# Can clomid help/hinder if there is a possibility you are ov'ing?



## JPSCoey (Jun 3, 2009)

I'm new here, just found this site and am going through Queen Charlotte's at Hammersmith too (NHS)...

I am 28, DH 32 and we have been ttc over 2 years. Basically I got af back for the first time in 2 years after coming off depo provera in December last year.
I am charting, opk's (All negative) cbfm (Always low) etc. 
I have had about 6 appointments with Doc Trew at Hammersmith so far where he has 'monitored my cycles' (Well we have just reviewed them each month, haven't done regular scans, cycle monitoring etc).
I have had an bloods (Thyroid, fhs, LH and thyroid function), hsg, laparoscopy which showed all is completely healthy. They could see small follicules but weren't sure if they were just old or dormant. I have one very small ovary (2.1mls) and one small. Because my cycles are irregular the only blood I haven't had is the progesterone 21 day test. OH's sa was normal

Next Wed I have another appoint to discuss the results from my laparoscopy and decide where to go from there. As I said after the op they said it all looked healthy but didn't give details.

Originally, Dr Trew would not give my clomid as he said no point if you are ov'ing and he thinks I was as my 3 cycles then after coming off depo were 32, 34, 37 so + or - only a couple of days representing a regular pattern which indicates ovulation and he was therefore 95% sure of ovulation

However my cycles since then have been 18 and 31 days with heavy spotting for a week or more in the middle (Possibly af?) I take this as irregular and think he will probably think the same   

Last time the options were:
1. keep trying naturally,
2. Have a laparoscopy then if all ok to go ahead, apply for ivf. (We chose this option)
3. apply for ivf

Do you think he might consider clomid?
If I did get clomid and do happen to be ov'ing can it be detrimental to ttc, apart from the risks with multiple pregnancy increasing? It's just that he said there is absolutely no point in clomid if you are ovulating. I think that I ovulate but very irregularly. Doesn't it make you make more eggs and therefore give me more eggs and a higher probability of catching one?

Please help if you can as I don't want to go in there and feel rushed and like I am making an uninformed decision.

I also wondered if there was any other general advice you could give me with going through HH under the NHS and Dr Trew. We are under the Hounslow borough.

Sorry this is so long winded, any questions please ask! I also posted under Hammersmith and was advised to post here, sorry if you have read it twice?

Is there anywhere with the success rates of clomid? Would it increase your chances of conception if you are ov'ing but irregularly?

Thank you and lot's of


----------



## trixxi (Dec 4, 2008)

Hi JPScoey, 

Welcome to the forum!!

Am I right in saying you have not had day21 bloods done?  Or day28 bloods done if you have longer cycles?

I am not 100%  sure but did think these bloods give conclusive results for ovulation and without these it is an assumption that you are ov'ing.  

my doc thinks I ov but not frequently, this is why I was prescribed clomid.  

I have just read on another site that clomid is used to increase the follies for ivf.
Success rate is 70-90% of women ov in the first three cycle and 40% of theses become pg in that time.

The biggest problem if you ov irregulary is knowing when you are so you can plan bms around that time, this is where it helps me.

I am no expert but it sounds to me like your doc is making assumptions about you ov'ing.  I was very irregular and my gp took bloods weekly to get a clear pic of my progesterone levels (including CD21 and CD2.  Some months were better results than other,  but results above 30 are required to sustain a pg.

Bit of a waffle there !!!!!!!!!
Surely you would be better having conclusive info re ov'ing rather than natural or ivf, its a bit of a leap?

I would have a discussion with you doc and explain your thoughts about ov'ing and possibilities of giving clomid a go for 6 months, before the ivf route.

hope that helps  

T xx


----------



## JPSCoey (Jun 3, 2009)

trixxi said:


> Hi JPScoey,
> 
> Welcome to the forum!!
> 
> ...


Tx so much Trixxie, that is great advice. Yes I have onl had a random bloodtest once when I had a 188 day cycle and would you believe it, it showed I had ov'd and would get af soon! I have been charting, opk's, cbfm etc since then (7 months) and nothing says that I have ov'd for these cycles at all. My cycles have been between 18 and 37 days for the last 6 months since the 188 day cycle.

So I think he based the assumption that I ov on the crazy coincidence that out of the 188 days in the cycle I had the blood test happened to be done after I ov'd!

It would be a huge jump... he said no point in clomid if I am ov'ing but wouldn't it help if I ov on average once a year?

The success rates sound great if you actually ov...

How many cycles have you had? What have your sa been? I really hope that you get your bfp asap.

