Sorry if I sound silly/ upset anyone, I'm new to ART
I just finished my first IUI with Clomid I had 3 follicles. I'm waiting to find out the results but in the meantime my doctor's nurse ordered me injectibles Gonal F for my next cycle. My REs plan for me was 1 month Clomid + IUI and 2 months injectibles + IUI then IVF. My CD3 FSH was 10.3 we only tested once so far and we've been trying for 1.5 years with nothing. I have a 3 year old who took me a year to conceive naturally with 2 m/c along the way.
I really want to have another baby but I am not sure I can handle twins,my daughter has some developmental delays. My question is, do injectibles up the risk of multiples much more than Clomid. My doctor said Clomid has only a 10% chance of working and injectibles 15%, I want this to work, but I'm so worried about multiples . I was thinking of asking to cancel the injectibles this cycle and only do Clomid +IUI again.
Me-35 DH- 36 9/14/08 TTC #2
Homo MTHFR C677T 3/07 5w 6d 5/07 9w 3d
I am not sure about the statistics on this, so I will speak from my experience and from I've gathered from being on these boards. Generally speaking, I do not think the risks are much different. With both Clomid and injectibles, the idea is that you produce more than your normal 1 follicle per month and that's supposed to increase your chances. I did both Clomid and injectibles, and I had about the same number of follicles each time - sometimes two, sometimes three. I don't think doctors will let you do an IUI if you have four or more follicles that are ready to ovulate, either with Clomid or injectibles. You may be likely to develop more follicles on injectibles than Clomid, at least until they figure out your dosage correctly, but I doubt your doctor would proceed with the IUI if you did. Basically, with either medication you run the risk of multiples, but I think there can be more control with injectibles because of dosage regulation. Also, you can always cancel the IUI/abstain in a cycle where you are not comfortable with the number of potentially viable follicles.
I hope you won't have to even do more cycles because this one worked, however. Good luck!
DH (35) Me (33) Ovulate on my own, no MF issues, infertility unexplained. Failed Treatments: 3 rounds of Clomid (1 IUI); 2 rounds of injectibles (2 IUIs), and one IVF - all with great response but BFN. FET # 1 (November 2011) - 3 5-day blasts transferred (also doing acupuncture) - BFP! It's twins! (Betas: 9dp5dt - 371; 11dp5dt - 726; born at 36 weeks) (Total time TTC = 2 years).
My only knowledge here is what my RE told me about injectibles. She said if they put me on injectibles, they would *only* do IVF, because of the high risk of multiples (like triplets and beyond, I think). And I"m curious about it, because IF my body stopped responding to oral meds, we'd have to switch to injectables. But then on these boards, I see lots of people doing injectables + IUI, so it is something I would certainly ask her about if we ever need to.
Whenever you have multiple mature follicles you have the risk of mulitples (regardless if you are using Clomid or injectables). I was worried about it too. I'm a twin and it scared me to think that I we might have twins. After 2 iuis with Clomid, 1 with Letrezol, and 3 with injectables we had 2 or 3 follicles on all cycles except the second injectables (we only had 1). So far, we have had all BFNs. I test tomorrow for the last iui.
After the first BFN I was always hoping for multiple follicles because this ups the change of actually getting that BFP. We talked about if we did get pregnant with multiples how would we feel. We were okay with twins but not with triplets. We decided if that happened we would reduce the number. I'm not sure if you have talked about that at all or what your feelings are about that avenue, but know that it can be an option for multiples.
I'm glad that we never skipped an iui with 3 follicles because we never got a BFP. Our insurance requires 6 iuis before ivf, with three injectables. If we had skipped any, we would still be doing iuis. Our next step is IVF and we will follow the federal guidelines about the number of eggs to transfer. For us, that would be 2 and we will have a chance for multiples again. This is a risk we are willing to take to get that BFP. I'm not trying to talk you in to do doing an iui if you are scared of multiples. I just wanted to share my story to help you make a decision. Good luck on your journey and I hope you get a BFP!
TTC #1 on and off (but mostly on) since August, 2009
Me: 36 DH: 47 Unexplained infertility.
