So, my New Year’s Eve appointment didn’t go very well.
I had my u/s and my doctor said that my ovaries were not responding to the clomid the way he would like. Basically, I had some follicles that responded, but they were only .5 cm in size, when they needed to be 2 cm. Then he mentioned that after 5 days on clomid I should have shown more progress.
Hold the phone.
Five days?
The prescription I got (that he wrote) was only for four days. He said it wasn’t likely that not getting the 1 extra day of clomid had any real effect on my follicle size, but he went off to do some research.
When he came back he informed me that we are going to try something called the stair-step protocol for clomid. I don’t think he is very familiar with it, but I appreciate that he is trying to make up for screwing up my prescription (and potentially wasting the $500 that we spent on this cycle). Basically the protocol is as follows: start clomid at 50mg on cycle day 4 or 5. Take for 5 days and have u/s. If there is not a good response, immediately start taking 100mg for 5 days. Have u/s. If there is still not a good response, immediately start taking 150mg for 5 days. Because he started me out on 100mg and I had minimal response, we essentially stated on the 2nd step so he started me on 150mg per day for the next 5 days. Right now I’m on day 3.
I have to say with the higher dose I’ve noticed more side effects. I’m nauseous a lot and my boobs have been very tender. I take it at night, and I’ve woken up both nights with nausea. So that really blows.
I have a follow up appointment on Monday for another u/s to see if I responded better to the higher dose. He told me that 150mg is the highest dose because after that there is no difference in response rate. Basically, if I don’t respond to the 150mg of clomid, I’m not going to respond to clomid at all.
Which is another thing he told me. Because we started out at the 100mg, he expected to see more of a reaction out of my ovaries, so he thinks there is a good chance I am clomiphene resistant. He then told me that his office’s protocol for clomiphene resistant patients is IVF. That’s it. No intermediary steps, no other treatments. If I go in Monday with follicles that still haven’t responded, this will be my last round on clomid. On the plus side, it means we haven’t spent 3 or 4 cycles (or $1500-2000) on a treatment that didn’t work. On the down side, husband and I decided before we ever got into this business that we were not interested in IVF.
So, if we find out on Monday that I’m clomiphene resistant, we’re basically done trying to conceive.
I have a hard time even writing that sentence. I guess I honestly thought that we’d come in, do a couple of rounds of clomid (because not ovulating was my only problem) and get pregnant. It never really occurred to be that we’d go through fertility treatments and not come out the other side with a pregnancy. I guess it is needless to say I’m not doing very well emotionally right now. At husband’s urging, I’m trying really hard to stay positive. There is still a chance that I will respond to the higher dose of clomid, and if that’s the case we need to be ready. At the same time, I feel like what little hope I had has been ripped away from me. *sigh*
I’ve done some research online about clomiphene resistance, and there are several studies that suggest there are other medications that can be used with clomid for a better effect. However, based on my Tuesday appointment, my doctor doesn’t seem really interested in trying them. So after this cycle we may go get a second opinion somewhere else. Either way, Monday will be a game changer for us.
Keep your fingers crossed for me that Monday goes well.
No comments:
Post a Comment