Intro, and background info about Clomid
Thanks for reading my Clomid story! As Raq has already said, this is a personal story and may not be the same for others, but it may be of interest/use to some! I will describe my TTC journey so far, to provide some background information, before posting again with my Clomid experience so far. Then I will post periodically with updates, as I have any appointments, or just to share the highs and lows! If anyone wants further clarification on anything, please PM me, and I will either answer individually or answer more generally via the Blog. Firstly, a bit of background about Clomid: Clomid (or Clomifene) is a drug used for people who do not ovulate, or sometimes do not ovulate. It is an anti-oestrogen, normally taken daily on days 2-6 of your cycle, to lower the level of oestrogen in your body at the start of your cycle. This then stimulates your body to work harder to produce more oestrogen in order to promote ovulation. It can cause some side-effects, such as nausea, hot flushes, breakthrough bleeding, breast tenderness, mood swings, headaches, blurred vision and increased risk of multiple pregnancy (because it can sometimes stimulate your ovaries to produce more than one egg). The most potentially dangerous side-effect is hyperstimulation, which means the ovaries become enlarged and develop cysts – this would require urgent medical treatment. Do a Google search if you want any more info - I didn't find just one website that I felt I could recommend. Blogger 1

My history before taking Clomid
A bit of background reading! I am currently 32 years old (born in 1975), and have been married since Summer 2006. I have a BMI of around 24. I have Polycystic Ovary Syndrome (PCOS). This is a very common condition in women, causing a variety of symptoms (weight gain, insulin resistance, excess hair on face, hair loss from head, acne, depression). One of the major symptoms is reduced fertility, caused by your ovaries developing cysts (hence the syndrome’s name), caused by several/many follicles ripening slightly, instead of just one follicle ripening fully. It is possible to have PCO but not have the S (the syndrome), and it’s possible to have the syndrome without having polycystic ovaries, so it’s a bit complicated! I first started having problems as a teenager, with acne and some facial hair, and irregular periods. I was referred to a specialist and eventually put on the contraceptive pill Dianette, which I was on for 12 years – this helped my symptoms considerably at the time. They didn’t actually tell me I had PCOS but over the years I worked it out for myself, and it was agreed by my GP. For more info on PCOS, check out www.verity-pcos.org.uk. This is a self-help charity for women with PCOS, and I have found it invaluable. Then I developed insulin resistance about 3 years ago, characterised by weight gain and desperate need to eat – I would be unbearable if I had a hypoglycaemic attack – until I ate again. I was again referred to a specialist, who advised me to come off Dianette, and work hard at keeping my weight under control. He also sent me for blood -*test*-('")s and an ovary scan, which showed that my blood was a bit out of balance, indicating PCOS, but that my ovaries looked fine – good news! Metformin A few months later (2 years ago), the consultant put me on Metformin, which is a drug commonly used to treat Type 2 Diabetes in cases where insulin is not required, and which has been used successfully for women with PCOS. It helps to balance the blood sugar, making it easier to manage your diet/weight, and there has been shown to be a link between insulin resistance and ovulation, so in many women it can help to promote a regular menstrual cycle and therefore increase the chances of getting pregnant. Metformin can also cause side effects, particularly stomach upsets, which are worse when starting to take the drug. I suffered a little with these (terrible wind!) for a few months, but after a while I didn’t much notice it. Metformin has helped me keep my weight under control, though I still have my moments of hypoglycaemia if I don’t eat healthily and regularly! As the Metformin worked for me, I was temporarily discharged by my consultant, who said I could return when we’d decided to TTC and if we had TTC unsuccessfully for 6 months (fast-tracked because of the likelihood of problems due to my PCOS). TTC We always planned to have children after we got married (my DH always knew we may find it difficult because of my PCOS), so in December 06 we began TTC – I had been taking my folic acid in anticipation of this. After 6 months with no success, I saw my GP in May 07, who referred me back to my consultant (well, a different one but in the same department). DH was also required to attend, and the appointment in August was great. The consultant sent DH off for a semen analysis (he had very good results, hurrah!), and sent me for a Hystero-Salpingogram (HSG), which is commonly called a ‘dye -*test*-('")’. They squirt some dye into your uterus, and take X-ray pictures to see whether your ‘tubes’ (Fallopian tubes) are clear. Mine came back fine, though I found the -*test*-('") quite painful, and I had quite a bad reaction to the -*test*-('") afterwards, almost fainting and feeling very unwell and a bit frightened as I had not expected any problems and was on my own. Then the fertility sisters took over my ‘case’ in September 07. I had a day 2 blood -*test*-('") (measuring hormones: FSH and LH I think) and a day 21 blood -*test*-('") (measuring progesterone), and the results came back ok. Then they began ‘follicle tracking’. I had an internal scan every two days from day 11 until ovulation, in which they measured the size of my developing follicle, and then told us when to BD (I have to be honest and say that I could have worked it out for myself but it’s useful to see whether I ovulated). Then I had a Day 21 blood -*test*-('") (or 7 days post ovulation, so for me it’s more like day 24). This happened for two months, and the first month all was fine, but the second month the Day 21 blood -*test*-('") showed that viable ovulation had not occurred. The policy in that hospital is that if, during follicle tracking, ovulation does not occur in any one month, they automatically try you on Clomid, to increase your chances. So in November 07 I started my first cycle of Clomid… more to follow! Blogger 1

