasting your time and money.  The doctor can have you trigger when your follicle(s) are just the right size by monitoring, and they can follow up with blood testing and ultrasounds to make sure you did, in fact, ovulate.  If your goal is to get pregnant then adjusting your dose monthly based on specific tests would be the route I would want to take.

I hope that helps!!

Sheri

[kaprovea]

I am seeing a regular OBGYN.  My doctor is not measuring my follicules.  I took a pregnancy test yesterday and it was negative.  My temps went up the first month I was on 50 mg to show that I had ovulated.  This month my temps have not went up to show I am ovulating.  When I went to the doctor in the first place I wasn't having periods after going off of birth control pills.  He started me on provera and that made me have periods and then they stopped when the provera stopped.  So he put me on clomid to make it start regularly.  The first month I took both provera and clomid.  This month it was just clomid.  When he gave me the clomid he told me to chart my temps and to come back in 3 months to see how the dosage was working and to make sure I didn't have any cysts.  

I would like some advice on what does an reproductive endocrinologist do?  Do they deliver babies too?

[Sheri1972]

Well, I don't think I would take the clomid if I haven't had AF yet!  If somehow you could be pregnant, the clomid can hurt the baby.  My doctor would never let me start clomid if I hadn't had a my scheduled AF!

Your doc isn't measuring your follicles on clomid with ultrasound to make sure they are maturing and that 50 mg is working for you?

If you don't feel like you're getting monitored and getting the answers you want from this doctor, I'd certainly look elsewhere. Is this a regular doctor or a reproductive endocrinologist?  I'm big on going to an RE for fertility issues, because you're playing around with powerful drugs and usually an RE will watch you very, very carefully.

Sheri

[Anya1984]

I totally agree,
if you didn't Ovulate on Clomid 50 then you need a higher doze..I just did my third round of Clomid on 150 and will check on Saturday if I ovulated by doing sonogram. Your doc at least needs to take your blood to see if you Ovulated...

[Heather5]

Did your temps show ovulation your first month on clomid? If not, maybe you need a higher dose...

As for progesterone blood test to check for ovulation, I think you should ask your doctor if he/she will let you take one. It might be too late for this cycle, but maybe next. It needs to be done about 7 days after (suspected) ovulation.

U/S monitoring seems to be more common when you see a specialist (RE), as opposed to a regular doctor or obgyn.

Good luck to you!