School me on OPK's & Clomid

brij2006 · September 2013

I started Clomid today, and will take it for the next 5 days. My Dr wants me to begin OPK's 5 days after my last pill.

So someone explain this to me, because I'm getting conflicting information. I've read to test in the morning, test in the afternoon, and another one said to test at night. One place said to not pee 4 hours before testing, and another place said it doesn't matter.

Now I feel like I'm just going to be peeing on things everytime I go to the bathroom. So when taking Clomid, when should I start testing, what time of the day do I test, and how many times a day should I?

I finally have H on board with trying Clomid and seeing if it works. We will likely be only doing this 1 round on it, then we will wait to do a 2nd round till the New Year (due to insurance changes). So we want to give this an honest effort. He was thinking to do EOD beginning 5 days after I'm finished with the Clomid, and I just do the OPK's to help see whether I'm Oing or not. Not necessarily basing our timing on a positive OPK, since my Dr said EOD or ED (which isn't feasible) should be fine.

caseyandlizzie · September 2013

Are you being monitored by your Dr while taking Clomid?

brij2006 · September 2013

I go in on CD21 for something, but I'm not sure exactly what. My packet didn't explain it very well, but I know I'm supposed to call at CD19 and let them know whether I've had a +OPK yet or if my temp has spiked. Then I go in between CD21-24 based on that.

ILoveRedVino · September 2013

I've never used OPKs.

But, when I was having monitored cycles (Femara, not Clomid), I would do in around CD12-14 for a follicle check. That's how they'd know how my follicles were growing and based on that, we'd plan a trigger shot. Because I was so carefully monitored, there was no reason to do OPKs.

Panderp · September 2013

You shouldn't have to use OPKs while on Clomid, because your doctor should be giving you ultrasounds to check follicle development. CD21 bloodwork assumes a CD14 ovulation, because the CD21 is a 7DPO progesterone blood draw. You can ovulate anywhere from 5-10 days after your last Clomid pill. I always ovulated 11 days later.

Bottom line- it doesn't seem like you're informed enough about what is happening with the use of Clomid. And your doctor needs to do the monitoring-- not only to make sure you don't overstim (it happens even at the lowest doses)- but also to make sure that the follicle or follicles are maturing normally.

Have you had an HSG done to make sure that you have no blockages first?

Panderp · September 2013

ETA- When I started with Clomid, I was all easy breezy and thought people were alarmists about the monitoring. And in most cases, yes, the 50 mg of Clomid doesn't do much harm. But Amberley nearly overstimmed on 50 mg and had to cut pills in half. And hindsight was 20/20-- I hadn't even had an HSG yet to make sure that in the event I did ovulated, that the egg could actually get to the right place to be fertilized.

amccul20 · September 2013

when taking clomid I was monitored by the RE so I didn't use OPK's...but on cycles when we're just naturally TTC and I use OPK's I was testing twice a day. once in the am and once in the pm because i didn't want to miss a +.

caseyandlizzie · September 2013

I know you're paying OOP, but like @Panderp said, you need to educate yourself on the protocol your Dr. is suggesting. Clomid is given out like candy by a lot of OB's, and I know yours is a fertility OB, but there's a lot that can happen during a medicated cycle that can have adverse effects if you are not monitored.

BruinsBabe33 · September 2013

Everything @Panderp said.

ecinereb · September 2013

I'm not going to get into the debate on monitoring or not. While I think it should be the standard I know that's it's not and think it's a risk you can decide whether you're willing to take.

But to answer your question about OPK's, my old RE said to take them first thing, new RE says between 11 and 1 after 3-4 hours of not peeing or drinking a lot of water. I personally usually took on first thing until they were getting positive and then first thing and then after work around 5. Guess with the new RE I'll be doing one around 11.

We were told to start OPK's day 10 and BIO EOD from day 10 or BIO the day of the first +VE OPK and the day after.

Your doctor should be providing you with specific instructions.

Panderp · September 2013

Its a really, potentially bad risk.

brij2006 · September 2013

I go in on Friday for my ultrasound, then I meet with him to go over the ultrasound and the next steps. I'm going to ask him then about monitoring. The only thing I have is my IF packet you get at the beginning, that explains the different procedures. He also said about coming in during the cycle, but the only thing my packet says is around CD21.

I'm a complete information person, and feel like I don't know much about what's going on. Except to start clomid and take it for 5 days. Then my packet says to do OPK's 5 days after my last pill (the Dr also told me this at the last appointment).