Clomid history to date
First cycle In November 2007 I began my first cycle on Clomid – 50mg daily for days 2-6 of cycle. DH and I were so pleased that the fertility consultant and sister had been so helpful, and it really wasn’t taking us long to get to this next stage. We realise we are lucky to have had such a prompt and helpful response, and all through the NHS. No complaints here, at the moment at least! I opted to take the tablets in the evening, just before bedtime, because I had read that the side-effects could be most noticeable shortly after taking the tablets. I was a bit worried about the side-effects, but not too anxious, as I normally don’t react too badly to drugs – e.g. Dianette, Metformin and any other occasional antibiotics or anything. Anyway, the only side effect I had while taking the tablets was a bit of blurred vision and tired eyes, but to be honest that could have just been tiredness! However, I did notice increased activity in my lower stomach, i.e. ovary region, just before and during ovulation. In fact, it was really quite painful, like period cramps, though apparently this was due to increased fluid after ovulation – quite normal with Clomid. Anyway, I had fertility tracking in the first month, and 2-3 follicles were shown as enlarged, but in the end only one ripened, so the fertility sister was pleased – all on track. Day 21 -*test*-('") showed that I had ovulated – score of 50 (it needs to be above 30). But AF arrived! Second cycle Next cycle (Dec-Jan) was interfered with by Christmas, so I had no follicle tracking but still took the Clomid, as the fertility sister had said that it was safe enough as I had reacted ‘correctly’ to the first attempt. Again I had no side-effects to speak of, other than some ovary pain, and we DTD daily throughout the fertile window, and I was really hopeful – but AF arrived again! I should mention that as well as the scans, I do monitor my CM, and it has been useful to see how reliable CM has been as an indicator of impending ovulation (I don’t use OPKs as I’ve heard they can be a bit unreliable with PCOS sufferers as the hormones can be all over the place). Clomid is known to sometimes cause dryness in mucous (not just CM but nasal etc. too!), but I have not noticed any difference while taking it. Third cycle Again, no side effects to speak of, and one follicle has ripened and I appear to have ovulated on day 17. This month, the fertility sisters both had trouble finding my right ovary – I have been pushed and prodded and propped up in funny positions but with limited success! But the left ovary produced a ripe follicle, and it’s likely that the right ovary is ‘quiet’ so they’re not worried. Would be nice to see it next month though! I have a Day 21 blood -*test*-('") due on Friday (which will actually be day 25), and will post the result early next week – fingers crossed for a score of 30 or above! AF (or BFP!) expected around 14 February.

