clomid info

A lady mentioned to me she was about to start on clomid, she said she'd
have one ultrasound first cycle and then she'd on her own.

What I remember from this group is that this is not a great idea and the
the ovaries should be monitored by ultrasound 48hrly to check there is
no hyperstimulation, so intercourse can be avoided and the risk of
multiples reduced.

I explained this and mentioned the poor outcomes for higher order
multiples, to which her response was she didn't mind - I feel like
yelling back you'd mind if you lost the whole brood in the 2nd
trimester, but there is little point if I can't provide some links to
decent information.

I also recall there being a lifetime limit on how much clomid you should
take, is that correct?

Can anyone provide me with a link to some decent information I can send her.

Cheers
Anne

"Anne Rogers" wrote in message
. ..
A lady mentioned to me she was about to start on clomid, she said she'd
have one ultrasound first cycle and then she'd on her own.

What I remember from this group is that this is not a great idea and the
the ovaries should be monitored by ultrasound 48hrly to check there is no
hyperstimulation, so intercourse can be avoided and the risk of multiples
reduced.

That is sort of correct, but as we know, most OB's don't do that. It is
rare to hyperstimulate from Clomid. Hyperstimulation is usually referred to
during IVF cycles, when the ovaries produce 20+ follicles, and way way way
too much estrogen, and it can cause very severe medical problems for the
mother. Clomid doesn't tend to do that, rather, produce several follicles,
from 3-8. Multiples is the obvious problem with this, as you stated,
although the majority of them are twins or trips, as far as I know. I mean,
there may be quads or more from Clomid, but they aren't the most common
outcome.

It's also used to check and see that the dose prescribed is actually
working. You always want to start on the lowest dose possible (50 mg) and
work your way, up if necessary. You can go to 100 mg, or 150 mg. Because
of the lifetime limit, if 50mg isn't working for you, you want to know as
soon as possible so you can use a higher dose next cycle. Clomid actually
works by blocking the follicle stimulating hormone (FSH) receptors, so your
body produces more FSH, thus stimulating your follicles to produce more.
Once you are blocking that receptor, it doesn't matter if you take a higher
dose of Clomid, you don't get any added benefit. It's like filling a hole
with a bucket of dirt, and then adding another bucket. The hole is still
filled after the first bucket of dirt, the second bucket just sits on top
doing nothing.

I would guess that is why her doctor is going to monitor her first cycle, to
see how she is responding to the first (and I assume lowest) dose. If she
only makes 1-2 follicles on the lowest dose, she is not likely to suddenly
make 7 on the next cycle. But, if she hasn't gotten pregnant in 3 cycles of
clomid, her odds of getting pregnant in the second 3 cycles are slimmer than
they were before.

I explained this and mentioned the poor outcomes for higher order
multiples, to which her response was she didn't mind - I feel like yelling
back you'd mind if you lost the whole brood in the 2nd trimester, but
there is little point if I can't provide some links to decent information.

I also recall there being a lifetime limit on how much clomid you should
take, is that correct?

6 cycles in a lifetime, although many OB's do not seem to follow this. But
then they don't follow the u/s monitoring advice either. If possible, they
shouldn't be in a row. Clomid tends to progressively reduce the thickness
of the uterine lining, although only while using it, so you should probably
take a break after 3 cycles to allow your lining to grow thick and happy
again.

Can anyone provide me with a link to some decent information I can send
her.

I'd Google clomid and see if you can find a website for a RE -- reproductive
endocrinologist. Their websites can be very informative.

Sorry I can't cite anything, I just have all this fertility information
rattling around in my brain from the past 10 years!
--

Jamie
Earth Angels:
Taylor Marlys -- 01/03/03
Addison Grace -- 09/30/04

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Password

It would also depend on the country that you are in also. I was in Clomid
in the UK and the only monitoring that occurred was during the first month
for progesterone (to see if you ovulated) and any other month where the drug
was increased. Also in NZ as far as I am aware there is no monitoring with
ultrasound.

I'm not sure what the strict following of the treatment in the US but not in
these other two countries as I assume that the dosage is going to be the
same (ie 50, 100 or 200mg) Most likely resources are lower in the UK and
here so they do not have the ability to monitor everyone.