Thanks again hun.


----------



## MistyW (May 6, 2008)

Hi JPSCoey  
Your doc seems to making huge assumptions about whether or not you are ov'ing.  I had cycles anywhere between 24 and 28 days, yes they were classed as 'regular' too.  I was also spotting mid cycle, but I was definitely only ov'ing every once in a while.  This was proved by my blood tests.
Clomid was a miracle drug for me.  It got me ov'ing straight away - and I knew when it was happening because it ached.  Great for helping time BMS  
I think that you have problaby made your mind up already?  It won't do any harm to try the magic pills whilst you are on the waiting list?  Especially as all the other tests have appeared normal.  It certainly won't hinder anything.  You could end up with twins though  
Best of luck.
Let us know how you get along xxx


----------



## trixxi (Dec 4, 2008)

Hey J...........

Clomid can make you ov and regularly, thats why i am on it, my cycles have gone to 45days the last 2 on clomid have been 30days, so at least with clomid i know when i am going to ov so thats when we get busy!!  when you have long cycles not only does it mess with your hormones but you cant bms every day for 21 days to cover incase its a short or long cycle, although DH would probably argue the point that you can !!!

I am just about to start taking my 3rd round tonite, so got my fingers crossed!! Did you mean side effects?  If so pretty emotional, headaches, hot flushes to name but a few but at least the good news is you dont get them all at the same time!! 

T xxx


----------



## JW3 (Apr 7, 2008)

There are also other alternatives to clomid which may be better for some people.

I have heard of an NHS trial where they are giving Puregon first instead of clomid and it works better for some people.

It is more expensive to the NHS but there are less side effects and there is a marginally higher success rate.

Clomid thinned my womb lining so much that embryos were unlikely to implant, when I stopped clomid the womb lining got better, so puregon has been much better for me.


----------



## kdb (Apr 9, 2009)

Hi Jenny - I have my first Clomid cycle scan on Monday so no idea whether womb lining thickness could be an issue for me, but am interested to know how they diagnosed it was Clomid that was causing yours to thin?

Was it during your month off Clomid in December -- did they scan you then and your lining was a better thickness?

Hope you manage to have a nice relaxing weekend; your job sounds full-on - but it's great that you are passionate about it


----------



## JW3 (Apr 7, 2008)

Hiya KD74

Apparently it is quite a common side effect of clomid.  Normal womb lining should be 8-10.  The first month I was on clomid mine was 6.6 and it got worse from then on until 5.5.  They said at my clinic after that they maybe should have stopped after the first 3 goes given it was this bad.  I have been scanned on puregon which does not have this side effect and last month the lining was 8.9 and before a similar number.

I am completely healthy and well in the age range so I think that's why the clinic were surprised with such a low womb lining, I was relieved when I found out for definite that it was the clomid and not just another problem with me.  As so far I've been quite unlucky with my tx.

Clomid effects your pituitary gland which can effect other hormone levels and this is why it can have the womb lining effect on some people.  Other drugs given for ovulation induction are pure hormone (puregon (FSH) or menopur) and therefore don't impact on your other hormone levels.

Good that you are having a scan on Monday - good luck      Lots and lots of people are succesful with clomid  

I don't think many people get offered alternatives so I like to let people know there are other things out there that are available to try


----------



## JPSCoey (Jun 3, 2009)

JennyW said:


> Hiya KD74
> 
> Apparently it is quite a common side effect of clomid. Normal womb lining should be 8-10. The first month I was on clomid mine was 6.6 and it got worse from then on until 5.5. They said at my clinic after that they maybe should have stopped after the first 3 goes given it was this bad. I have been scanned on puregon which does not have this side effect and last month the lining was 8.9 and before a similar number.
> 
> ...


Thank you, this is really interesting. Why do they not give everyone puregon instead of clomid if it has less side effects? Is it just a newer 'thing' that is like (say) different antibiotics, some work well for some people, others for other people? (If that makes any sense?)

I had a blood test for fsh and it was 'normal' so I wonder if puregon would still be a viable option?

Thanks for the thoughts, it has def given me something else to consider and ask MR T about!


trixxi said:


> Hey J...........
> 
> Clomid can make you ov and regularly, thats why i am on it, my cycles have gone to 45days the last 2 on clomid have been 30days, so at least with clomid i know when i am going to ov so thats when we get busy!! when you have long cycles not only does it mess with your hormones but you cant bms every day for 21 days to cover incase its a short or long cycle, although DH would probably argue the point that you can !!!
> 
> ...