What happens next?
At my last scan I asked the fertility sister what the plan was for the coming months – I was conscious that I had only been prescribed 4 months’ supply of Clomid, and this was already the third month. The plan is (assuming no BFP)… If the blood -*test*-('") comes back telling me I have ovulated, I can have three more cycles of Clomid at the current dose. If not, they will up the dose to 100mg. If I stay at 50mg I have three more cycles but I don’t need them to be tracked, as my cycles are regular (about 30 days) and I tend to ovulate on day 17, so we would need to ‘try’ during that time (‘try’ is the word they use – no BD or DTD for them, ha ha). I can, however, be tracked if I wish, and that is a decision we will need to make if we stay at 50mg. I am inclined to skip the tracking but ask for the blood -*test*-('"). The reasoning is that it’s a pain to pop out of work so regularly – I work from home and they fit me in during lunch hour so it’s not obvious to colleagues but it’s still not ideal as it’s 20 mins away so I am gone for over an hour. Also I already know when I ovulate, due to monitoring CM and generally how I feel (not very scientific but there we go)! But the blood -*test*-('") would show whether the level of hormone means it was viable – so if, say, month 4 was not viable, they could increase my dose to 100mg, rather than trying at 50mg for three months, not knowing that 100mg would be better. Anyway, to continue with the future plans, if I need to increase the dose to 100mg I will need to be tracked for one month at least, but otherwise the 6 month plan still stands. After that they would move me on to IUI, so I will be reading the IUI blog with great interest! Blogger 1

Emotions
Because of having PCOS, I always expected to have fertility problems. Sometimes I wonder whether my low expectations are hindering our progress, but to be honest I think I’m a realist rather than a pessimist – I have not got depressed about it on the whole. Each month we ‘try’, and each month AF arrives. I have always expected this (in 13 months I have never done a pregnancy -*test*-('")!), and am calm about it, simply feeling reassured that AF is pretty regular (has spanned 26-36 days but has been around 30 days these last six months), and my HSG was clear, and I am ovulating most months, and DH has excellent swimmers – so our chances are not bad on the whole! I also feel that we have the advantage of all this knowledge (that others that have been TTC for just as long or longer don’t have), and excellent support from our GP, consultant and fertility sisters, so we are lucky. It has just started to get a bit harder since the HSG, because I had heard that you can have increased fertility as a result of the HSG, and once I knew my tubes were clear I thought the BFP might come soon afterwards. Also, I have realised that I am half way through my six months on Clomid, so there are not many months left before things get a bit more ‘serious’ as we head towards IUI and perhaps eventually IVF. On the whole I just feel lucky that, although I have PCOS, all my results have been good, and DH’s swimmers are very good, and so really there are very few reasons why it has not happened for us yet. Hopefully the lovely Clomid will work its magic, but if not, we are prepared for the next part of the journey. I am also conscious that miscarriage rates for women with PCOS are higher, so I am determined not to be too excited if I do get a BFP. But I would love to just get to that stage, and then I would have more confidence that it really will happen for us eventually. Inevitably, the longer we ‘try’, the more we find ourselves thinking about holidays and the future and our house and even baby names, and so despite our agreement not to get too ‘hung up’ on it, it will be a very big disappointment to us if it doesn’t happen. I am also conscious that now we’ve been married nearly two years people may be expecting an ‘announcement’ soon. I have started to be aware that people are watching my alcohol intake, and looking at my stomach (I do have what I call a PCOS belly!). Nobody has said anything yet, and we’ve not told anyone we’re trying (other than one work colleague who is not in my team), but I anticipate that pressure will build this year, from friends and relatives. That will be hard to bear, but if pushed we would tell the truth. I will report early next week on my blood -*test*-('") result! Blogger 1

