# Whats the next step after clomid in UK?



## cbmd

Ive done three round of clomid all of which were unsucessful.
Been put on Metoformin for 3 months to see if that works (have pcos) not overweight though. It did seem to give me a more regular cycle last month, however not sure about this month.
When i go back to F/S he said he would maybe next step check my tubes arent blocked but other than that didnt say if there were any more steps we could take.
Is IVF the only next option or there are other options inbetween?
I wouldnt be eligible for IVF so just wondering if i would have to pay to try privately
x


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## StephieB

I'm currently about to start my second round of clomid after having a month off (I had a bit of a breakdown last time AF showed up and _vowed_ I was giving up TTC...that lasted about 4 days but too late to take this cycles Clomid :blush:)

I think its difficult to say what will be next because every single FS seems to have a different route they go down, just to keep us on our toes I think! Having said that we are 'unexplained' so have had SA, TV Ultra Sound, HSG etc... and everything has come back clear so they threw Clomid at me. I believe our next stage after 4 months of Clomid would be IUI before IVF, but I know in some instances if doctors don't think you have an increased chance with IUI they will go straight for IVF. 

:shrug: Sorry that really wasn't much help was it! But I would say they would check your tubes and if everything comes back clear IUI?? 

I find it a bit strange they haven't checked for any blocked tubes already before prescribing Clomid though, it sort of defeats the object of your ovulating on Clomid but theres still a blockage?


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## cbmd

that really helped!! I nearly gave up ttc this month, i just felt like it had taken over my life, i am sick of temping, peeing on sticks, bd'ing when we cant be bothered and getting nothing for it!! i didnt really like clomid but stuck it out.
my fs is rubbish i think, he just shoved me on clomid without investigating anything. which is why sometimes i feel like paying private although im not sure we could really afford it.
i reckon when i see him in july he will say ivf is only option, although for some reason he now wants to check my tubes! its like its all in reverse!
how long have you been ttc for?
xx


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## StephieB

We have been TTC for, erm...26 months now I think (I've lost count!) 

The way its been for us is when we first went to the GP he sent DH straight for a SA and me for an ultrasound to check for PCOS and blood test after blood test, and they came back absolutely fine, then we saw the FS who just took a bit of history and said she was sending me for a HSG, that came back clear, then we waited another two months to see the FS again and she practically threw Clomid at me. I'm not too sure how convinced I am with the FS, we honestly waited 4 months for an appointment to walk into the room, she said "How often do you have sex"..."Heres 4 rounds of clomid" and sent us on our way. I don't think she looked up from the desk! :shrug: so even though we've been investigated, I too feel like we've been prescribed Clomid just to keep us quiet for a few months! 

We've been told by our new GP that we shouldn't be taking Clomid because theres no physical reason we need it, but I still can't bring myself to through them away, so I'm defying doctors orders currently :haha:

We're annoyingly changing FS as we've recently moved to a new area, so it's going to be a while before we get another appointment I think, so we're looking at trying to 'relax' until around November I think, and no doubt we'll be told something completely different by a different hospital then!! Bah! 

Are there any indications that there is anything wrong with your tubes? If it helps, having a HSG is supposed to help as it kinda blows all the cobwebs away, so it could be a blessing in disguise!? 

:flower:


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## Kyla

Hi, I saw your post and wanted to share my LTTTC journey with you to give you some hope.

I got my bfp last week after 2 years and 3 months of trying, this is my 2nd baby and my DH's first. We weren't eligible for IVF because I already have a child.

I have PCOS with a high BMI and was referred to FS who prescribed Clomid after DH's SA was normal. After 8 doses and hit and miss ovulation, I was advised to go for a Lap and Dye test to check for blockages (as pp says it sometimes clears away the cobwebs too). I also had Ovarian Drilling/Diathermy done in December. This is where they punch holes into the ovary to break up the thick capsule around it seen in PCOS patients and makes you more likely to ovulate or respond to treatment.

After the op, I was given a couple of months free of any fertility medication, although a lot are put/kept on metformin, while my hormones settle down. I still wasn't ovulating on my own, so last month I was given the choice of either further Clomid which my body would better respond to, or to try Femara/Letrozole at 5mg along with 1700mg Metformin. I opted for the Femara for a change. I'm happy to report that it worked on my first Femara cycle.

