QuestionHi Brenda,
I have a history of endometriosis since 2001 and had a course of Lupron and Femara from Feb-July 2007 to treat adenomyosis which was successful. My doc recommended to get pregnant now with the help of clomid in hopes it won't take as long to conceive. All of my labs including but not limited to LH, FSH and progesterone have all been normal. My periods were induced using provera which was unsuccessful so they then prescribed premarin for 21 days. That was a success. So my 1st period after the lupron treatment was 4 days long and cycle length was 35 days. I had another period on my own that started 10/22/07 and that's when I started my first course of clomid 50mg taken on cycle days 3-7. The home ovulation prediction kits never showed an LH surge. But on 11/11 thru 11/14 I felt like I had an ovarian cyst rupture. I had a transvaginal ultrasound on 11/16 which showed some free fluid but no cyst they also saw follicles on my ovaries which we thought indicated I ovulated. Since 11/18 I have had intermittant nausea and vomiting and no signs of a menstrual cycle coming. Also all hpt's have been negative. I'm now on day 41 and wonder if I could be pregnant or would I need provera again to restart my periods. I hope I gave enough information. I've heard that clomid can delay your periods but how long of a delay would there be?
Thanks. So much for your help.
Sincerely,
Tabitha
AnswerDear Tabitha,
With Clomid therapy, ovulation most often occurs from 5-10 days after a course of Clomid. This means that, given a successful course of therapy, you likely would have ovulated/conceived between approximately 11/3-8 (possibly a few days longer with a lengthier cycle duration).
You are absolutely right that the Clomid can delay periods. The length of time can vary, so there is no set answer as to how long the delay can be - especially when you consider that most women, by virtue of the fact that they are taking Clomid in the first place, are experiencing irregular or unpredictable cycles. This is why pregnancy is absolutely ruled out before every single course of Clomid.
The symptoms you describe are hormonal in nature and can also be related to hormone fluctuations within your cycle. That is why it so difficult to "diagnose" a pregnancy based on symptoms alone. You will simply need to test to know for sure. You have said that all HPTs have been negative, however did not say when they were done. Although some tests claim accuracy on the first day of a missed period, I usually suggest that women wait until the week after a missed or spotty period before testing for pregnancy. This typically equates to about 3 weeks after a potential conception date. So, I would not have recommended that you even do a HPT until around 11/29 at the very earliest anyway.
I would suggest waiting another few days and testing again. Make sure to use 1st morning urine to get a concentrated sample for the most accurate results when testing. If those results are negative, your doctor's office will most surely do a quantitative blood pregnancy test (serum beta hCG) before ever starting another course of Clomid. That test will give an actual amount of hCG in your bloodstream rather than just a positive/negative result. Any amount of 25 mIU/ml or more would be considered positive for pregnancy.
I hope this has helped you and answered your question. I wish you well.
Brenda