'Day 21' blood test result
It's good news - day 21 (well, day 25 for me as proof of ov came on day 18) Progesterone -*test*-('") gave a score of 48, indicated that I have ovulated again on my third month of Clomid! It is looking like the 50mg dose is enough to keep me ovulating each month, so I will have to ask nicely for the day 21 -*test*-('") in the next three months as they may not think it's necessary. Assuming that I ovulated on Thursday 31 Jan, I'm now 12dpo, which is around the time that AF tends to come or I get some mild cramping and spotting for a couple of days, heralding AF's imminent arrival. I have had no cramping so far, other than a weird sharp pain briefly yesterday. I will try to stay calm as usual... Ironically, if we do get our BFP this month, it will mean that I'll be 14 weeks pregnant when we fly to New York, and 8 months pregnant when we go on holiday to Lundy Island (tiny, remote - 2 hours away from mainland Britain by boat)! So in a way it would be a very bad time for it to happen! But we didn't want to put our life on hold while TTC (as it is taking a while!). I will update the blog when AF arrives or some better news! I will -*test*-('") on Friday morning if no AF by then (potentially boozy weekend coming up) - but from past experience, AF will beat me to it... Blogger1

13 Feb update
Last night I woke up at 2am feeling nauseous. Very weird, though I have had this once a few weeks back, so maybe it's cycle-related. I'm pretty sure AF is appearing, as I've had a tiny bit of spotting today, but I have been feeling so weird in general that I can't yet give up all hope for this month. My blood sugar has been all over the place - I woke up so hypoglycaemic that my whole tummy felt like it was imploding and tingling in my solar plexus. I tried to eat slow release foods this morning - porridge with raisins, granola bar, apple, another granola bar - all within 2 hours. I felt so hungry, even after I'd eaten! I hate having PCOS sometimes! I have had a headache all day and felt really lethargic, and had a very upset stomach, and I don't know why. Normally AF follows stomach cramps and spotting, but no other symptoms. Thank goodness I work from home! I expect it's just a virus, and you would think that the spotting would tell me that AF is on her way, but I can't help trying to interpret the signs in a different way! I won't be on email tomorrow, but will send an update on Friday morning. Don't get your hopes up guys - I think the writing is already on the wall for this month. Blogger1

AF turned up - cycle 4 begins!
As expected, AF did turn up :( CD3 today, so I started taking my fourth cycle of Clomid last night. I need to phone the fertility sister on Monday and discuss whether or not I should be tracked this month. Looking on the bright side, at least I won't be 8 months pregnant when on Lundy in September! But given the choice, I would of course have chosen the BFP over the holiday... Blood sugar still all over the place. Felt so hungry/ill last night that I had to eat a banana in bed (not good for the teeth!), to keep the hunger at bay for long enough to get me to sleep, and then I was munching oatcakes within minutes of waking up this morning. Grr. I hate having PCOS! Blogger1

Spoke to fertility clinic
Not much to report really. The fertility sister suggested us trying on our own for the next couple of months (i.e. still on Clomid but without the follicle tracking and day 21 blood -*test*-('")). I did ask whether it'd be possible to have the blood -*test*-('") without the dildo cams, given that I have a good idea of when I ovulate, but she said they didn't do it as it wasn't reliable enough and could increase anxiety levels if the blood result is not good. Fair enough, I guess. So, we're on our own this month. Kinda feels nice to be back to 'normal'. If we're unsuccessful these next two months, they will want me back in on month 6 to do some extra -*test*-('")s in preparation for the next stage - IUI. Fingers crossed it won't come to that... Blogger1

