QuestionHello,
I am seeing a fertility specialist and I have taken 3 round of clomid, 100mg. First cycle saw no response but the last two had decent size follicles. This was combined with IUIs and I did get pregnant on the third cycle but I miscarried during week 7. After a three month break, we are trying again. My RE was concerned that my lining had thinned too much and has switched me to Femara. Three questions 1) How do cycles length, day of ovulation and follicle sizes vary with the two different medications? 2) How many cycles should I try Femara before switching to injectables? I've heard most people get pregnant within 6 cycles but I wasn't sure how my miscarriage impacted things. 3) With Femara, when is the best time to do an IUI? We've been doing one 24 hours after the HCG shot but I've seen mixed evidence on the best time to do the IUI and I would like your opinion. Thank you in advance for any advice you can offer.
AnswerHello Marie,
Here's the answers to your questions:
1. There is little difference in response to Femara or Clomid.
2. 3-4 cycles. Your pregnancy counts, so you are back to square one in terms of counting cycles. Don't count the first three since you got pregnant.
3. The timing of the IUI is dependent on when the follicles are the appropriate size, not dependent on the medication you take. I recommend doing two IUI's - 24hrs after HCG and 48hrs after.
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.
