Planned Parenthood Services/Clomid?

[L.Mayhem]

Hi all, I'm new to this forum and will try to keep this post brief. I apologize in advance if my intentions go awry. I'm almost 26 with a long history of PCOS and endometriosis. I've been on the pill off and on for about the past 12 years. My endo was diagnosed via laparoscopy about 4 years ago, at which time they lasered tissue from my body.

Last June, while on the pill I began pregnant. At my ten week check up the Nurse Midwife was unable to find a heartbeat, so I was sent for several vaginal sonograms as well as hCG blood tests. They found that my levels were falling rather than rising, indicating a miscarriage. I waited a few weeks, hoping my body would naturally expel, but it was pretty torturous and my body showed no signs of naturally expelling. Rather than having a D&C, I elected to insert Misoprostol tabs to induce the physical miscarriage. Needless to say it was a physically and emotionally painful experience.

Afterward, my partner and I decided we wanted to TTC and our midwife advised we wait one full cycle before resuming our efforts. It took two months for my period to return and for the past 8 months I have only had 3 cycles and only 2 appeared to be even close to regular. I've been trying to track ovulation by charting BBT and using OPKs, but haven't had any luck.

My last cycle began April 7th and lasted about 9 days. It was light and long, but otherwise pretty regular. That indicated I should ovulate around the 21st. My BBT didn't show any temperature increase until this morning. My OPK line was light on the 19th, darker on the 20th, almost as dark as the control line on the 21st and then light on the 22nd, lighter each day until it was nearly invisible on the 25th. We BD'd three- four times between the 18th and 22nd. On the 21st I had very light spotting and light cramping on my lower left side. I believe those are signs of ovulation.

Now, I guess it's just the waiting game. Tomorrow I have an appointment at Planned Parenthood for my annual exam. I want to also ask them about what fertility testing and services they offered. I was wondering if anyone else has seen physicians at PP for fertility or TTC issues and if so, what their experiences were.

My second questions is about Clomid. Does anyone know if PP prescribes Clomid? Also, what are womens' experiences taking Clomid? It seems that Clomid is an appropriate medical intervention for those with PCOS.

Wow, like I said, I suspected this would be long. Sorry for the novel-like length of this first post. Any input, opinions, experiences, kind words appreciated.

[renene1]

why go to PP for services?

L.Mayhem,
I don't believe that PP is in the business of sustaining pregnancies as I'm very aware of their belief in ending pregnancies and a "woman's right to choose". You might really want to seek out an OBGYN that can help you regulate your levels of progesterone and estrogen naturally seeing how your body still may not be back to normal, post-miscarriage.

A friend of mine has been on Clomid and that is prescribed to encourage ovulation but I'm not sure if that's what you would need with PCOS.
Dr. Thomas Hilgers in Omaha, NE specializes in NaPro Technology and is very well versed in hormone regulation and knows all about PCOS and other female issues regarding our cycles. I was on hcG prior to getting pregnant with my son and had to be on progesterone support the whole pregnancy. My boy was 9 lbs at birth! Anyhow, their website is www.popepaulvi.com and you can read up on information they have. There might be someone where you live who specializes in this type of treatment and can help you out.

As an FYI, being on the pill for many years can severely alter your hormone levels and can actually prevent the ability to get pregnant in the future as this removes the ability for your body to make the cervical mucus needed to get pregnant. I learned this from our practicioner here through PPVI. Another FYI is that after having a baby or miscarrying, your body needs to actually have 3-4 cycles to renew the endometrium (lining of the uterus) to be able to sustain a healthy pregnancy. I learned this from my OBGYN at the university hospital.

Best of luck!
Rene'

[bella99]

Actually, PP provides good quality prenatal services in many areas. The fact that they, as an organization, support a woman's right to choose, means nothing in relation to that. Any OB/GYN can do testing and prescribe Clomid, it's a matter of if you have coverage for the testing and medication, although Clomid is actually quite affordable. As far as if they will, they might not, but it doesn't hurt to ask.