Also as far as I am aware yes the risk of multiples increases with Clomid
but something like 5-10% higher chance of twins and 5% (sorry long time ago
memory failing) of triplets. Also Clomid is not a drug where the more you
take the more you necessarily respond. eg some women respond at 100mg but
not 50 or 200. I respond at 50 but not 100mg. It's a drug that tries to
even up the initial hormone response at ovulation so that all the other
hormones and processes fall into line and increase the odds of a successful
ovulation. But because the drug amounts a smaller you are more likely to
achieve ovulation without risking multiples, unless of course you get a
women that would say respond quite adequately at 50mg but also responds VERY
well at 100mg and 200mg but the doctor puts her straight onto 200mg without
trying lower doses first. I think that's the kind of situation where you
could run into bigger problems with multiples.

Lastly I also was aware of the 6 cycles per lifetime limit and in the UK one
cycle was 3 months but that of course would vary from country to country and
even county/state to county/state.


--
Pip, in NZ

My girls :
DD1 Jasmine - 5 weeks early - March 02 - 4lb 12oz
Still as small as a peanut but as smart as a whip!

DD2 Abby - 8 weeks early - Feb 05 - 3lb 14oz
Two and a half and still a terror!!

"Yes you can drive me insane just by talking to me!"

"Anne Rogers" wrote in message
. ..
A lady mentioned to me she was about to start on clomid, she said she'd
have one ultrasound first cycle and then she'd on her own.

What I remember from this group is that this is not a great idea and the
the ovaries should be monitored by ultrasound 48hrly to check there is no
hyperstimulation, so intercourse can be avoided and the risk of multiples
reduced.

I explained this and mentioned the poor outcomes for higher order
multiples, to which her response was she didn't mind - I feel like yelling
back you'd mind if you lost the whole brood in the 2nd trimester, but
there is little point if I can't provide some links to decent information.

I also recall there being a lifetime limit on how much clomid you should
take, is that correct?

Can anyone provide me with a link to some decent information I can send
her.

Cheers
Anne

Anne Rogers wrote:
A lady mentioned to me she was about to start on clomid, she said she'd
have one ultrasound first cycle and then she'd on her own.

What I remember from this group is that this is not a great idea and the
the ovaries should be monitored by ultrasound 48hrly to check there is
no hyperstimulation, so intercourse can be avoided and the risk of
multiples reduced.

I explained this and mentioned the poor outcomes for higher order
multiples, to which her response was she didn't mind - I feel like
yelling back you'd mind if you lost the whole brood in the 2nd
trimester, but there is little point if I can't provide some links to
decent information.

I also recall there being a lifetime limit on how much clomid you should
take, is that correct?

Can anyone provide me with a link to some decent information I can send
her.

A couple of links to blog posts by mothers of multiples, detailing some
of the downsides:

http://raisingweg.typepad.com/raising_weg/2004/10/trying_not_to_s.html
(Triplets)

http://twinklelittlestar.typepad.com/letter/2006/10/the_truth_about.html
(Twins)

It is only fair to point out that a) I could find you a slew of posts
from parents who are thrilled with their experiences of parenting
multiples rather than singletons, and b) both of these women *did* have
monitoring following fertility treatment, so it's not as though these
posts are exactly pro-monitoring accolades. But if you think she needs
to hear about the downside of conceiving multiples before making her
decision - well, there it is.


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

"That which can be destroyed by the truth, should be" - P. C. Hodgell

Sarah Vaughan wrote:

A couple of links to blog posts by mothers of multiples, detailing some
of the downsides:

http://raisingweg.typepad.com/raising_weg/2004/10/trying_not_to_s.html
(Triplets)

http://twinklelittlestar.typepad.com/letter/2006/10/the_truth_about.html
(Twins)

Oh, another one (less personal, more statistical):

http://allthis.typepad.com/allthis/2006/11/the_ivf_ethics_.html


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

"That which can be destroyed by the truth, should be" - P. C. Hodgell

On Sep 7, 11:43 am, Anne Rogers wrote:
A lady mentioned to me she was about to start on clomid, she said she'd
have one ultrasound first cycle and then she'd on her own.

What I remember from this group is that this is not a great idea and the
the ovaries should be monitored by ultrasound 48hrly to check there is
no hyperstimulation, so intercourse can be avoided and the risk of
multiples reduced.