Panderp · September 2013

I get that being OOP makes it more expensive, but better to pay and know what's going on than to throw money down the drain.

brij2006 · September 2013

@panderp I agree. I would rather be safe than sorry. I will be asking a lot of questions on Friday.

He has also not done an HSG yet. I asked if that was necessary, and he said he does 1 round of Clomid first to see if I react. If I do not, then he does an HSG.

DH absolutely loves this Dr, and I'm greatful for that, but there have been a few things that have made me consider a 2nd opinion. Now if only an actual RE wasn't an hour and 45 minutes away from me (each way).

Panderp · September 2013

I'm sorry. I really think it's a waste of money to not do the HSG first. You are allowed to be your own advocate here. If Clomid does work for you, and one or both of your tubes are blocked, you don't even have a real chance this cycle.

I would push for an HSG this cycle and spend the rest of the month educating yourself where treatments are concerned. I did things out of order, and I get just wanting to move forward, but knowing what I know now, I should have moved forward with my RE sooner and stopped with my OB. There were signs quite early that I wasn't responding correctly, and my OB just didn't know enough to make the correct changes.

amandaf6383 · September 2013

brij2006 said:

@panderp I agree. I would rather be safe than sorry. I will be asking a lot of questions on Friday.
He has also not done an HSG yet. I asked if that was necessary, and he said he does 1 round of Clomid first to see if I react. If I do not, then he does an HSG.
DH absolutely loves this Dr, and I'm greatful for that, but there have been a few things that have made me consider a 2nd opinion. Now if only an actual RE wasn't an hour and 45 minutes away from me (each way).

The problem with the bolded is that you can "react" to Clomid and still be shit out of luck because you have a blockage of some sort. Hence the HSG.

My advice would be to not take the Clomid until you've gotten all questions answered and a HSG - but that's just me.

brij2006 · September 2013

@amandaf6383 I've already started the Clomid.

Panderp · September 2013

Oof

lilliesandvino · September 2013

I feel like everyone told you all this stuff already and you proceeded anyway.

You mention being oop, we get it, but you may not be putting your money in the right place. Why in god's name are you taking a drug (that has limited applications) without knowing the whole story?

And your H loves the doc, great, but why does he have more say than you do? Is he comfortable with all the complications that can arise from taking this drug? Liking a doc is great, but I think you really need to get more info about what your body is doing.

brij2006 · September 2013

@lilliesandvino

I started the Clomid this morning, then posted this when I got to work. I had no idea that usually you go in around CD12-14 for a follicle check. I knew that monitoring was something everyone pushed while on Clomid, but when I read that I call in at CD19 and go in around CD21, I assumed that was the monitoring everyone was talking about.

For the OOP part, we want to do things right and do them once. I would rather spend a little extra money up front, and be better off later on. So it isn't like I've been telling my Dr to not run tests because we're OOP.

This Dr is also very well known in the area for what he does. 3 of my cousins went to him, and now have 6 children between the 3 of them. So I know what he does is successful, but I'm now 2nd guessing his judgement on it. H is saying to just let the Dr do his thing and trust him.

lilliesandvino · September 2013

Ok.

Panderp · September 2013

I would advise against blind trusting doctors. Even idiots get things right sometimes.

Venti29 · September 2013

On my second unmonitored cycle of clomid I ended up with four heartbeats.
Please don't do this, push for the monitoring. All the 'this won't happen to me' or 'I didn't know' doesn't mean shit when you're sitting in a room having 'selective reduction'.

CincodeMayoLove · September 2013

I also poopooed the monitoring. I was way naive back then. Nothing happened to me, but the serious risks like venti and amberley experienced are not worth it. Call and demand monitoring. Say you know someone who over stimmed on a low dose. USs are pricey, but nothing compared to the costs you will have to pay if something goes south.

brij2006 · September 2013

I go for the U/S tomorrow, and I'm going to say something to him about monitoring. If he refuses, then I know it's time to switch to a different Dr. Even if he doesn't refuse, I'm going to question why he never mentioned it, and this will be the first and last Clomid cycle with him. We will switch to an RE that is further away, but it isn't worth the risks to stay closer.

CincodeMayoLove · September 2013

My RE is an hour away. It's worth the drive to know you're in good hands. Smart plan and sounds like your on the right track with an us tomorrow. Glad you're moving in the right direction. GL and hope this is the only cycle you'll need

brij2006 · September 2013

@cincodemayolove

The RE is an hour and a half away. My current Dr is an hour. But I found out that the RE has a satellite office an hour away, and I can do everything but IVF out of the closer office. So hopefully I will have a better experience there, and actually understand and be explained what their doing and why.

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