DTD pressure
Last week was DTD week. On the two Clomid cycles with scans, I was shown to be ovulating on day 17. This month I had some occasional ovary-type pain from day 13 to day 18, but I wouldn't say I had a lot of EWCM - it was more watery, though there was plenty of it. Fingers crossed that I did ovulate, though I'm not 100% confident. Anyway, we generally try to DTD at least once every 48 hours from when I start getting increased CM and for about a week. This month we were doing well until DH got a bit fed up / stressed at the crucial time! I didn't put pressure on, and we had a good long talk on Saturday evening, which helped a lot. I said that on the one hand it's not life-critical to give it our best shot every month on exactly the right days, because we've been TTC for 15 months now and we will just get totally stressed and disillusioned. However, I did say that we have limited cycles on Clomid because of it being linked with increased risk of women cancers etc. and it is wasteful for me to be drugging myself up and putting my body under stress if we're not going to at least give it a reasonable chance where possible. I then explained briefly about the next stage - IUI - and how I would need to be injecting myself with hormones and that his swimmers would need to be 'cleaned' and it would all be quite a lot more involved and stressful than taking a tablet. This freaked him out somewhat so I do think that if my Clomid journey comes to an end, we will have to have a good chat as DH needs to be prepared for the next step - up to now he had not realised exactly what it entailed. DH then revealed that he really is baffled at why it is taking so long. 'All' his other friends conceived in the first month of trying (I pointed out that this probably wasn't true), and as all our results have come back so well (even my PCOS is not showing to be causing any obvious blocks to conception atm), why has it not happened? He cited the whole thing about so many young girls getting pg having just dtd once at a random time of the month - to which I replied that nobody knows how many other young girls DON'T fall pg with the same experiences - they don't exactly document this! I then described the whole thing about how sperm survive up to 5 days but possibly considerably less, and the egg survives 24 hours after ovulation but possibly considerably less, and it takes a while for the sperm to swim up to the egg, and they could just miss it or one could meet the egg but the fertilised egg just not implant... This got him really depressed and he said it's a miracle anyone fell pregnant at all! I agreed that it was a miracle, and we just need to believe that it will happen for us when the time is right. It was good to talk, even though it was quite emotive at times. We need to keep talking about the consequences of each step, and I, for one, am mentally preparing myself for needing to go through IUI. I just hope DH will be able to handle it. BTW we did do ok this month really: we DTD on days 13, 14, 16 and 19. So maybe this month will be our month! We have our appointement with the consultant next Tuesday (11th March), so I will update you after that. Blogger1

Ha ha, so now you know who I am (if you hadn't worked out already)! Not concentrating this morning - oops. Blogger1

Appointment with consultant this afternoon...
... and I think AF is on her way! Poor DH is getting despondant - when I tol him last night that I was having AF cramps, he basically said 'no surprise there - after 14 months TTC it's hard to expect anything else'. I'm hoping that the consultant will upbeat and positive, as DH in particular needs a boost right now. I also hope she will describe the next stages (probably IUI), so DH can prepare mentally for what may be to come. To be honest with you I'm anxious about how disheartened DH has become, and I'm worried that he is starting to think that we will never have children, and that he may be resigning himself to it. But for me, who always expected a long TTC journey, this is just the next stage. We need to keep talking! I'm also wondering whether we really need this appointment. We previously had one booked for November, but the fertility sister postponed it because I was in the middle of treatment with her, and she said there was no need to see the consultant at that time. Well, I am still having the Clomid in communication with her - but I decided not to remind the fertility sister that another appointment was coming up, because I thought it was important that the consultant is fully aware of what's been happening - and, as it would probably be at least 3 months before another consultant appointment came through and we only have 2 months of Clomid left, it would be a waste of a month to wait before deciding about IUI. Sounds a bit sneaky but I think it's for the best that we see the consultant now, if only to get DH involved again (he doesn't come to the fertility sister appointments). Anyway, I'll let you know how we get on! Blogger1

