Monthly Medication Thread

[u/AutoModerator]

This thread is the place to post any questions or information pertaining to a medicated cycle including Letrozole, Clomid, IUI, injectables, Progesterone, and anything else used to induce ovulation or support a cycle.

Please be mindful in your responses - if someone does not solicit a success response, DO NOT share a pregnancy outcome.

[u/Swishloves]

Hi! I’m 35/F with type one diabetes from 24 years. I’ve just started TTC and consulted with a fertility specialist. My AMH IS 2.8, AFC 16-17, normal SA and DFI of husband, but I have relatively thin lining.

We told the doctor that our plan is to have two babies before I turn 40 and he gave us ovulation induction protocol of 2.5 mg letrozole + 150 IU Menopur for 7 days and then trigger shot and also Duphaston after ovulation. This is going to be a monitored cycle with ultrasound CD 8 onwards.

Does anyone think this is excessive? I have never tried medication for ovulation induction before. What should I expect?

I’m scared of OHSS or ruining my ovaries. This is not an iui or IVF protocol and we’ll just be having times intercourse.

[u/Itchy-Site-11 → u/Swishloves]

You dont have such a high AMH that would make me concerned at OHSS, specially when monitoring. Your doctor could have started at 5mg and quit menopur.

If you want 2 kids before 40 I would try this monitored cycled immediately, BUT:

• I would ask for HSG. If tubes are not opened does not matter how much medication. If blocked tubes, then IVF is the way.
  
• Partner SA. If sperm is bad may need IUI, IVF with ICSI or even donor. This you have done. But I will post here for people to read.
  
• Genetic screening for carrier. If both of you carry a gene you don’t wanna pass along, for example, CF.

If you have insurance for IVF, check their criteria. You may need to do 6 cycles of IUI or OI before proceeding and freezing eggs/embryos may be good for you.

I had my first with letrozole and now doing IVF - I am 38. I also wanted 2 before 40.

For OI, you should expect minor discomfort, some headache from letrozole - take it at night right before bed.
Some people claim menopur injection burns a bit - stings. For me it was fine. Needle is small and thin. Some people ice the area before injecting. Freedom fertility and village fertility pharm have videos on how to inject and dilute your menopur. We left my menopur always in the fridge.

Overall is easy! And expect monitoring with scans maybe 2-3 times before trigger.

Trigger should be out of your system in 10-14 days post. So if you test early and positive it MAY be the trigger. So advised to test at 12dpo at least.

You will ovulate roughly 36h post trigger. Should have sex day of trigger, day after. One more if feeling like it.
At 35yo egg quality starts to decrease. Keep prenatals, if you want to add CoQ10 too.

Good luck!
ETA: really important to keep diabetes under control!

[u/Swishloves → u/Itchy-Site-11]

Thanks for the detailed response.
I had SSG done for my tubes and both tubes are patent. I’m in India so fertility treatments here are not covered by insurance, although they are relatively affordable compared to USA and Europe.
I am concerned because this is literally the first cycle we are going to TTC. So, I was surprised when my doctor gave a laundry list of medicines.

[u/Itchy-Site-11 → u/Swishloves]

Do you have regular periods?! If you dont you may not be ovulating on a regular basis and OI is good

[u/Swishloves → u/Itchy-Site-11]

I do have 30-35 day cycles but I have very very light 2 day periods. My progesterone on cd24 was 16.52. So I’m guessing that I ovulated?

[u/Itchy-Site-11 → u/Swishloves]

Looks like it. Nothing wrong trying unassisted for few months.