Clomid June, 2011- BFN
IUI #1 August, 2011 (Clomid/Ovidrel) - BFN
IUI #2 September, 2011 (Clomid/Ovidrel) - BFN
IUI #3 October, 2011 (Letrezol/Ovidrel) - BFN
IUI #4 December, 2011 (Gonal F 75u/Ovidrel/Prometrium 200mg) - BFN
IUI #5 January, 2012 (Gonal F 75u/Ovidrel/Prometrium 200mg) - BFN
IUI #6 February, 2012 (Gonal F 150u/Ovidrel/Prometrium 200mg) - BFN
IVF #1 ET on 5/1/12-transferred 2 5-day blasts, Beta on 5/10/12 was BFP, U/S shows Twins!
I am high risk with a singleton, so when doing fertility treatment for DS, my doctors were *very* concerned about the risks of multiples. They really weren't even crazy about me on clomid but I don't ovulate on my own. For me, clomid only ever gave me one egg, same with femara, but I do think femara is a better option for people concerned about multiples because it tends to normally only give one mature egg. I also did a cycle where I took femara for 5 days and once I had a "lead" egg took follistim to grow it faster for 5 days. (Even on femara and clomid, I had a few cycles where it took me 30+ days just to ovulate.) I would ask about an oral med + injectible combo cycle, which my RE was willing to do, although I suppose some of them are not as flexible.
(This is slightly off topic, but it took me 4 doctors before I found an RE I liked. I got pregnant my first full cycle that he monitored/managed. One of the frustrating things for me were RE's that were very inflexible, like saying they refused to prescribe femara-which is how I ultimately got pregnant with my son who is a perfectly healthy, happy 10 month old- or doctors that would only do oral meds or only do injectibles but not combo cycles, etc. I wasn't going to put up with that crap. While I am very well aware that I am not a doctor, that doesn't mean you have to passively listen and do whatever the RE says, there are plenty of RE's to go around and IMO, the best ones who are the ones who *are* flexible, they see how the cycle is going and adjust/plan from there.)
Me-28 DH-30 --my blog-www.butterflies-and-rainbows.blogspot.com
DD-Olivia, angel baby, 9-28-09, 23+2 wks class I HELLP/severe pre-eclampsia, emergency classic c-section (1.5 years ttc)
DS- April 2011, 36w2d, 7lbs 4 oz, 20 inches. (Stressful high risk pregnancy, lovenox and low dose aspirin and gd, but pre-eclampsia and HELLP-free and perfectly healthy baby.) (femara 7.5 mg, HSG-all clear, trigger cd 14, IUI 38 hours later, circle + bloom= BFP 11 dpo (9 cycles TTC))
DS2-10/12- high risk again with lovenox and LDA, no pre-e or HELLP, no GD
lauraz76:My only knowledge here is what my RE told me about injectibles. She said if they put me on injectibles, they would *only* do IVF, because of the high risk of multiples
This was my experience too. We went straight from Letrozole + IUI to IVF (before we knew that we *had* to do IVF) because of the risk of high order multiples for me. On the lowest dose of Letrozole I made 1-2 good follies. My RE wouldn't even do an injectibles IUI cycle with me because he knew he'd have to cancel it. He was right; my first IVF cycle yielded 24 mature eggs on very low doses of drugs. Obviously the protocol would have been different and I wouldn't have had 24 mature follies for IUI, but I'm sure I would have had too many for my or my RE's comfort zone.
Every patient is different though, and as you know injectibles + IUI are indicated for some people. It depends on your AFC, age, etc. I would discuss and get clarification from my RE, if I was you, before making a decision about the next cycle. Also, a pp made a good point: even with three mature follies on clomid you're at risk for multiples. I wonder why she wants to move on to injectibles since you made 3 follies on clomid? Does it have to do with quality?
Me (34) + DH (38) + 4 furbabies =
TTC #1 since October 2010, see my bio for infertility history
July 19, 2012: FET #1 of the one blast frozen from first fresh IVF-- BFP at 5dp5dt!! beta #1, 6dp5dt = 20; beta #2, 12dp5dt = 412 (DT = 34 hours); beta #3, 14 dp5dt = 907 (DT = 42 hours). EDD April 6, 2013. It's a !
April 19, 2013: born 41w6d at 9lbs6oz!