Need some clomid advice STAT!

[oasis84]

In the last couple of days I've been diagnosed with PCOS (due to irregular periods and an elevated AMH of 8.1) and prescribed 1500 mg of metformin and 100 mg cd 5-9 of clomid. DH and I -- both 29 -- have been ttc for 6 cycles. I have no other symptoms of PCOS (I weigh 107 lbs, no hair or skin issues). The doc did an ultrasound two weeks ago and saw what he thought might be a couple of cysts but everything else looked fine and dandy. I already ovulate on my own, confirmed via sustained temp shift. Generally I O on about CD 18 or 19 but I can and do have cycles that last upwards of 40 days.

My question is: I'm leery of taking 100 mg of clomid as I understand most docs prescribe 50 mg first and am considering just doing the 50 this month and if that doesn't work moving on to the 100. I feel like the doc was a little overzealous with the meds and I don't want to cause problems down the road bc I was prescribed more clomid than I might need. We also definitely do not want multiples so I'm worried about that too. On the other hand, if 100 mg really increases our chances of conceiving then I feel like I should just bite the bullet?

This is all happening so fast and I'm definitely not the type of person who likes to take medication or has complete faith in modern medicine. I'm grateful these interventions are there when we need them but it's starting to feel like a runaway train and I'm feeling a little sad the process hasn't turned out as natural and free flowing as I'd hoped it would be.

Any advice would be appreciated!

[oasis84]

Anyone?

[jjh5351]

I'm sorry I have very little knowledge of clomid- as I haven't been prescribed it thus far. I just thought I would bump for you! Maybe try in the infertility board, I know many of those ladies have probably tried clomid many times! Good luck!

[andaluza]

I think you are right to wonder why you would need to take the larger dose right off the bat. Can you discuss that with the doc? Is the doc going to do a blood test on a certain cycle day to confirm if you ovulated on the clomid? Personally, if you are questioning the clomid from the start, I would ask for a blood test for progesterone to try to confirm ovulation that way, then decide about clomid. I became more informed only while I was in the process of ttc and actually don't know if I was indeed ovulating on my own prior to doing 6 mo of the pill and then 3 months of lowest dose of clomid. I got pregnant the month I stopped the clomid (I stopped because I had come to question/hate it and my gyn wanted me to stay on it). There was a clomid thread on the infertility board that Vivica started you may want to look for. A few others also got pregnant right after stopping clomid, like me.
I think clomid can be great for some women under the right circumstances, but it seems to me that it is overprescribed. In my case I knew when I wanted to ttc/have the baby, I had a weird period cycle, and was 35 when I got pregnant so my gyn was probably trying to save me some time. What would have happened had I ttc naturally from the start? I'll never know and I'm not certain why my doc never confirmed if I was ovulating on my own before going the bc then clomid route. I wish I had known more about my body when beginning the process.

[oasis84]

Thanks andaluza I'm definitely ovulating on my own -- I get a temp spike every cycle that confirms it and last month I had a progesterone test on 6 DPO that confirmed it -- I think I was in the 40s but can't remember off the top of my head. The doc prescribed clomid bc of my irregular cycles and supposed pcos (diagnosed bc my AMH level was high at 8.1) but I have no other symptoms of PCOS aside from irregular cycles (I'm slim with a BMI of 19, no hair growth or skin issues). In any case he also put me on 1500 mg of metformin.

I did indeed decide to only take 50 mg of the clomid CD 5-9 as opposed to the 100 mg prescribed to me. I'll update this post once I know how it turns out for any women out there in cyberspace who might be facing the same dilemma about whether or not to raise your clomid dosage.

[thezoolife]

Good luck!

[Twomommyfamily]

I know this post is a couple weeks old now, but I'm curious Oasis, what did you do? 

I was prescribed 100mg clomid for this cycle (my first clomid cycle) and I decided to half the dosage. I'm taking 50mg days 3-7. I was worried about thinned lining, multiples, and cysts. I don't have PCOS, I have low-borderline AMH. We wanted to step up our efforts to conceive, but we weren't ready for 100mg yet. I ovulate on my own as well. My RE said that she prescribes clomid days 3-7 for women who ovulate independently and days 5-9 for women who do not ovulate on their own. I really don't know what to expect when we go check the follicles in a few days. 

[oasis84]

Hi twomommy --

I ended up halving the dosage to 50 mg. My doc prescribed CD 5-9 so that's what I did. But I did a lot of research on the internet and most of what I came across seemed to indicate that the difference between 3-7 and 5-9 is individual doc preference. I have read that if you're younger 5-9 is standard bc it produces more mature follicles, while older women are recommended for 3-7 bc it produces more follicles in number. Again, not sure what truth there is in this. 

In any case, I ended up O'ing on CD 15/16 according to OPK/temp spike which puts me right at about 6 days after finishing my last pill.

I'm glad I went with 50 mg bc my side effects were pretty minimal at that dosage but I could see it being more of an issue of the dosage was upped (restless sleep was my biggest complaint). When O came around, I definitely knew it was happened bc of the intense pinching I was getting in my ovaries, but it was nothing I even felt I had to medicate for. 

I'm 7 DPO now so no idea yet if the clomid was successful. If it was -- great. If it wasn't I think I'll still stick to the 50 mg for the second cycle, too. Like you, I do ovulate on my own so I'm worried about multiples and all the other stuff!

Good luck!