Good luck T for your 3rd round. It's great that your cycles are shorter now. I totally get what you mean, it is exhausting trying to bd every day in case it is 'the day' when you may be ov'ing with loooooooooooooong cycles! Yes I meant side effects   just realised I typed SA!!! Didn't mean sperm analysis! 


MistyW said:


> Hi JPSCoey
> Your doc seems to making huge assumptions about whether or not you are ov'ing. I had cycles anywhere between 24 and 28 days, yes they were classed as 'regular' too. I was also spotting mid cycle, but I was definitely only ov'ing every once in a while. This was proved by my blood tests.
> Clomid was a miracle drug for me. It got me ov'ing straight away - and I knew when it was happening because it ached. Great for helping time BMS
> I think that you have problaby made your mind up already? It won't do any harm to try the magic pills whilst you are on the waiting list? Especially as all the other tests have appeared normal. It certainly won't hinder anything. You could end up with twins though
> ...


I think I have made my mind up... I am going to ask/point out why I need clomid/alternative and go on the waiting list for ivf. My only apparent problems (unless they tell me otherwise at the laparoscopy review) are small ovaries (Is quality or quantity better? I have heard different opinions)  and irregular cycles, spotting inbetween for about a week.

Thanks for all your advice and I hope you all get what you deserve really soon. I will   for you.


----------



## kdb (Apr 9, 2009)

Thanks so much Jenny, that is really helpful to know.  When I had my first ultrasound (for amenorrhea) in November my lining was 6mm, and that was pre-PCO dx, pre-acupuncture, pre- everything, so if it's less than that at Monday's scan then it may be due to the Clomid.  We shall see  

JPS - I'm seeing Mr Trew too (but privately because HH delayed my referral for so long) - so would love to hear from you what his thoughts are about Puregon.  I don't have any more appts booked with him unless I don't respond to this first round of Clomid.

Thanks again!
chat soon


----------



## JW3 (Apr 7, 2008)

JPSCoey - Puregon costs the NHS more £££s than clomid and can only be given with scans.  I think this is the reason most people get clomid.

KD74 - lining just needs to be up to 8mm when you are due for implantation (after ovulation), so don't worry if it is less at other times as it will probably thicken up


----------



## JPSCoey (Jun 3, 2009)

JennyW said:


> JPSCoey - Puregon costs the NHS more £££s than clomid and can only be given with scans. I think this is the reason most people get clomid.
> 
> KD74 - lining just needs to be up to 8mm when you are due for implantation (after ovulation), so don't worry if it is less at other times as it will probably thicken up


Thanks Jenny, I went to the clinic and saw a diff doctor as the temp one I had was on holiday. She had no idea and thought you need to apply for funding for clomid/puregon. I checked with the ivf /fertility unit next door and they said you don't need to, you get 2 free monitored cycles. So after they explained this to the consultant, I took the booking form to them and am waiting for the prescription to be posted to me.

All she could tell me about the difference between puregon and clomid was that 'puregon is stronger' She wrote down both on the form and said we will see what they will fund. So now that I don't need to apply for funding I actually don't know which drug she is going to give me the prescription for... I have tried to research online. Do you need to take clomid with the puregon?

Is it puregon which stimulates the follicles to be released whereas clomid encourages the follicles to be made? My fhs levels were tested and came back 'normal' so would this mean puregon is not suitable?

How are you?


----------



## JW3 (Apr 7, 2008)

One of the other reasons puregon can be preferable to clomid is if your ovaries over react.  I was on the minimum dose of clomid because its a tablet but with injections they can give you a really tiny amount.  There is so much to know about all this.  All my hormone levels are normal.

Good job you went and asked the fertility clinic then.  Hope you get your prescription soon - good luck   

I am ok thanks, on th ethird go of this now so really hoping it works


----------



## kdb (Apr 9, 2009)

Hi Jenny - am going to do some research this weekend on puregon and menopur thanks to your info and experience!

Lining at my scan yesterday (CD15) was only 4.8mm    but the follies had both grown to 20mm... can't help thinking 'what's the point' this month if there's not going to be a healthy lining.  I asked the clinic (sonographer) about clomid affecting womb lining and she said flat out "no it doesn't".  Assuming I ov this month (blood test booked for 19/6) they won't expect me to have scans next cycle, but I wonder if it's worth me having one to see whether lining is better or worse.

I don't fancy wasting another three months on clomid producing good follies which can't implant!

Enjoy your half day today!  Sounds like you'll need to catch up on some sleep during your week off    Are you going away for a break?


----------

