Moving on to injectibles

I've just come off 3 cycles of Clomid without a pregnancy.


All cycles gave me multiple excellent eggs at 20mm but my luteal phase was always a problem. My endo lining was getting thinner by the month because of Clomid, making it difficult for implantation.


Any advice as to what I should do next?


- Take a 1 month break and go back to Clomid? I heard a break will help with the endo lining.


- Doc is suggesting that I move onto injectibles, which means I start injections tomorrow.


- I plan to get a HSG this month and heard that it gives great results in the first 3 months. Should I not go for the break this month?


What do I have to look out for with injectibles? I wasted my first month on Clomid without going for any monitoring coz I didn't do enough research. Anyway know which is better FSH or HMG? Doc is suggesting FSH, but my sister with PCOS had success with HMG. Tests show I should not have PCOS.

Hi Ears,

Did you had HSG or Diagnostic Laparoscopy yet to check your tubes conditions, sometimes not only clomid causing our lining thin but the blockage tube will cause us having an ectopic pregnancy.


You should a break from job or holiday can help with fertility. Besides practise relaxation technique & Yoga could help to maintain weight.


FSH is more common, but since your sister having PCOS conditions, you might have it too. Discuss with your doc whether assessment needed thru lapro = key hole surgery is needed.


As you knows, PCOS could inherited with unexplain gene or uncure or no solutions yet. But thru lapro surgery our chances of pregnancy will increase from 15% to 70 % if you're below 32yrs old (to get boy).


Before any FSH or HMG is started, surgery assessment is needed to correct problems for block tube, cyst, ovarian cyst, or cancer could be detected too.


regards,

Before you move onto surgery (even though laparascopy is considered minor surgery), you should discuss it thoroughly with your doctor. I know that laparascopy can be effective where there is heavy endometriosis and also where ovarian drilling may be necessary, but from what I read there is a high risk of some level of adhesions. Have you had any symptoms of endometriosis? Has your doctor given you an HSG test to see if your tubes are blocked? If they are not blocked, perhaps, it would make sense to try the injections. You should mention that your sister has PCOS, since the condition often runs in the family. Many women with PCOS don't have outward symptoms and only find out about they have PCOS after they fail to conceive. Ask your sister what dosage of injections she received - if you do have PCOS and don't know it, you might be at increased risk of ovarian hyperstimulation, and the doctor will have to monitor you carefully.


I also tried 3 months of IUI on Clomid unsuccessfully. My lining also became thin due to the Clomid. I got a second opinion from another doctor who said that the only thing he would have done differently is put me on injections (at a low dosage, as I had one incidence of hyperstimulation on Gonal-F). I have not yet decided whether to go for IUIs (on injections) or IVF, but I will not be going back on Clomid, given its negative effect on my lining.

Guys, thanks ever so much for the info and advice!


I went to see another doc today for a second opinion and arranged for a HSG on Saturday since I'm on CD3 right now. He also suggested that I take a month or 2 break so that my lining can recover. I read that the chances of conception right after a HSG can be higher so I'm wondering whether I'm wasting this cycle if I do the HSG without any ovulation induction.


As for the PCOS, I did do some tests a year ago. They didn't find any small cysts on my ovaries. And bloodwork at the beginning of the last 2 cycles shows that my FSH is twice as much as my LH level which is the reverse of PCOS. So for now, I will rule PCOS out.


The doc I saw today also recommended FSH over HMG. He said something about HMG being manufactured from humans so there is increased risk. Whichever they decide to use will depend on hormone levels at the beginning of that cycle.


The doc also said that because I had been on the BCP for nearly 10 years that would most likely have damaged my uterus lining to some degree. He says that I should never have used Clomid in the first place.