Clomid/Trigger Shot Question

[LibbyLou]

Hi ladies...I know a lot of you have experience with getting trigger shots to induce ovulation, so I'm hoping you can help.

I'm on CD 27 of my first Clomid cycle with no ovulation yet. I'm taking 1000mg of Metformin daily for PCOS, and I took 50mg of Clomid on CDs 5-9. I have a gut feeling that I'm going to need a trigger shot to actually ovulate with the Clomid. Is that something that my OB/GYN would be able to do, or will I need to see an RE for that? My OB/GYN is the one who diagnosed me with PCOS and put me on the Metformin and Clomid. I have an appointment with him on July 1st, but if I'm ultimately going to need to see an RE I'd like to go ahead and try to make an appointment because I know they can be hard to get in to see.

I'm keeping my : that upping my dosage of Metformin and/or Clomid is enough to induce ovulation, but I'd like to think ahead in case it doesn't. Planning makes me feel like I have at least a little control in this whole process.

[biomama]

I have my clomid cycles monitored by ultrasound, so they know what's going on with the follicles. They time the trigger shot based on when I'm about to ovulate anyway, and they can tell that my U/S (and I tell them what my OPKs say).

I would say you may want to get in to see an RE. They can do a lot more monitoring and have a better idea of what will work best for you. OBs are not really trained to do all of that.

Good luck, and keep us posted!!

[dachshund mom]

I'm new to all this - first clomid cycle here - but I have been reading a lot about it and I'll give you my opinion.

OB/GYNs seem to just try clomid unmonitored to catch the easy cases. Mine offered it without even doing a u/s to check for cystic ovaries, but I personally wanted more monitoring and went to an RE (NO multiples for me ). It sounds like the clomid didn't work for you and your dr will prescribe progesterone to restart a new cycle when you go on the 1st.

If you want to trigger, you'll need to go in for ultrasounds to see if there are any eggs to release. They only work for a few days, so say you randomly do it on cd12 but don't have mature follicles until cd20, it does no good. They seem to be used mostly for people doing IUIs so they can time it better, although I did buy one because I too was doubting my body's ability to release an egg. I'd be nervous about uping the clomid dose without going in for an ultrasound anyway.

I've seen two REs and both gave me a cycle plan. Progesterone, clomid, ultrasound and trigger, prog and pregnancy test, and a set day to restart progesterone if I didn't O. I like having a plan as opposed to the "here's some clomid, come back in a month" approach.

I just O'd on cd30 after having no follicles on cd12 and cd14. I don't know how common that is though, since I was about to start progesterone again on cd31. I'm still shocked. Are you mucousy? I had 6 days of mucous and an almost positive OPK the day before O.

Sorry, I'm unfocused and rambling right now (5dpo pregnancy symptom?!?!).

[LibbyLou]

Originally Posted by dachshund mom

I just O'd on cd30 after having no follicles on cd12 and cd14. I don't know how common that is though, since I was about to start progesterone again on cd31. I'm still shocked. Are you mucousy? I had 6 days of mucous and an almost positive OPK the day before O.

I've had a day or two with watery CM, but no EWCM at all...mostly creamy. (Lord, I never thought I'd type a sentence like that...lol) It does concern me a little that the OB/GYN isn't monitoring me with ultrasound. I had some mild symptoms of OHSS after the Clomid, but I was out of the country so I couldn't go to the doctor about it.

My only hesitation with making an appointment with an RE is that the closest RE is a 2-hour drive from where I live. How many visits do you typically have to make during a cycle? I haven't told anyone at work that we've started fertility treatments, so I have to come up with excuses every time I have an appointment. I think I've already been to the "dentist" twice this year.

[lifeguard]

I went through an ob/gyn. I did clomid cd5-cd9. She then did an ultrasound on cd15 - follicle just starting. Another ultrasound on cd18 & one follicle. It was at that point that I got the trigger shot. We were very fortunate & conceived on the first cycle.

I know it is not uncommon for ob/gyn's to prescribe & wait to see what happens but that doesn't work for everyone as you may ovulate (or just develop a follicle) later in the cycle then anticipated meaning your timing will be off.

I personally liked the constant monitoring as I know it is not recommended that you do more than 6 cycles of clomid in a row & I was quite certain it wasn't going to work.

[LibbyLou]

Thank you for all the feedback. It is really helpful. I've decided to ask my OB/GYN to monitor the next cycle with ultrasound. If he is unwilling/unable to do that, then I'm going to seek out an RE.

[dachshund mom]

Originally Posted by LibbyLou

My only hesitation with making an appointment with an RE is that the closest RE is a 2-hour drive from where I live. How many visits do you typically have to make during a cycle? I haven't told anyone at work that we've started fertility treatments, so I have to come up with excuses every time I have an appointment. I think I've already been to the "dentist" twice this year.

I told my boss because all the initial bloodwork, HSG, gtt, all that, was taking some time. I also changed REs so I went through it twice. Now though, I'll only be seeing my RE once a cycle for the cd12 ultrasound. My insurance doesn't cover infertility (except diagnosis), so we've worked out a deal where I pay the $300 for the ultrasound and get a consult with him at that appt. He did the cd14 for free this cycle and he calls in my prescriptions.

I recommend you call and talk to the nurse to find out their usual cycle plan. My second RE is so great and walked me through what they usually do, but was completely willing to work with me if I wanted to change something.