Clomid and IUI
silli_kitti - May 6th, 2005 10:26 AM
[ Original Post ]

We've been TTC naturally for 3 cycles without success. Because of my age (37), we decided to go to the next level of treatment and were advised to do clomid and IUI.

I've had my first IUI, but am concerned about my treatment this cycle. I had u/s on cd 11 which showed 2 follicles 12 and 20 mm. Had my second u/s on cd 16, follicles were 24 and 39 mm. Bloodwork over cd 11-16 showed normal, steady E2 rise (but dropped to 825 on cd 16) and steady LH but at high level (19, 24, 26, 29, 27, 31). I was triggered on day 16 with HCG injection, was told no intercourse until the IUI which was done on cd 18.

Is my baseline LH too high?
Does it matter that my E2 dropped before the HCG injection?
Does it matter that my follicles were so large (I've read that 18-22 mm is ideal)?
Is the 39 mm follicle post-mature?
How does all this affect my chances of success?

I know this is a very stressful time, and I've been reading too much on the internet about this subject, but somehow I feel like this cycle was a waste of time because I was not monitored properly and my hormone levels were sub-ideal and my follicles post-mature.

Comment


 

Barry Jacobs, M. D. - May 6th, 2005 6:37 PM

Clomid is a very poor product. Only about 15% to 20% of patient become pregnant on Clomid, and almost all of those become pregnant in the first 3 to 4 treatment cycles. The published data imply that Clomid can impair fertility in women who are already ovulating. There are much better products to use. At 37, you do not have much time to waste. For more information, I invite you to see our web site at <www.texsfertility.com>.
Good luck.


silli_kitti - May 9th, 2005 7:51 AM

Thank you for your response. I have visited your website.

However, I was hoping you might clear up my worries this cycle (my first) by answering, if possible, the specific questions I posted. To tell me that Clomid is not a good product when I'm in the middle of a Clomid cycle and worried sick about it is neither helpful nor hopeful.

If Clomid is really such a bad product with a poor success rate, why is it so widely used? I realize it is most one of the most cost-effective treatments, but surely the medical world is not making women wait needlessly and suffer psychologically for so many months, especially since the initial cost savings actually turn into bigger costs when the treatment fails and more expensive options are sought.

Furthermore, I read the section entitled "If I only knew then" which quotes "previous patients" stating they had been on clomid for 5 and <gasp> 15 years! Both my OB/GYN and my RE, as well as my pharmacist, have stated that Clomid is a good start, but should not be used for more than 4 or 6 cycles (i.e., about 6 months) since further treatment is not beneficial, but more importantly, because long-term use of Clomid has been linked to ovarian cancer (or was it cervical cancer? I really just honed in on that C word), though conclusive studies have not been conducted. I was shocked (and now I'm just skeptical) to read you had encountered someone who was on Clomid for 15 years!