Next Step after clomid?

[~Andrea~]

After 4 failed rounds of clomid this time (I got PG on the second round with Gabrielle), I am now seeing an RE. I'm just curious for those who had failed clomid cycles, what was the next step? I see my RE today at 12:30 so I'll come back and let you all know what she says. I am just curious what others have done. :updown:

[EricaMG]

Andrea- I'd recommend going on to injectibles, if that's an option for you. I did Follistim and responded quite well to it. The shots are really not that bad, once you get used to them.

[Brooke]

Ny neighbor is starting her 1st cycle of injectibles this cycle. She tried clomid last fall but I'm guessing she didn't respond because they monitored her alot and only did a few cycles of it. She plans to do 6 cycles of injectibles with IUI and if they don't work, they're moving to adoption because they don't have any IVF coverage.

[Dori]

Good luck today Andrea!

[Chantal]

Hi Andrea... my next step is to start Femara this cycle I would strongly suggest that you ask your RE about that, before going to injectibles....

Injectibles come with the risk of hyperstimulation of the ovaries... not to mention the discomfort of needles. Now - they are effective... proof is in the posts here at OUAL by women who have used them.

I, personally, am happy with the idea of Femara. There is alot of great info to support its effectiveness - in particular, with women who have higher body fat masses.... aka: ME. On the flip side -- the women here at OUAL who have been put on injectibles, also had failed Clomid AND Femara cycles.

Good luck!!!!

[Kaybee711]

Your RE may want to keep trying the clomid because they have different protocols. Plus you have started additional medications as well right? For me, it was tamoxifen after clomid which worked- yeay! Then injectibles which didn't work. The last thing is IVF. You would think they could come up with some more less expensive procedures.

[schwanda]

I didn't respond to clomid or femara. We did injectibles with IUI.

Amanda

[Suzi]

Femara and Tamoxifen have the same action and Femara has the same affect as Clomid without the NASTY s/e. Many REs will try Femara after Clomid, some won't even bother. Before that though, I'd guess that the RE would want you to do Metformin before going on to injectables if she does suspect PCOS as you could have results with the help of Metformin. Not to mention that you just started the synthroid...I think injectables are a ways off for you yet.

But....after all the things I mentioned, it's injectables... you don't need them...

[Michele]

De-lurking to ask probably a stupid question...

Isn't Tamoxifin the breast cancer drug? My Mother is on it and my good friend who is going through treatment will be on it soon. Both of them say that it causes menopause b/c it blocks hormones. So, how does it help with infertility? Just curious...

[Suzi]

Yes, tamoxifen is the breast cancer drug. Tamoxifen is an anti-estrogen (as is Clomid) and it actually increases fertility/ovulation rates. Whereas Clomid works on the pituitary gland to develop follicles, Tamoxifen acts directly on the ovary and therefore it's possible that follicular development may be better. Researchers have found that some women respond better to tamoxifen (specifically those diagnosed with PCOS) and some respond better to Clomid.

[~Andrea~]

it's almost 2 am, so I will be back tomorrow (today) with an update. The short of it is, nothing yet, see how the synthroid works, see PCP and get on metformin/glucophage and hope that makes me O on my own. If not more clomid Of course I did get PG on clomid with Gabrielle so I shouldn't complain

[Kathryn]

glad to hear the appt went okay

[sunnyflower]

I just saw this and wanted to pop in. We did 6 months with clomid and then were going to go onto GOnal F, but I got pg just in time. WHen did you start the synthroid? I just started taking it and it has been a big help to me in regards to mood and such. My SIL started taking it and then 3 months later was pg. I think it really helps with balancing all of the hormone levels!

Hope your appt went well.

~Kerrie

[Chantal]

Andrea... I am on 112mcg of synthroid... have been for 2 years now... I am also almost 5 months into taking 1500mg of Metformin. The Met is supposed to amplify how Clomid works on the body. I don't have insulin resistancy issues - but was given the Met to work with the Clomid. I never did O on my own with just 3 months of using Metformin. But they say that it typically takes about 3 months for your body to start getting the full effect of the drug.


I hope that the combo of the 3 drugs is what gets you pregnant

[Michele]

Originally Posted by Suzi

Yes, tamoxifen is the breast cancer drug. Tamoxifen is an anti-estrogen (as is Clomid) and it actually increases fertility/ovulation rates. Whereas Clomid works on the pituitary gland to develop follicles, Tamoxifen acts directly on the ovary and therefore it's possible that follicular development may be better. Researchers have found that some women respond better to tamoxifen (specifically those diagnosed with PCOS) and some respond better to Clomid.

Thank you Suzi! My friend with breast cancer was told that she could not get pregnant for the 5 years she will be on Tamoxifen. She is freaked out b/c she really wants to have kids and was given the impression that it would harm her fertility. If you take it for infertility, do you stop once you are pregnant (maybe that's why she shouldn't get pregnant, b/c she can't stop taking it)?

*I realize that you are not a doctor, you just seem really knowlegable on this topic!
**Sorry to hijack this thread with my questions!

[Suzi]

Actually, it is not advisable to get PG while on tamoxifen for treatment of BC because tamoxifen may cause damage to developing embryos. For this reason, your friend should not try to get pregnant during her 5-year course.

It sounds contradictory that tamoxifen can be used as a fertility drug but that it's harmful to developing embryos, but it's not. As a fertility treatment, tamoxifen is used to stimulate the ovaries to get more eggs ready for ovulation. At this point in the process, the eggs have not yet been fertilized - and tamoxifen does not damage unfertilized eggs. It's only AFTER the eggs are fertilized and become embryos that tamoxifen may have a harmful effect.

Your friend can talk to her doctor about her 5-year course of tamoxifen and her specific risk for BC recurrence. Depending on her age, there are options for her to go off the tamoxifen in 2 years and TTC. In the meantime, the tamoxifen is NOT having any ill effect on your friend's fertility!

[Michele]

Originally Posted by Suzi

Actually, it is not advisable to get PG while on tamoxifen for treatment of BC because tamoxifen may cause damage to developing embryos. For this reason, your friend should not try to get pregnant during her 5-year course.

It sounds contradictory that tamoxifen can be used as a fertility drug but that it's harmful to developing embryos, but it's not. As a fertility treatment, tamoxifen is used to stimulate the ovaries to get more eggs ready for ovulation. At this point in the process, the eggs have not yet been fertilized - and tamoxifen does not damage unfertilized eggs. It's only AFTER the eggs are fertilized and become embryos that tamoxifen may have a harmful effect.

Your friend can talk to her doctor about her 5-year course of tamoxifen and her specific risk for BC recurrence. Depending on her age, there are options for her to go off the tamoxifen in 2 years and TTC. In the meantime, the tamoxifen is NOT having any ill effect on your friend's fertility!

Thank you! That is what I kind of thought, but wasn't able to put into words that well. I'm going to tell her to ask her doctor about a 2 year course...she is very depressed about having to wait at least 5 years to TTC.

[Suzi]

I wish your friend the best of luck!!

[Chantal]

Tamoxifen and Femara (Letrozole) are short lived drugs... meaning they leave the body soon after the last dose. That's one of the BIG reasons they are used in fertility treatment - because once conception occurs... the medication has already left the body


I start my first Femara cycle next week... hopefully its my last

[Suzi]

Chantal, good luck with the femara...I know many women have no luck with clomid and get PG with femara. And the BIG bonus is the nasty clomid effects are negligible with femara (not to mention IF you have any, they stop as soon as you quit taking it!). and