Had OB/GYN Appointment Today

Mom2Eliz · #1 (**permalink**) 05-26-2005, 07:02 PM

Hi everyone!
I finally got a few minutes of quiet to write to you guys.
Well, the GYN appt. went well. Can I just say I LOVE my Doctor? She is just so wonderful. Not a word about my weight or my age...gotta' love that! Anyway, here's what she said. She looked at my charts and said that I'm ovulating, but "not ovulating right"... that I'm not producing "good eggs" and that I need to take Clomid. She drew some bloodwork (the Hormone Panel, Thyroid Function Test, etc.), and said I would need to get a Transvaginal Sono (Oh man...I hate those!

), and a Pelvic Sono. She gave me a prescription for Clomid 50 mg and wrote out these instructions: The very last part is confusing..I think in her haste in writing it out, she made a mistake. There's something missing. What do you guys think she means? I mean, I will call her to clarify this, but what do you think?

"Start Clomid on CD 5. Take Clomid Daily. Have sex on day 3 of Clomid, day 5 of Clomid, and 2 days after Clomid."

So what does that mean "and 2 day's after Clomid"? Weird. She said that I should take the 50 mg of Clomid for 4 cycles, and if that doesn't get me pregnant, then she will up the dose. She said that after starting on the Clomid, she wanted me to get another pelvic sono (I forgot when I'm supposed to get it done...after the 1st cycle on it?) to make sure my ovaries aren't overstimulated. She told me that I could get bloated or get Ascites (when a lot of fluid enters the pelvic cavity...happens in people with hepatitis too.) if my ovaries are overstimulated which I knew (happened to a Physical Therapist I sometimes work with). She also mentioned that I may have PCOS (except they call it something else nowadays b/c you don't have to have cystic ovaries to have this syndrome). I did have a pelvic sono (normal) and hormone panel (I think normal, or nothing really notable) about 4 years ago..just before getting pregnant with DD. I have always had irregular cycles, so who knows. It may have just been by the grace of God (actually I KNOW it is) that we had DD without really trying and without any meds.
I'm so glad that I made that appt. and got all that taken care of. I have some hope now.
Oh, and some good news. I lost 15 lbs since last year! I was thrilled that I didn't weight more, but losing...woohooo! Now if I can get more off while we TTC...that would be awesome!

I have to get to bed b/c I have to be up at 5am for work tomorrow...arghhh. I see there are some new posts though and I'm anxious to read how you guys are doing. I'll read them now, but won't get to respond until tomorrow. Take care and have good night

Leese · #2 (**permalink**) 05-26-2005, 07:52 PM

Your Dr sounds great. About those istructions, the way I would interpret them is that she meant to bd on day 3 of Clomid, day 5 of Clomid, and then 2 days after finishing Clomid. So if she's got you taking it for 5 days, starting on cd5, you would bd on days 7, 9, and 11. But I would definitely call and make sure you and she have the same interpretation. I've never had a transvaginal ultrasound, but that doesn't sound like a lot of fun,

.

Glad she's watching over you while you're using meds, and great job about the

!!! Congrats on the great appt.

