Combo of Clomid and Injectables?

[calinina]

Hello,
Has anyone done a combo with clomid and injectables? I've done clomid for 4 cycles, and got pregnant 1 out of those 4 cycles, but had a cp at 6 weeks. I also did a cycle with femara and got a bfn with only 1 follicle. My doctor wants me to move on to IVF and skip injectables because she thinks I'll overstimulate on injectables, so we compromised to do CD3-7 on clomid and CD8-9 injectables. Has anyone done this? I'm thinking to do this combination for 2-3 cycles and then consider IVF. I'm hoping and praying doing this combo will bring on another BFP!

 

[messica]

If you only ended up with one follicle on femara why does doc think you'll overstimulate?

I've not heard of combining, as far as I know you either do one or the other. I would assume doing injectables after the femara is already on board would make you far more prone to overstimulation.....



Curious if this combination proposal is coming from an actual RE or if your doctor is just a run of the mill OB/GYN?

 

[calinina]

@Messica- Congrats to you @the twins!

Although I only had 1 follicle with femara, I usually have 2-3 follicles with clomid. Since I'm young and usually start off my cd3 scan with about 20-30 follicles, my doctor thought I would definitely overstimulate if I did injectables..she actually prefers me going straight to IVF. However, since IVF is pricey, and I know I can get pregnant, I've decided to do a combo approach with clomid/FSH because the injectables will give me a boost- I'm hoping to have 3-4 mature follicles..so we'll see..oh and my Dr is an RE.

 

[messica]

20-30 antral follicles is a completely normal number. Your response to clomid having 2 or 3 follicles mature is perfect and absolutely no indication of any kind of risk of OHSS. What about those numbers was your doctor concerned about?

If you were pushing 40ish antral follicles that would be a different story. But if that were the case you'd also be considered a poor candidate for any kind of FSH injectables. Even low dose would be extremely risky.


Why does doc think you need IVF if you're responding so well? Seriously, many women would LOVE to have such beautiful numbers! They're glorious! Is MF an issue?

 

[calinina]

@Messica, you are so sweet!
DH has morphology- 5.4% and his count is usually between 16-30k so no real issues there...we're in the unexplained category. The only reason my doctor kept giving me about going straight to IVF and not doing injectables was her fear of overstimulation but I guess we'll see how I respond..
Did you have unexplained infertility?

 

[messica]

There's nothing wrong with exhausting all options before diving into IVF! Your doctor knows you best, and I definitely don't know every option out there so what you're trying may totally be your lucky combination. You never know how any given cycle is going to go so don't lose hope no matter which route you end up taking

MF was our issue. I had my first two more than 10 years ago getting pregnant with both first time I tried while in a previous relationship. My husband and I tried on our own about a year and a half before doing the testing and it was pretty bleak. Lowerish count with mid morph and pretty crummy motility. I started meds, more targets, higher odds - then we gave IUI's a try, more targets, less travel for swimmers, higher odds - and then we ultimately moved onto our only shot at IVF. We were very VERY lucky to ultimately be blessed with our boys


I hope you update how these next cycles go. Since it's not a common protocol it could be helpful for anyone else who tries a similar route.

 

[calinina]

@messica, I'll definitely share my updates
Also, why did you decide to skip injectables and go straight to IVF?

 

[messica]

@messica, I'll definitely share my updates
Also, why did you decide to skip injectables and go straight to IVF?

The point of meds like clomid, femara and injectables is to induce hyperovulation. As I had a good solid response on hyperovulatory pills there was no reason to do hyperovulatory injectables too.

If hyperovulatory pills *don't* induce hyperovulation, if estrogen is super low and there's little to no chance they'll work, if egg quality or lining is a concern or you're experiencing terrible side effects, then injectables are typically tried as a last resort because of how expensive they are. They didn't offer me any edge up on conception or implantation so there was no reason for me to try them outside of utilizing IVF/ICSI at the same time.

12 medicated/triggered cycles was enough. It was pretty obvious our swimmers needed a helpful intervention, not the eggs lol

 

[calinina]

Thanks so much for all of that information. We'll see what happens with this cycle. I'm on CD 6 and have a terrible headache from the Clomid..I'll start the 2 days of injectables tomorrow. Excited to see what will happen this month