Clomd/Femara vs. Injectables???

So I met with a new RE and I asked what the treatment protocol be if the next cycle failed...I mentioned injectables...he said that with PCOS and me responding to clomid I would have a greater risk of OHSS and would not suggest that for me...my previous RE said that after 3 failed cycles of clomid/IUI that we would move onto injectables and I had asked since I respond how would that effect me and he said it would be something they would have to monitor super closely...my question is has anyone responded to clomid/femara but still with failed cycles and moved onto injectables? Why did your RE move to injectables? How did you react?

TIA

Re: Clomd/Femara vs. Injectables???

They usually move you onto injectables after failed cycles with clomid/femara to up your chances. Maybe the amount of follies you are making arent enough. If you have PCOS, it could be an egg quality issue. With the injects, you'll make more follies therefore upping your chances of getting pregnant. They definitely have to monitor you closely, but they should have been doing that with clomid/femara anyway. You are in good hands with your new RE!

Re: Clomd/Femara vs. Injectables???

I was producing 3-4 follies on clomid and I think maybe the concern is OHSS...I was just wondering if you do react well to clomid/femara is there a need to move onto injectables if you have failed cycles???

Re: Clomd/Femara vs. Injectables???

I already told you whats going on with me, I was just wondering what OHSS stands for? Maybe I'm out of the loop. That might be why my dr. hasn't suggested injectables. I think I'm going to ask them to go over more options with me at my next appointment.

Re: Clomd/Femara vs. Injectables???

OHSS = ovarian hyperstimulation syndrome..I was curious why one RE would suggest injectables and the other wouldnt...its puzzling to me...

Re: Clomd/Femara vs. Injectables???

As someone who does not have PCOS but is a very high responder and developed OHSS during both IVF cycles, it is no fun! Maybe your RE is concerned that 3 or 4 follies is really all you would want for an iui. Any more and the cycle may have to be cancelled. I went to the same RE and had a successful IVF cycle there. Even though I hyperstimulated, I was monitored VERY closely. I think I went every morning for monitoring. When i did 2iuis with a different RE, and used injectibles, it was a close call both cyles b/c i had many follies and the iuis were almost cancelled.

Re: Clomd/Femara vs. Injectables???

most PCOSers who are under 35 are at risk for OHSS when they cycle with injectables, but a good monitoring dr. will almost always still go with an injectable protocol. it is riskier but it is absolutely manageable. if you respond to clomid/femara i suppose theres no reason to jump into injectables, but i personally wouldnt skip right over to IVF, although i guess i can understand why some doctors would. you can always ask if they will do an injectable cycle with you and if you are a high-responder, switch to IVF. my first injectable cycle i hyperstimulated and had 10+ mature follies. the cycle was cancelled i had very very very mild OHSS and had to go on BCP for a month after to get rid of all of the follies. bad for an IUI/TI cycle good for IVF (but we werent ready for that yet). my dosage was cut down a ton after that and i had several injectable cycles with 5 or less mature. so they are def manageable if the doctor is willing. eventually i was switched to IVF because of the risk of hyperstimulating on an IUI/TI cycle, and when I ultimately did IVF I did end up with very high e2 (6000+) and mild OHSS. even after all of that i think the injectable cycles prior to IVF helped them get my dosage right for optimal follie prodiction during my IVF so I still think it was the right move. good luck!

Re: Clomd/Femara vs. Injectables???

I only would have 1 follicle which stalled with femara. My first injectable cycle I had 3 nice size follicles still got a BFN, second cycle I had 4 nice follicles (20+), i triggered and got a BFP and I am almost 40wk with a singleton. I have PCOS and DH has a few issues, nothing significant. I was happy we moved forward because my insurance only allowed a total of 6 IUI's and I have no IVF coverage.
FYI I was 29 when we started, 30 when I got my BFP

Re: Clomd/Femara vs. Injectables???

i went from clomid to femara to femara plus injectables bc i was not responding toow ell with just the pills

Re: Clomd/Femara vs. Injectables???

I guess we shall see how I respond to femara...I def dont want to jump into ivf since we have not exhausted iui's...I was just curious as to how one facility would suggest injectables and the other is def against it...

Re: Clomd/Femara vs. Injectables???

No PCOS but 2 follies with femara and 4 with injectables.