PJ's Mom · #3 (**permalink**) 05-27-2005, 05:29 AM

I just wanted to let you know what happened with me in regards to ttc with clomid. First of all, clomid makes you gain weight and it makes you crazy, but that is certainly worth it if you get that baby. There are a couple of things that I have concerns about. First of all, I am also 39 and have sucessfully had a baby. I did use clomid to conceive him but I truly think we are lucky. We just finished our 4th round of clomid. We decided to go to a new RE because we didn't like the one we were using - he got mad if you asked questions. My new RE said that clomid is not that effective in people "my age". He said that as you get older you naturally produce less estrogen and clomid fools your body into thinking there is less estrogen when your body already has less estrogen. I took what he said with a grain of salt and then reseached it when I got home. I found that clomid is not indicated if you are over 35 (I think this was the age listed, maybe it was 38?). I also read that there was a study done that indicates that the rate of conception for people our age on clomid is 2-3%. Not good. My RE wants me PG asap because as time ticks on, the fertility goes down. He said injectibles are much more effective (especially with the weight issue also). We are going to start injectibles next month if we didn't get pg this time. Another problem with clomid is that it can thin your lining and cause implantation problems and m/c. I think a lot of ob/gyns prescribe clomid because it is about all they can prescribe without sending you to an RE. I hesitated before writing this e-mail because you seem to so upbeat about what she said. Then I thought I wish someone had told me this early on and I might have tried clomid again or I might have moved right on to injectibles. At our age we just don't have a lot of time to have people making bad judgements about what will work. Clomid may work for you - as you can see it did for me but I think we were very, very lucky.

If you do end up taking the clomid, the studies show that you ovulate 5-10 days after taking the last dose. I am cofused as to why she said to bd while you are taking it. I ovulate a little later than usual on it actually. OPK kits do work while after finishing Clomid so I would definately do that to make sure you bd around the right time. IMHO, you should have your follicles monitored (with a transvaginal u/s which is no big deal at all) to make sure it working - I would not wait 4 cycles to have my dose upped. I also would think it would be appropriate to get a trigger shot to be sure you do ovulate the eggs you may have produced. I know people who take clomid and get pg without doing this but again, time is not on your side and I would do anything I could to improve my chances. I also have IUI (intra-uterine imsemination) with DH's sperm because clomid can make your cervical mucous dry up and make it difficult for his swimmers to get "up there". Our RE also said that only 50,000-100,000 sperm actually make it all the way to the follopian tubes and by doing an IUI you put millions there, increasing your chances. Also, our RE said you should not take it more than 6 cycles in you lifetime becasue there are some indications that prolonged use increases the probability of ovarian cancer.

OMGosh - I went on and on and on didn't I? I hope I didn't upset you, that wasn't my intention. Is it at all possible for you to go to an RE? At your age (and I can say that because we are the same age) it is very appropriate if you have been unsucessful TTC this time. If you have any questions, feel feel to email me. Listen - you still have tons of hope. 39 isn't that old and you have already had a successful pg. You chances are pretty good already - I just think you need to at least think about some different options. Hang in there - it will happen!

BabyBrain · #4 (**permalink**) 05-27-2005, 12:05 PM

Yeah, I think you BD on days 7, 9, and 11 for sure, but I wouldn't limit it to that---I think I may be ovulating soon and my DH and I are BDing daily, just to be safe.

Mom2Eliz · #5 (**permalink**) 05-28-2005, 05:03 AM

Thank you, everyone, for your great input!

Elizabeth, you supplied a wealth of information to me...I so appreciate it! I feel, the more I know about the Clomid, the better. We must be educated consumers, even when it comes to having babies! I'm so glad that the Clomid worked for you. I did know about Clomid thinning the uterine lining and it causing hostile CM, but I didn't know that it wasn't indicated or "recommended" in women our age. I really wish we hadn't waitied so long to TTC again...it was foolish. So now I'm wondering..where am I going to find a RE that is "fat-friendly" (Geez, I hate that description for some reason) on Long Island? We have some great hospitals and I know that there is a Fertility Center associated with one of them, but will they take me? I also have to find out what my insurance will allow. We have GHI (we can change to another plan in Sept, but that will be more expensive and we would have to put this off for 3 months alt least). I'll be doing some research the next few days, that's for sure. In the meantime, I got a PEAK on my fertility monitor today so we will try it the old-fashioned way. Who knows, maybe lightening will strike twice

.

Thanks again, everyone. I will keep you posted!