I explained this and mentioned the poor outcomes for higher order
multiples, to which her response was she didn't mind - I feel like
yelling back you'd mind if you lost the whole brood in the 2nd
trimester, but there is little point if I can't provide some links to
decent information.

I also recall there being a lifetime limit on how much clomid you should
take, is that correct?

Can anyone provide me with a link to some decent information I can send her.

Cheers
Anne

what do you like to do

It is only fair to point out that a) I could find you a slew of posts
from parents who are thrilled with their experiences of parenting
multiples rather than singletons, and b) both of these women *did* have
monitoring following fertility treatment, so it's not as though these
posts are exactly pro-monitoring accolades. But if you think she needs
to hear about the downside of conceiving multiples before making her
decision - well, there it is.

thanks, I was kind of hoping for a balanced report of "best practice" in
dealing with such drugs, though maybe there isn't one, it seems like
there is wide variation of what different doctors are doing currently, I
think this lady is so desperate to conceive that she'll believe anything
- she had a laparoscopy not long ago to check stuff, which I gather is a
pretty normal thing when investigating infertility - but then discovered
today that she hadn't actually been tested to see if she's ovulating,
which I'd thought was pretty much the first thing you did, the kind of
thing a GP would do before even referring someone to a fertility
specialist. When there are news articles about higher order multiples,
they often say the women was using fertility drugs but rarely say which
ones, I've managed to find out that both the sets of sextuplets born on
10th June were following use of follistim, but I doubt many women are
are thinking, hmm, clomid, well, that increases the risk of multiples,
but higher order ones are rare, so that's fine, but must avoid
follistim, that can cause sextuplets! It seems like many naively believe
that their doctor wouldn't prescribe anything that might cause a problem
- yet multiples are scarily common in the US, there has been a lot of
press about the increased number of multiples in the UK, but I'm pretty
sure that the problem is far worse over here. Pip mentioned no
monitoring following clomid in the UK - but I'm pretty sure it's used
far far less often, so the lack of monitoring balances out. It actually
seems like British fertility doctors are being pretty thoughtful, but
many consider that even the increase in twins isn't acceptable, here,
there have been a few thought provoking articles following the two lots
of sextuplets on the same day thing, but barely a mention of lower order
multiples, fertility medicine seems much more of an industry here, the
kind of thing that gets advertised on the side of buses, it almost seems
like exploitation, thankfully, I haven't been through infertility, but
I'm sure my guess of how desperate I would feel is far below the genuine
depth of emotion, I'm sure I'd cling on to any hope a doctor could give
me of conceiving. Again, I've not been close to anyone who's gone
through loss or severe complications of multiples, so my guesses of how
devastating some of the occurances must be are likely to be
underestimates that are too painful to even imagine. The reporting of
the poor outcome for the Morrison family seems unusual for here,
probably only making the news because of the coincidence of two sets of
sextuplets on the same day, yet as one by one they died (it seems one is
still alive in a critical condition), the news swiftly moved on to the
anticipation of the arrival of Florida's first sextuplets, born on 1st
September at 29+4.

Anne

"Anne Rogers" wrote in message
. ..

It is only fair to point out that a) I could find you a slew of posts
from parents who are thrilled with their experiences of parenting
multiples rather than singletons, and b) both of these women *did* have
monitoring following fertility treatment, so it's not as though these
posts are exactly pro-monitoring accolades. But if you think she needs
to hear about the downside of conceiving multiples before making her
decision - well, there it is.

