failed 4th round of clomid- doctor wants to see while af is present

[Overwhelmed]

Hey all. I just finished my 4th cycle of clomid 100mg and AF came yesterday. The clomid is working (great follicle size) but we still haven't conceived. My doctor told me I needed to come in while I was on my period this time, but he didn't tell me why. Has anyone had their doctor tell them to do this? Does anyone know why? I know they want to do the hcg shot this time but I didn't think I did that until like day 14.

 

[LoveCakes]

Hi, the only thing I can think of is to take day 2 bloods? Let us know...

 

[Overwhelmed]

What are day 2 bld tests?

 

[Disneyfan88]

I'm guessing that your doctor wants to collect cycle day 3 blood work and/or check your antral follicle count. Both are common when undergoing fertility treatments.

Your hormone levels would be checked via blood work and can include AMH, FSH, Estradiol, and LH. They may also test your thyroid and prolactin levels.

All of these things can potentially help diagnose a reason for why you have not gotten pregnant yet. Best of luck!

 

[Overwhelmed]

Thank you both. I am hypothyroid so I know that is under control by my thyroid doctor. They did check my prolactin and that was fine. But the others have never been checked. Thank you again.

 

[Overwhelmed]

Now I'm glad I am going to the doctor because AF has decided to act funny. She was light for a day, heavy for a day, then stopped completely for half a day then started lightly for the rest of the day. Totally lost.

 

[Disneyfan88]

Now I'm glad I am going to the doctor because AF has decided to act funny. She was light for a day, heavy for a day, then stopped completely for half a day then started lightly for the rest of the day. Totally lost.

One of the common side effects of Clomid is that it can thin out the lining of your uterus. Your description of AF sounds like it's possible that you are experiencing such a side effect. My OBGYN, who was the one who originally put me on Clomid last year, eventually prescribed me estradiol pills to take during my 3rd Clomid cycle in an attempt to counter that side effect.

When I went to see my current RE, she tried me on a cycle of Femara (which we combined with IUI) while we waited for my AMH results to come back from the lab. Femara works similarly to Clomid, but my doctor prefers it as it does not thin the lining of the uterus. My AMH results came back low, so we decided to go straight to IVF for the next cycle.

 

[Overwhelmed]

Thank you. That is very helpful. I will ask about it tomorrow with my doctor. I know when I was on 50 the lining was fine but my LP was only like 10 days, which is why they increases me to 100. I never thought to ask about the lining on 100.

 

[Disneyfan88]

Have you had your tubes checked to make sure that they are clear/open? If not, that's something else that you can ask your doctor about. Good luck!

 

[Overwhelmed]

I have the prescription, but they keep telling me to hold off. One issue is because infertility is not medically necessary, it is not covered by insurance. But since I had an ectopic last year I could have a blockage, which means they are trying to recode the prescription as a tubal blockage. The RE around here does not have very good reviews and when I talked to them they didn't seem too concerned with anything but making money.

 

[Overwhelmed]

So doc gave me a prescription for the hcg shot for day 14 and another round of clomid 100. He did his own pregnancy test which was bfn but took a beta quant just to be sure. He also got a bunch of history they didn't have before.

Do you know when I should pick up the hcg shot from the pharmacy? And about how much does it cost?

 

[Disneyfan88]

So doc gave me a prescription for the hcg shot for day 14 and another round of clomid 100. He did his own pregnancy test which was bfn but took a beta quant just to be sure. He also got a bunch of history they didn't have before.

Do you know when I should pick up the hcg shot from the pharmacy? And about how much does it cost?

The hCG cost will differ according to pharmacy and possible insurance coverage. When I inquired about the price of mine, it was around $100 USD.

The hCG shot should be timed for just before ovulation. Many people do not ovulate on cycle day 14, so I'm a little surprised that your doctor asked you to trigger on a specific day. When I did Femara with trigger and IUI, my doctor told me to use ovulation tests to determine the timing of the trigger. My protocol involved me testing until the test was "close to positive" (where the second line was getting close to positive but wasn't yet as dark as or darker than the control line). At that point, I was to call the office, go in for an appointment to check my follicles, and bring my trigger shot with me. That's when they would tell their patients when to trigger and also show them how to do.

I'd go ahead and get the trigger shot now so that you have it available when you need it.

Good luck!

 

[Overwhelmed]

Thank you. I go in in day 14 to have my follicles checked. He said to bring the shot with me and as long as my follicles are good (day 15 since 14 is a Sunday) he will do it there. Last cycle I had 3 follicles all over 22. The cycle before I had 2 follicles at like 20 and two at 18.

 

[Disneyfan88]

Thank you. I go in in day 14 to have my follicles checked. He said to bring the shot with me and as long as my follicles are good (day 15 since 14 is a Sunday) he will do it there. Last cycle I had 3 follicles all over 22. The cycle before I had 2 follicles at like 20 and two at 18.

Do you normally ovulate around the same day / day 15? I'd maybe recommend still tracking your ovulation with tests (twice a day) and calling to go in sooner in case it looks like you might ovulate before day 15. If the tests show that you still haven't ovulated, you'd still have your day 15 appointment setup. I'd hate to know that you bought the trigger shot and couldn't use it because you already ovulated.

 

[Overwhelmed]

That is a good idea. I usually o after day 15. One of the reasons they want to do the trigger. Usually it is like day 17 or 18 and then period is day 27 or 28. They increased the clomid to try to extend my LP, which is did this past month- finally to a 13 day LP.