QuestionHello, I am a 30 year old female and I have always had very irregular periods (since age 14). When I was a teenager I had a 9 mo battle with anorexia but I have since fully recovered and am at a healthy BMI. I have been on Bcontrol since age 17 and have been trying to conceive for over 1 year. Have been tested for early menopause and that was false. I've also cut out caffeine, transfats, reduced my exercise, and started yoga. I just had my first round of clomid and one follicle grew to 12.9mm and then stopped. Is this normal? Also, what should I do next? My husband and i want to be aggressive with treatment. We've heard that some recovering anorexics need more than just clomid to help. Thank you for any help you can offer
AnswerHello Chrissy,
I think that Clomid is the first level of treatment for you, but the dosage needs to be tailored to your body. It sounds like the dose used in this cycle was inadequate. The next step would be to increase the Clomid. It is recommended to start Clomid at 50 mg per day and increase each month by 50mg if there is no response. However, I go a little faster. I start at 100 mg, go to 200 mg then the max dose of 250 mg. If that doesn't work then I try a medciation called Femara (Latrezole) 5.0 mg. If that doesn't work then you need to go to injectable medications, and you might want to consider to proceeding to IVF in that case, because you might stimulate too much and have too many eggs to ovulate naturally.
If you are in a hurry and want more aggressive treatments, then you should see a fertility specialist, not a general Ob/Gyn. The specialist in this case is someone who does all levels of infertility treatments, including IVF. Don't go to an IVF only clinic, however. That's just as bad.
I hope this helps,
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.