thanks, I was kind of hoping for a balanced report of "best practice" in
dealing with such drugs, though maybe there isn't one, it seems like there
is wide variation of what different doctors are doing currently, I think
this lady is so desperate to conceive that she'll believe anything - she
had a laparoscopy not long ago to check stuff, which I gather is a pretty
normal thing when investigating infertility - but then discovered today
that she hadn't actually been tested to see if she's ovulating, which I'd
thought was pretty much the first thing you did, the kind of thing a GP
would do before even referring someone to a fertility specialist. When
there are news articles about higher order multiples, they often say the
women was using fertility drugs but rarely say which ones, I've managed to
find out that both the sets of sextuplets born on 10th June were following
use of follistim, but I doubt many women are are thinking, hmm, clomid,
well, that increases the risk of multiples, but higher order ones are
rare, so that's fine, but must avoid follistim, that can cause sextuplets!
It seems like many naively believe that their doctor wouldn't prescribe
anything that might cause a problem - yet multiples are scarily common in
the US, there has been a lot of press about the increased number of
multiples in the UK, but I'm pretty sure that the problem is far worse
over here. Pip mentioned no monitoring following clomid in the UK - but
I'm pretty sure it's used far far less often, so the lack of monitoring
balances out. It actually seems like British fertility doctors are being
pretty thoughtful, but many consider that even the increase in twins isn't
acceptable, here, there have been a few thought provoking articles
following the two lots of sextuplets on the same day thing, but barely a
mention of lower order multiples, fertility medicine seems much more of an
industry here, the kind of thing that gets advertised on the side of
buses, it almost seems like exploitation, thankfully, I haven't been
through infertility, but I'm sure my guess of how desperate I would feel
is far below the genuine depth of emotion, I'm sure I'd cling on to any
hope a doctor could give me of conceiving. Again, I've not been close to
anyone who's gone through loss or severe complications of multiples, so my
guesses of how devastating some of the occurances must be are likely to be
underestimates that are too painful to even imagine. The reporting of the
poor outcome for the Morrison family seems unusual for here, probably only
making the news because of the coincidence of two sets of sextuplets on
the same day, yet as one by one they died (it seems one is still alive in
a critical condition), the news swiftly moved on to the anticipation of
the arrival of Florida's first sextuplets, born on 1st September at 29+4.

Anne


I haven't heard any of these stories about the recent multiple births.
Interesting. I had no idea that there were two sets born on the same day in
June, nor that any died, nor that any were expected in Florida in September.
I wonder if the population where you live is much more demographically
focused on fertility issues?
--

Jamie
Earth Angels:
Taylor Marlys -- 01/03/03
Addison Grace -- 09/30/04

Check out the family -- www.MyFamily.com, User ID: Clark_Guest1, Password:
guest
Become a member for free - go to Add Member to set up your own User ID and
Password

"Nikki" wrote in message
news:jbOdnRpEg7IMaHzbnZ2dnUVZ_jCdnZ2d@prairiewave. com...

"Sarah Vaughan" wrote in message
...

A couple of links to blog posts by mothers of multiples, detailing some
of the downsides:

http://twinklelittlestar.typepad.com/letter/2006/10/the_truth_about.html
(Twins)


Well she is a negative Nelly


I do realize how blessed and lucky I am to have had a complication free
pregnancy and delivery - at term. I was a nervous wreck worrying about
all the risks. I'd rather do them one at a time but I'm having a blast
now that they are here and the scary part is over.


I didn't think she was negative at all. Honest. She has had a much harder
time of it than you have, both during pregnancy, delivery, and with
parenting. You were lucky enough to have an easy pregnancy, but you also
had older children, so you had a better idea of what to expect, and a better
mindset to begin with. I think she was right on, and said many things I
feel sometimes as the mother of two non-twins.

: P
--

Jamie
Earth Angels:
Taylor Marlys -- 01/03/03
Addison Grace -- 09/30/04

Check out the family -- www.MyFamily.com, User ID: Clark_Guest1, Password:
guest
Become a member for free - go to Add Member to set up your own User ID and
Password

I haven't heard any of these stories about the recent multiple births.
Interesting. I had no idea that there were two sets born on the same day in
June, nor that any died, nor that any were expected in Florida in September.
I wonder if the population where you live is much more demographically
focused on fertility issues?

There were two sets on the 10th June, 1 in Arizona, born at about 30
weeks, after delivery the mum almost died of heart failure, the other
set were in Minnesota, born at 22 weeks, amazingly all lived beyond the
first week, but only 1 is still alive. I first saw the story on here, in
the kind of message that I usually skip over, but for some reason I took
notice and googled it and sure enough, the story showed up, I think I
saw it on the BBC website later the same day. Every so often, I googled
it again to see how they were doing and that's when I noticed the
Florida ones. Actually, I think they were on the front page on cnn.com
also. To be honest, I'm really not at all up on anything specific
locally, we don't get a paper, I don't watch TV, the radio station we
listen too doesn't really cover the news. I keep up with the national
news via the America section at the bbc and cnn.com.

Cheers
Anne