Anticlimax!
Oh dear - we got there and they had rescheduled the appointment until 10th June! I don't remember getting a letter - not sure if I'm going mad or it just didn't arrive. I'm not surprised really, as I'm just about to start my fifth cycle of Clomid and as I'm scheduled for six cycles, there is not much need to see the consultant at present - and it seems that the fertility sisters are in regular touch with the consultant, so they can probably make a decision about whether to go on to more cycles of Clomid or prepare for IUI, without us actually needing a consulation. DH was fine about it. In fact, he generally seems quite withdrawn from the situation. As we walked from the car to the hospital I asked him whether he had any particular things he wanted to ask the consultant, or any info he hoped to find out, and he said no, not really. He said he's just not that fascinated by the medical detail - just happy to do what he's told! Not sure I think that's entirely healthy, but there we go. Lucky it's me that's the woman, needing scans and suchlike! AF has announced her presence - I have started spotting. Round 5 of Clomid, here we come! Blogger1

Cycle five - first scan
An update on the last couple of weeks… AF arrived, and I started taking round five of Clomid. For the first time since starting on Clomid, I really felt the effects of the drug, feeling really ‘down’ and tearful, and DH would definitely agree that I was rather ‘hormonal’ at times! Luckily, the effects ease soon after the last tablet of the month, on day 6. I decided to get ‘tracked’ again this month, as I had a month off tracking last month and no BFP, and I did notice that I had less pain around ovulation time so was slightly concerned that the Clomid wasn’t working. Yesterday, on day 14, I had my first scan of this cycle – previously I have ovulated on around day 17 so luckily the Easter bank holiday weekend didn’t get in the way for me. When I arrived, the fertility sister talked about getting me ready for IUI next month, explaining that I can have 12 cycles of Clomid (of which this is cycle five) and up to three cycles of IUI to have during those 12 months (to fit round holidays, allow for emotional recovery breaks if we need them etc.). She suggested that we get ready for IUI next month, and explained that DH and I would both need blood -*test*-('")s, which we would need to organise now. (I am aware that DH and I haven’t actually agreed to go ahead with IUI. We need to talk about what it means for both of us!) However, next she scanned me, and unfortunately neither ovary showed any significant activity (she actually managed to find my right ovary for the first time in ages, after a lot of undignified prodding and me turning over several times!). It is possible that I am having a slightly longer cycle, in which case it’s a bit early to see much, but it’s also looking possible that I’m not ovulating this month despite the Clomid  I’m having another scan on Friday, and if that shows nothing, I need to go up to 100mg of Clomid next month, and then be monitored on that for a month (to ensure my ovaries are not hyper-stimulated) before progressing to IUI. In that case the blood -*test*-('")s need to be postponed until next month – I will find out on Friday. (I’m not sure how I feel, to be honest. I’m mightily relieved that I decided to be tracked this cycle, otherwise we may not have known whether I am ovulating on 50mg Clomid (I will have been tracked in cycles 1, 3 and 5). But I’m not looking forward to the possibility of going up to 100mg of Clomid, with the likelihood of worse side-effects. And I’m disappointed that we might be having a ‘wasted’ month, even though had we had a BFP this month it may have jeopardised our trip to the States next month – would be during week 7!) I asked the fertility sister for more info on IUI, explaining that DH is very ‘removed’ from it all, not wanting to know all the details, but that I wanted him to understand at least the basics! She laughed, saying it was a common reaction, and gave me some leaflets. Interestingly, we would have to fill in a questionnaire about our lifestyle, indicating any factors that might rule out the hospital doing the procedure, e.g. if our relationship was violent! I’m supportive of such a thing, but it did make me realise that IUI is a significant step further from Clomid in terms of assisted conception. I need to talk to DH about how he will feel if he isn’t present at the conception of a child – it sounds silly but we both do need to accept that. I think my feelings are ‘on hold’ until Friday, when I should know whether there is a chance of me ovulating this month. I still don’t feel too emotionally drained by the whole TTC process so far – but I am aware that there may still be a long way to go. I will let you know how I get on on Friday! Blogger1