PJ's Mom · #6 (**permalink**) 05-28-2005, 05:47 AM

I am so glad you weren't mad at me. You know if you are going to have to wait to get on better insurance, I think I would go ahead and try the clomid. It is not that it won't work it just is not as effective as injectibles (the injectible sucess rate goes up quite a bit - I forget what he told me. I got a lot of info that day and I can't remember it all). It did work for me - may be it will for you too. If it doesn't then you can go to an RE when you get new insurance (or maybe you rinsurance might cover an RE - I know you are going to find out). As for the fat friendly RE, I am waaaaayyyy overweight and neither person I went to acted like it was an issue. I brought it up with our new guy and he said there is a "magic weight" that people can get pg at and it is different for everyone. I weighed about 220 when I got pg with ds. I weigh about 255 now (trying to lose but clomid makes it almost impossible). My best friend Beth was 260 when she got pg naturally with twins. I am still going to try to lose weight as we go through this process. When I initially called both RE's I was totally blunt about my weight and asked if that was in issue becasue I didn't want to waste his time or mine. Both places said it wasn't a reason to deny tx. I have a friend who works at our local hospital (the largest one) in labor and delivery and I had told her how concerned I was about my weight. She laughed out loud and said that they have people twice my size have sucessful pg's. She said there have been ladies that had to have special beds, special gowns, etc. She said I shouldn't let that stop me from ttc. We all know it is healthier to be thinner but this is all have had my whole adult life (and most of my childhood). Saying I have to lose weight to have a baby was like the impossible dream. I did lose some to have ds but I gained it all back and then some while pg with him. I really don't think I would have gained as much if I had not dieted (hard) before having him. I am trying to do a lower carb diet with lots of lean meats and vegetables (RE recommendation because I asked). I have lost some weight but as soon as I finish the clomid I have seen no weight loss at all and I have been careful and I exercise everyday. Frustrating but it is better than gaining and I know I am healthier. I also want to say something about "waiting so long". I believe that God has a plan for us and I truly believe that my DH and I had to go 12 years to get this particular wonderful perfect baby. He is so good natured and easy going - he rarely cries and when he does he stops pretty quickly. I used to lament the fact that we had waited so long to get help (we had pretty much decided that we weren't going to have kids) but I love my DS so much - in my mind it was perfect timing. I feel that way about this one, too. I am disappointed when I am not pg but I also trust that God is picking out the perfect brother or sister for PJ. If it is meant to happen, it will. Just my thoughts. Anyway, good luck with whatever you do.

Slingnmom · #7 (**permalink**) 05-28-2005, 09:58 PM

Ok is she saying you can only BD 3 times your entire cycle?!

I would think you could BD as often as you'd like

increase the chances I say! Although research has said that at LEAST every other day is best for sperm production instead of everyday.

PJ; One can never have too much information!.

I guess I am lucky. I've NEVER had a problem with TTC and my weight. I weighed 267 when I got pregnant with my last baby, and weighed over 300 by the time that pregnancy ended most of it water retention though

. I wanted to lose wieght for me and am kind of dangling at around 247 right now until I can get motivated again to lose some more. I'd love to lose about 50 more before geting pregnant but I don't know if I can atually get motivated to do so. We'll see.

I've only had ONE doctor be obsessed about my weight and it was the first OB dh and I saw when pregnant with our first. It made my DH so mad (he was with me during the appointment) he just vented the entire way home afterwards. Luckily we were moving anyways so we never stayed with that doctor. The rest never said anything or acted like it was an issue.

Now I birth unassisted so I really don't have a problem with my "attendant" other than keeping him off me when he's horny

which is usually why I am pregnant in the first place

Here's to hoping you are a graduate soon Lisa!

Mom2Eliz · #8 (**permalink**) 06-02-2005, 09:09 AM

Stephanie, I don't think she's limiting it to just those 3 days, but for some odd reason she want's us to DB on those days. It sounds early in my cycle to BD, I mean, I don't usually ovulate until CD 24-26...is the Clomid going to make THAT big of a difference in when I ovulate? I'll do what she said, but I won't restrict BDing. I got the results from BW and my ultrasound back but that will be in another thread