So, don't give up hope. I know I was close to giving up many times, it's so hard a journey to be on. See what your FS has to say about the lap and if s/he recommends ovarian drilling in your case. It may be that a higher dose of Clomid is all that is needed, but the lap will help to reassure you. There are other options before IVF, such as IUI and injectable fertility drugs with a trigger. Good luck on your journey :hugs:


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## cbmd

stephie - i have no idea whats wrong really, im a similar boat to you. I get told different things, i was diagnosed years ago with pcos from my high testosterone levels, then years later my bloods came back as normal. Some scans on my ovaries show cysts other dont! so im assuming i have pcos, i do have some of the other symtpoms so i probably do. i have no periods at all since coming off bcp about 4 years ago, ive had a few forced on with provera and clomid made me had one about day 50 each time. my fs is pretty much the same as yours, he just says 'i really dont think there is a big problem we will get there in the end'.....'heres 3 months of clomid' and thats without any other investigations. so im not sure if i have any problems with my tubes, like you say cant do any harm can it? its just so frustrating, im such an impatient person and years of ttc really bugs me :)

kyla- first of all congratulations that amazing, really does make us remember it can happen! thanks for all the other informations as well. id never heard of femera or injectables. i wish you a happy and healthy 9 months :)

xxx


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## FutureMama1

Hi Ladies! I was on Clomid for 6 months (2011) and was told that as this did not work, the next step would be IVF. When I went to my IVF consultation they told me they wanted to try Gonal F injections with TSI for up to 3 months, I have just started my 1st month. 

If this does not work they advised IVF will definitely be the next step, FX this works as I really don't want to have to do IVF :(

xx


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## smallstar

cbmd - I live in the Kent area in the UK and as StephieB has said i think it depends on where you live and what FS you see!! I am yet to see any two fertlity journeys through GP and FS be the same if im honest!!!

For us it was off the b/c pill and then 9months TTC then saw doctor as my priods were very irregular, she said to wait it out as it can take up to a year for cycles to return to normal! and i wouldnt be seen for any tests for infertility until a year. At the year mark saw doctor again he then sent other half to get SA i then had various blood tests, ie 21day etc, and then i had an internal vaginal scan (not pleasant!!!) :( post this and finding nothing wrong i was referred to a FS who then booked me for a Hycosy (like lap and dye test) injects dye into your uterus to check for blockages, found nothing wrong, then prescribed me clomid for 6 months, had ONE check to see if i had ovulated or was able about to ovulate - blood test and internal scan!!!

Everything came back fine and now i am in "grey" area of not knowing what the hell is wrong with me!!! :(

We are not eligible for IVF until 3 years of trying...and other than that we have not been offered anything else other than possibly additional clomid and just continue to try!!!

Joyful UK NHS!!!!

x


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## FutureMama1

smallstar said:


> cbmd - I live in the Kent area in the UK and as StephieB has said i think it depends on where you live and what FS you see!! I am yet to see any two fertlity journeys through GP and FS be the same if im honest!!!
> 
> For us it was off the b/c pill and then 9months TTC then saw doctor as my priods were very irregular, she said to wait it out as it can take up to a year for cycles to return to normal! and i wouldnt be seen for any tests for infertility until a year. At the year mark saw doctor again he then sent other half to get SA i then had various blood tests, ie 21day etc, and then i had an internal vaginal scan (not pleasant!!!) :( post this and finding nothing wrong i was referred to a FS who then booked me for a Hycosy (like lap and dye test) injects dye into your uterus to check for blockages, found nothing wrong, then prescribed me clomid for 6 months, had ONE check to see if i had ovulated or was able about to ovulate - blood test and internal scan!!!
> 
> Everything came back fine and now i am in "grey" area of not knowing what the hell is wrong with me!!! :(
> 
> We are not eligible for IVF until 3 years of trying...and other than that we have not been offered anything else other than possibly additional clomid and just continue to try!!!
> 
> Joyful UK NHS!!!!
> 
> x


Smallstar, I am in the same situation. The waiting list for IVF in Dundee is 3 years!!! I have only been on the list since March this year so got a long way to go :(

Just hope Gonal works because I really don't know If I can keep going with this, it is so stressful and definitely takes over your life.

I went for the same tests as you, they have told me that I do not ovulate due to low level hormones?! They had high hopes for me on Clomid as I was ovulating but after 6 months, I still did not get pregnant?! So confused!!!

xx


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## smallstar

FutureMama1 - Im not even eligible for the waiting list UNTIL i have been trying for 3years!! Seems like forever away :( and then the possibilty of the actual waiting list being 3years + :( So disheartneing isnt it....just thinking about it is so sad.

My FS and doc said that because i was having irregular periods and was not falling pregnant after 12months that it was likely i was not ovulating on my own therefore prescribed me clomid. I did ovulate with clomid well the blood test showed high level of progeterone and the internal scan schowed ripe follicles, but it did not conceive after 6 clomid cycles. I have 3 more clomid months left, tablet wise if i want to take then, but i decided to stop at 6 months in Decmeber last year....just got too much for me :( 

So since January i have just left it to good old (unreliable) mother nature!!! periods are starting to look like they may be getting back to some normality and i have a test end of month to see if i am NOW ovulating on my own but im not getting my hopes up....seriously feel like my body and brain is fried before ive even really started....i never in a million years thought TTC would lead me into LTTTC and it would be so difficult....
x


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## FutureMama1

smallstar said:


> FutureMama1 - Im not even eligible for the waiting list UNTIL i have been trying for 3years!! Seems like forever away :( and then the possibilty of the actual waiting list being 3years + :( So disheartneing isnt it....just thinking about it is so sad.
> 
> My FS and doc said that because i was having irregular periods and was not falling pregnant after 12months that it was likely i was not ovulating on my own therefore prescribed me clomid. I did ovulate with clomid well the blood test showed high level of progeterone and the internal scan schowed ripe follicles, but it did not conceive after 6 clomid cycles. I have 3 more clomid months left, tablet wise if i want to take then, but i decided to stop at 6 months in Decmeber last year....just got too much for me :(
> 
> So since January i have just left it to good old (unreliable) mother nature!!! periods are starting to look like they may be getting back to some normality and i have a test end of month to see if i am NOW ovulating on my own but im not getting my hopes up....seriously feel like my body and brain is fried before ive even really started....i never in a million years thought TTC would lead me into LTTTC and it would be so difficult....
> x


It seems we have a similar issue......I do not ovulate on my own either and I have irregular cycles, anthing between 28-75 days!!

Tests revealed that I have a hormone imbalance and that is the reason I do not ovulate. Clomid was prescribed and tests showed that I was ovulating however after 6 months I still did not get pregnant :cry:

NHS must be different in England? They never said anything to us about having to try for 3 years before we can go for IVF?! I know how frustrating it can be, nothing ever seems to happen quickly!! Long waiting lists followed by delays in starting meds, it can get very annoying :grr:

So you have been given 9 months worth of Clomid? I only got 6 months, mind you, I don't think I could have coped with the mod swings and hot sweats any longer! 

How long have you been trying?

x


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## smallstar

FutureMama1 - Yeah think NHS must be different in England but like i said also i have not come across two stories the same about docs and FS!!! Its like a pot luck who you get what they say and do!!! :growlmad:

I was given 6 months initially but my FS said that i could go on for 9 months so prescribed me three more months but i havent taken them....like you the mood swings, and generally feeling yuk with it, plus the STRESS of it all got too much for us :cry:

We have been actively trying since May 2010 but came off b/c pill March 2010....what about yourself?

x


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## FutureMama1

smallstar said:


> FutureMama1 - Yeah think NHS must be different in England but like i said also i have not come across two stories the same about docs and FS!!! Its like a pot luck who you get what they say and do!!! :growlmad:
> 
> I was given 6 months initially but my FS said that i could go on for 9 months so prescribed me three more months but i havent taken them....like you the mood swings, and generally feeling yuk with it, plus the STRESS of it all got too much for us :cry:
> 
> We have been actively trying since May 2010 but came off b/c pill March 2010....what about yourself?
> 
> x

Smallstar - I've been trying for 3 years now and have been getting assistance for about 12 months. I have never once fell pregnant and never tested + on an OPK!:growlmad:

Clomid was apparently helping and I was ovulating but I never got a BFP. The one thing i did not really like was the fact that the Dr's kind of left me to it. With the exceptioin of the first month, there were no mid-cycle tests or anything so I felt like I never really knew what was happening! 

I am now on Gonal F with TSI and I'm always up at the hospital for scan's! I've been 5 times already and I'm only on CD15!! Things are moving slowly but really hoping this works!! They will give me a trigger to ensure I ovulate and will tell me when we need to :sex: FX we get a :bfp:

It is a lot of work for all us Ladies and very tough to live with! New medication/month means new hope which is good but I can't take the disappointment. I always try to tell myself not to get my hopes up too much but it's hard. :headspin:


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## lady luck12

cbmd said:


> Ive done three round of clomid all of which were unsucessful.
> Been put on Metoformin for 3 months to see if that works (have pcos) not overweight though. It did seem to give me a more regular cycle last month, however not sure about this month.
> When i go back to F/S he said he would maybe next step check my tubes arent blocked but other than that didnt say if there were any more steps we could take.
> Is IVF the only next option or there are other options inbetween?
> I wouldnt be eligible for IVF so just wondering if i would have to pay to try privately
> x

Hi cbmd, I was told my left tube was blocked, but when they operated via key hole they found I had endometriosis, and it's only now I've been put on clomid myself.
I would ask for an investigation via key hole to see what's going on, and you might be able to have IUI before IVF. Good Luck & :dust:


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## cbmd

thanks so much ladies......seems like from what you all say nhs are different. Im going back to f/s on the 4th July so will see if he will do that dye thing maybe to see whats going on. he refused to give me more than 3 months of clomid not sure as he doesnt really say much.
i had much better cycles on clomid...i actually had one 28 day cycle even though dont think i ovulated but before i had about one period every two years!!!! 
xx


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## lady luck12

definatly push for the lap & dye hun. Since being referred to my consultant I have turned into a proper nag but it has helpped to get things moving in the right direction, coz I think they believe we have PLENTY of time to get pregrant, and they are in no rush to do things.
All the best xx


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## cbmd

thanks will do...i think your right about putting your foot down. i feel like im in and out in 5 mins and dont ever really talk about anything, its like he just wants me in and out as fast as he can, he doesnt even re read my notes and he clearly cant remember what hes done with me before. i dont like him really but i actually got told by the gp hes the head fertility specialist!! which i find unbelievable.
ill let you all know what he says...knowing him to get rid of me he will just say ivf knowing too well im not eligible! x


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