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Clomid Question
What are the consequences of not having a period and taking clomid?
I know how you feel. I'm sure you've been trying forever - as most people have been by the time we get to clomid. It seems like time moves in slow motion when you are trying for something so hard. And the fact that you can only try once every 28 days or so makes the waiting game really suck. I am glad you are getting in to see your dr. I am sure they can help you move on to the next step (the shot, af, another round, or whatever you need). Be patient and remember that your time will come. It took me 18 months of trying, but my time is finally here - don't give up yet! :)
Thanks for your response...I just phoned the doc's office and I'm going to see if I can't come in today and get a progesterone shot...the doc told me on 9/19 that more than likely I didn't O b/c of my BBT's and sent me to have a progesterone level done...well it came back too low...now I'm just sitting here on borrowed time basically...My DH finally gets a decent shift in which we can actually BD as we should and now the doc's office is off point...I just want to start my period, start the clomid, and start trying to make a baby...this is just so frustrating and upsetting!!
I took clomid without getting a real period and I would not suggest doing it. Here's what happened: I did a round of clomid correctly under the supervision of my dr. I went in for a blood test - came back negative. Since I was late already, dr gave me provera. I had some spotting after starting the provera for days and 2 days of it was red. Counted that as a period. Well, in fact it was not. I didn't know this and started taking clomid again as perscribed. Well, 3 days into it I was having so much pain so I went to the ER and found out I was having an ectopic pregnancy. The clomid was agrivating it and making the pain worse.
There are too many vairables. I would NOT suggest taking clomid without starting your period. Some people don't show up on a hpt - my sister didn't show for over 3 months on a home pregnancy test. I would suggest seeing your dr. Forget the nurse, and get in to see your dr. Looks like you are either preggo, having an ovulation issue, or just not starting your period.
Another consequence of starting the clomid without af is that you could have possibly not ovulated (even if a stick says otherwise) and now your grown eggies are turning into cysts - not usually a big deal but clomid can make them grow more and feel worse. Trust me, you don't want to experience a big cyst bursting on your ovary - it's not so comfortable.
There are just too many factors. See your dr before taking another round. They can help you get things sorted out. :)
There are too many vairables. I would NOT suggest taking clomid without starting your period. Some people don't show up on a hpt - my sister didn't show for over 3 months on a home pregnancy test. I would suggest seeing your dr. Forget the nurse, and get in to see your dr. Looks like you are either preggo, having an ovulation issue, or just not starting your period.
Another consequence of starting the clomid without af is that you could have possibly not ovulated (even if a stick says otherwise) and now your grown eggies are turning into cysts - not usually a big deal but clomid can make them grow more and feel worse. Trust me, you don't want to experience a big cyst bursting on your ovary - it's not so comfortable.
There are just too many factors. See your dr before taking another round. They can help you get things sorted out. :)
I was given instructions, however, I haven't had AF and didn't O according to the doc on 9/19 which is when he upped my dose of clomid...I can't take the clomid on CD3 if not cycle is present...I think I was supposed to have a progesterone shot, but the nurse I spoke to acted like she didn't understand what I was saying so I just hung up
You should have only taken them when you period arrived,your doctor should have told you this.they will not work.
feel very badly that you did not get instructions on how to take the Clomid®(clomiphene citrate). This reflects poorly on the medical profession because induction of ovarian ovulation can be somewhat complicated. You actually need detailed instructions depending upon what condition you have and which regimen the doctor likes to use.
Do I need to have a menstrual period induced before taking clomiphene?
In theory no, but in practice yes. If you knew for sure you had not ovulated and become very early pregnant, then inducing a menses would not be necessary. The reason most doctors give you progestins or progesterone to induce a menses is to make sure you have not recently ovulated or become pregnant. If you just ovulated, the progestins will usually not induce a menses until 14 days after ovulation. This protects you from inducing an ovulation on top of an ovulation or disrupting an ovulation and potential pregnancy with unneeded clomiphene.
Another reason to induce a menses before Clomid® is to make sure the lining of the uterus is at the right phase for egg implantation. If a menses is induced, then the endometrial lining has had only 14 days of growth and stimulation at the time of ovulation. When no menses is induced, the endometrium has been growing and been stimulated for 30 or more days and may not be as receptive to egg implantation.
Finally, if a menses is induced, the doctor knows for sure that you are not pregnant. Even if you use the most sensitive home pregnancy test you could still be pregnant with a negative test. Thus having a menstrual period is good reassurance that you are not pregnant and that the lining of the uterus is best prepared for an ovulation and potential pregnancy.
Birth control pills can be used instead of the progestins if that is all you have. They would be taken for 5 days, one each day, just as you would take progestins orally (e.g., Provera®). The menses may start anywhere from 2 days to about 2 weeks after finishing the progestins or birth control pills.
After my period, when do I take the clomiphene?
The most common regimen is to take the clomiphene starting on day 5 after the start of menses for 5 days ending on day 9. Another regimen is to start on day 4 through 8 and a recent publication even indicates the Clomid® can be taken on day 1 through day 5 with a very successful pregnancy rate. If your doctor does not indicate otherwise, taking the medicine on days 5-9 is the usual and most commonly tested regimen.
Sometimes a 3 day regimen can also be used although it is not quite as successful at inducing ovulation, it may have a slightly higher pregnancy rate since the anti-estrogen effects of Clomid® on the endometrium are less pronounced.
What should I expect or look for after taking Clomid®?