From what my OB/gyn and RE have said, fertility is often increased in th 3-6 months following a miscarriage. And many many women, if not most, get pregnany very easily after coming off of hormonal contraceptives.

As far as Clomid is concerned. Yes, it can be a good treatment for PCOS, especially if that also includes having long, irregular cycles. I have been on Clomid and got pregnant once (miscarried) and also got pregnant after a cycle of injectables (healthy baby girl). Clomid works very well for inducing ovulation, but it does have some side effects that can affect one's ability to conceive, one being that it can dry up cervical mucus making the vagina hostile to sperm and two, it can cause a thining of the uterine lining, making it difficult for the embryo to implant, but those certainly don't happen to every woman that takes it. (it can also cause side effects like hot flashes, moodiness, and migraines).

[L.Mayhem]

To Renene1--Thank you for your reply. As Bella99 pointed out, PP does offer family planning services which is not just the right to end a pregnancy, but also the right to sustain a healthy full term pregnancy. I know that PP offers some fertility testing and treatment. I am a full-time student right now so I qualify for free services, that is why I can't go to an OB/GYN or fertility specialist right now. I actually owe a lot of money to my midwife from all the medical bills related to my miscarriage. Unfortunately the insurance I was carrying would have paid all the pregnancy related medical expenses after the birth of the baby, but since I miscarried I owe all the expenses including appointments, blood testing, vaginal ultrasounds, etc.

Bella99-- Thanks for your reply! Unfortunately that 3-6 month window has passed for me. It's now been 8 months with only 3 very irregular cycles. I've tried metformin and that didn't help regulate my cycle, so I'm hoping to learn more about Clomid and some other options at my appointment today. I'm kind of nervous, even though I know it's my right to inquire about fertility services. I am always worried about being judged, etc. But this is the most important thing in my life right now and I'd really like it resolved sooner rather than later. Congrats on your healthy baby girl Can you tell me any more about how injectables work?

[L.Mayhem]

Update: I went into PP for my exam today and was told two weeks ago over the phone that if I was a full-time student with no income of my own that I would qualify for funding. I didn't realize that it was funding from the federal government and apparently if you are not seeking birth control you are not elligible to even have an annual exam! This is NOT a PP policy, but rather a federal goverment policy. So, rather than paying $150 for my annual, I am seeking services through my student health center. More waiting now...

[saimeiyu]

That doesn't surprise me in the least. Although, I'd bet that they didn't give you the FULL truth. You might only be eligible for a birth control exam at PP, but I would think that as a low-income student, you most likely would meet the income eligibility guidelines to be on Medicaid, which will give you the full range of health coverage.

In regards to fertility services at a PP-- I don't think I've ever seen fertility services other than BC offered. They offer prenatal care, but no help in getting pregnant in most places, I think.

[nintendork]

Hello! I have had PCOS for many years and also took BCPs as a treatment. I wouldn't worry about the BCPs causing infertility issues as they actually helped to regulate your already out of whack hormones. I highly recommend taking Metformin; while it may not regulate your cycles it will help with other side effects of PCOS, such as insulin resistance, which would increase your fertility. Also Metformin is VERY cheap, $8.00 for 90.

I love Clomid (even if it does make me a little crazy while I am taking it). I am in my 5th cycle of TTC and took 50 mg of Clomid for 2 cycles and 100 mg of clomid for 2 cycles. The 100 mg worked the best as I actually ovulated! My insurance doesn't cover the clomid, so it cost me $18.00, not too bad. I am also taking progesterone from day 17-BFN or BFP. PCOS can cause a progesterone deficiency which may lead to a luteal phase defect.

I hope someone at your student health center can help you or at least give you a script for the clomid. I remember when I was an undergrad the school offered low cost health insurance as well, which may be worth looking into if you want to ttc.

[goldfinches]

Clomid is a very dangerous drug. If taken for more than 5 or 6 months, it can really adversely affect your health. Please, consider seeing an OB to be monitored if you decide to use it. Self monitoring isn't good at all with it.
I know you're in the very early stages of dealing with treating your PCOS.

Trust me, using a qualified specialist from the beginning will be worth it in the long run.