Tuesday, December 16, 2008

Sigh

Well, I had my Clomid consult today, and it served only to totally frustrate me. The doctor I saw today, the "fertility expert" in the new practice I'm going to, thinks that I don't have a luteal phase defect at all, despite what two other doctors have suggested. She thinks I've just had bad luck twice, and that the low progesterone levels I had early on in those losses were just indicators that the pregnancies were failing, rather than being the reason the pregnancies were failing. I've heard this theory online from many different medical sources. Basically, as the doctor today told me, even the top experts in the field of infertility disagree on whether low progesterone is a cause or an indicator of miscarriage.

She said she thinks luteal phase defect is "overly diagnosed" and that if that were truly what I have, a, I wouldn't have been able to carry Adelay without help, and b, the progesterone supplements I took would have saved the pregnancies that I lost. She thinks my problem is that I have a delay in my ovulating process, which is causing the DNA in my eggs to deteriorate before I finally release them, which is then causing poor quality conceptions that can't develop. This delay obviously doesn't always happen, but maybe more often than not it does. I do frequently experience kind of drawn-out, painful ovulation cycles, which seem to go on for days and days instead of being over in thirty six hours or whatever.

She pointed out that several days ago when I had my ultrasound, my follicle appeared just two or three days from being ready, but my cervix was clearly far from being ready. And it's only just today that I'm beginning to feel the pain in my side that always indicates ovulation is imminent. Which means that follicle has just kind of been swelling and swelling, waiting, and meanwhile the health of the egg is suffering. I guess. That is basically what I gleaned from the discussion. Has anyone ever heard of this or had this problem themselves?

She said she didn't think Clomid was strictly necessary in my case, that Adelay is proof that I CAN conceive naturally and not miscarry. But she said that given my history of loss, and especially since I responded so well to the low dose of Clomid I took to conceive Eli, that taking Clomid is probably what she would do if she were wary of another miscarriage. She said she'd have me come in on day fourteen of my cycle, and if I hadn't ovulated on my own yet even with the drugs, she'd give me a shot to make sure I did in time to preserve the health of the egg.

I am so confused! I mean, I'm kind of relieved that I don't HAVE to take Clomid if I don't want to. I'm not DOOMED to repeated miscarriages without it. But they are significantly more likely, apparently. So what do we do? Leave it to chance and hope for the best one more time? Or say better safe than sorry and take the drugs?

13 comments:

Jess said...

Wow, this is all so complicated! But it does sound like she knows what she's talking about, and it's good that she's giving you full information so you can make an informed choice instead of telling you that she knows what you have and forcing the drugs on you.

Still, I don't know what to do. I guess I don't know much about Clomid. Personally, if the low dose of it makes it more likely that your eggs will be viable and you won't have to go through another miscarriage, then it seems really worth it unless the side effects are horrible. I'm just remembering your last post and how you were saying that you do not have the emotional energy to go through that experience again. To me, not knowing the negatives of the Clomid, it sounds worth it.

d e v a n said...

I took Clomid to conceive O, for the same-ish reasons. Although, I didn't need it for the baby or for d, so I don't know how necessary it was.
I'd do it again though, even though I did NOT care for the side effects.

d e v a n said...

I took Clomid to conceive O, for the same-ish reasons. Although, I didn't need it for the baby or for d, so I don't know how necessary it was.
I'd do it again though, even though I did NOT care for the side effects.

Swistle said...

Oh so confusing! I think what I would do is peel away all the parts I didn't understand, leaving only the doctor's advice---since presumably the doctor DOES understand.

Shelly Overlook said...

Huh? Is it just me or is what she said sort of conflicting? Maybe I'm just easily confused, but I just don't follow her logic or explanation given your history. Not that I'm a doctor, of course. I'm sorry, though, that you're having to deal with this.

Mommy Daisy said...

Wow, like you needed more to think about. Maybe you need to go back and ask some more questions.

Personally I steer away for medications & stuff as much as possible. But, I haven't had a misscariage either, so that makes it a completely different ballgame.

Also, if you don't mind, can you e-mail me? I'd like to ask a few questions about your OB/Gyn if that's OK. I've been looking around for one (no, I'm not pregnant).

Jess said...

Since using the Clomid can increase your chances of having multiples, I would weigh the risks vs. benefits for you and your family. Will it ease your mind to tyake the Clomid? Will it cause stress because of the possibility of twins? Can you emotionally handle the possibility of another miscarriage? Can you handle emotionally handle the thought of twins?

If it were me, I wouldn't take the Clomid, but that's easy to say when I'm not in your shoes. I personally couldn't handle twins (well I'm sure I would figure out a way to if I had to), and wouldn't want to increase my chances.

I think you and Jim just need to figure out what is best for your family.

Jess said...

Sorry for the typos and grammar mistakes. My brain is fried.

Bird said...

Damn these doctors talk a lot, right? Ugh.

If it were me (and it totally isn't), I'd want the drugs. Of course, I'm sure they cost money and have side effects and everything. Even so, I've got a controllling streak and would want the good stuff. Again, I'm not you, I'm just saying what i would want.

I say, do what your heart is telling you.

Bird said...

Ack! Now I'm reading what other say about multiples and that is a good point.

This is hard. I'll say a prayer for you as you make this decision.

Astarte said...

I think I would take the Clomid. If you don't, and have another miscarriage, you'll beat yourself up over not doing it.

Annie said...

Yes, supposedly the earlier you ovulate, the better the egg. I have very, very long cycles, and I was given clomid fairly early in the TTC process to try to get ovulation within a decent time frame (day 14-21, rather than day 60). I took clomid for 7 months, and it made me miserable--total emotional basketcase, headaches from hell, and major bloating/ovulation pain. My friend who was also going through fertility treatments also had a rough time with clomid. Unless you really need it, I don't recommend it. The risk of multiples is pretty low if that's a concern. If you use the clomid for 3+ cycles, it will dry out your cervical fluid, which is why a lot of couples then move on to IUI. The clomid didn't work for us anyway after all of that. We took a break from clomid and went in for a consult with an RE and were going to start injectables, and lo and behold, that is the cycle we got pregnant.

Annie said...

Just wanted to add that I have never heard of clomid helping to prevent miscarriage--it really is meant to enhance ovulation. It is not expensive if that is a concern, but again, the side effects are not worth it IMO. We are in talks about a third, but I won't do clomid again. Of course, everyone is different, and you should definitely do what is in your family's best interest!