Most women do not have any symptoms from taking Clomid®. Some will have some lower abdominal cramps in the 2nd half of the cycle. Rarely (less than 1-2%) a woman may experience ovarian hyperstimulation syndrome. In this case the ovaries become quite enlarged and multicystic. They can cause moderate pelvic pain. There can also be large amounts of fluid secreted into the abdominal cavity (ascites). Sometimes the fluid can be so severe that it can cause heart or kidney failure.
If you have any pelvic pain or discomfort other than a few mild cramps, you should let your doctor know in case you may need an exam.
As far as the efficacy of clomiphene in inducing ovulation, its success depends upon the underlying cause of why you do not ovulate. If you have polycystic ovarian syndrome it is more sucessful than if the cause of ovulation is hypothalamic anovulation.
When can I check to see if I got pregnant using the Clomid®?
First it is best to check if you ovulate using the Clomid®. Most women do this by monitoring their basal body temperature. This basal (morning) temperature goes up by about 0.5 degrees F or more (BBT graph) and stays up during the luteal phase. Ovulation may occur anywhere from day 12 of the cycle up to day 18 of the cycle or occasionally later using Clomid®. If the temperature stays up for 17 days or more after ovulation, then you should run a pregnancy test. If it is positive, let your doctor know.
There can be a slightly higher early pregnancy loss rate with clomiphene induced ovulation so if you have trouble interpreting your basal body temperature and pregnancy test results, be sure to contact your physician.
What happens if I do not get pregnant this cycle?
If you ovulated and the pregnancy test is negative, then you should take another course of progestins and start over with ovulation induction at the same dose. If you did not ovulate, you will need instructions from your doctor as to whether to increase the Clomid® dose. Often the dose is increased from 50 mg to 100 mg, to 150 mg and then to 200 mg and at most 250 mg if no ovulation occurs at the lower doses. Do not increase the dose on your own without instructions from your physician.
Do I need to have a menstrual period induced before taking clomiphene?
In theory no, but in practice yes. If you knew for sure you had not ovulated and become very early pregnant, then inducing a menses would not be necessary. The reason most doctors give you progestins or progesterone to induce a menses is to make sure you have not recently ovulated or become pregnant. If you just ovulated, the progestins will usually not induce a menses until 14 days after ovulation. This protects you from inducing an ovulation on top of an ovulation or disrupting an ovulation and potential pregnancy with unneeded clomiphene.
Another reason to induce a menses before Clomid® is to make sure the lining of the uterus is at the right phase for egg implantation. If a menses is induced, then the endometrial lining has had only 14 days of growth and stimulation at the time of ovulation. When no menses is induced, the endometrium has been growing and been stimulated for 30 or more days and may not be as receptive to egg implantation.
Finally, if a menses is induced, the doctor knows for sure that you are not pregnant. Even if you use the most sensitive home pregnancy test you could still be pregnant with a negative test. Thus having a menstrual period is good reassurance that you are not pregnant and that the lining of the uterus is best prepared for an ovulation and potential pregnancy.
Birth control pills can be used instead of the progestins if that is all you have. They would be taken for 5 days, one each day, just as you would take progestins orally (e.g., Provera®). The menses may start anywhere from 2 days to about 2 weeks after finishing the progestins or birth control pills.
After my period, when do I take the clomiphene?
The most common regimen is to take the clomiphene starting on day 5 after the start of menses for 5 days ending on day 9. Another regimen is to start on day 4 through 8 and a recent publication even indicates the Clomid® can be taken on day 1 through day 5 with a very successful pregnancy rate. If your doctor does not indicate otherwise, taking the medicine on days 5-9 is the usual and most commonly tested regimen.
Sometimes a 3 day regimen can also be used although it is not quite as successful at inducing ovulation, it may have a slightly higher pregnancy rate since the anti-estrogen effects of Clomid® on the endometrium are less pronounced.
What should I expect or look for after taking Clomid®?
Most women do not have any symptoms from taking Clomid®. Some will have some lower abdominal cramps in the 2nd half of the cycle. Rarely (less than 1-2%) a woman may experience ovarian hyperstimulation syndrome. In this case the ovaries become quite enlarged and multicystic. They can cause moderate pelvic pain. There can also be large amounts of fluid secreted into the abdominal cavity (ascites). Sometimes the fluid can be so severe that it can cause heart or kidney failure.
If you have any pelvic pain or discomfort other than a few mild cramps, you should let your doctor know in case you may need an exam.
As far as the efficacy of clomiphene in inducing ovulation, its success depends upon the underlying cause of why you do not ovulate. If you have polycystic ovarian syndrome it is more sucessful than if the cause of ovulation is hypothalamic anovulation.
When can I check to see if I got pregnant using the Clomid®?
First it is best to check if you ovulate using the Clomid®. Most women do this by monitoring their basal body temperature. This basal (morning) temperature goes up by about 0.5 degrees F or more (BBT graph) and stays up during the luteal phase. Ovulation may occur anywhere from day 12 of the cycle up to day 18 of the cycle or occasionally later using Clomid®. If the temperature stays up for 17 days or more after ovulation, then you should run a pregnancy test. If it is positive, let your doctor know.
There can be a slightly higher early pregnancy loss rate with clomiphene induced ovulation so if you have trouble interpreting your basal body temperature and pregnancy test results, be sure to contact your physician.
What happens if I do not get pregnant this cycle?
If you ovulated and the pregnancy test is negative, then you should take another course of progestins and start over with ovulation induction at the same dose. If you did not ovulate, you will need instructions from your doctor as to whether to increase the Clomid® dose. Often the dose is increased from 50 mg to 100 mg, to 150 mg and then to 200 mg and at most 250 mg if no ovulation occurs at the lower doses. Do not increase the dose on your own without instructions from your physician.
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