QuestionHello - Thank you for taking my question. I am in my 13 cycle of TTC. Both my husband and I are 31. I have never had a pregnancy. This is our fifth cycle charting. My husband's SA is normal. My HSG showed clear tubes.
This is my first cycle doing the clomid challenge (100 mg CD5-9). CD3: FSH=5.1 E2=51 CD10 FSH=5.3
CD13 Ultrasound showed two follicles on the left (~12mm and 17mm), right side= larger follicle (24mm). Uterine lining was 5.3mm (a bit thin).
The RE said that everything looked great and to go ahead with intercourse. He was originally going to offer IUI, but since it is our first cycle on Clomid we want to try on our own with the medication. I am now on CD16 without a positive OPK (started testing on CD10). Everything I read online makes me question my RE about the larger follicle. It also has me questioning how much more time I should spend with this RE. He said that the larger one was great and the other two were a little small. Is my RE right or am I setting up for an anovulatory cycle?
Background: The other four cycles -three of the four I had either a clear therm shift or aligned +OPKs with cervical mucus (tend to O CD17-19). One cycle, temping was a bit wacky post-o and I never saw a +OPK. I also spot right at ovulation (bright red for 3-4 days spotting) and spot leading into my period (sometimes significantly - 6 days before regular flow). I have tried talking to the doctor about my spotting and they are somewhat brushing me off and saying that the clomid should help with it. I am worried that I am wasting my husband's and my time with this doctor. Please help -
Thank you
AnswerHello,
If you don't have confidence in this doctor, then he is not the right one for you. You should see a doctor that you trust empirically.
I think that Clomid is appropriate, as it is the first level of fertility treatment. I do not see any obvious reason for your infertility at this time. However, I use the ultrasound to time intercourse and give HCG to trigger ovulation when I do ovulation induction cycles. This cycle is probably too late, but you might want to ask about that with the next cycle. Usually the dominant follicle would ovulate when it reaches 20-24 mms. If your follicle was 17 mms before, it would take approximately 3 days to reach that point.
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
