Friday, August 28, 2009

Trying for Pregnancy. . . Thank You! Success at last!

QUESTION: I have been trying to get pregnant for 7months. My period is regular every 26 days. Ultrasound and sperm tests indicate normalcy. I was given Clostilbegyt 50mg to take on day 2-6 and Provera for 10 days fron day 16. Does this sound correct? Won't Provera induce a period and stop me from getting pregnent. Oh I'm 33.

ANSWER: Hello, 
 
I hate to see these type of questions because it shows that the doctor you are seeing is not treating you appropriately. Have you had all the infertility testing done? Hysterosalpingogram, Hormone testing, Hysteroscopy, Laparaoscopy, Midluteal phase progesterone level. If not, then you shouldn't be jumping to Clomiphene. For one, if you have regular periods, ovulation is not the problem, although you may have a hormone problem as manifest by a short menstrual cycle. The only other reason is to try "something" since there doesn't seem to be a reason for your infertility. Many general docs give Clomid because they can, and not for any good reason, thinking that because it is a "fertility drug" it will help you to get pregnant. That is incorrect thinking. It should only be used for a specific reason i.e. it is treating a specific disorder. 
 
Technically, if you are under 35 years old, you would not be considered to have an infertility problem yet, because you have only been trying for 7 months. We don't consider a person to have an infertility problem until they have not been able to become pregnant for over one year. If you are over 35 then we shorten that time line. In women under 35 years old, it takes 8-12 months for the majority to achieve pregnancy naturally. So you may just need to keep trying on your own for a while longer. If your cycles are 26 days, then you are ovulating around day # 12, so you should start having intercourse on day # 10 for 5 consecutive days. 
 
Provera is not used with fertility because it is a "synthetic" progeterone. We only use natural progesterones like Prometrium, Endometrin, Progesterone in oil, when augmenting the luteal phase for fertility treatments. That is what me suspect that your doc doesn't have all the knowledge required for your treatment.
 
Sincerely,
 
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
http://www.montereybayivf.com/
  
---------- FOLLOW-UP ----------
QUESTION: Great news, I am now 6 weeks pregnant after following your advice. However, before I got pregnant I had a yeast infection for almost three months. My doctor gave me Canesten tablets and inserts and that did not work.It eased the symptoms for two days and then they returned. She then gave me Flagyl tablets for both my husband and I for ten and five days respectively ( 3 tabs per day). I was also given Klion to insert every night for ten days. That last dose of medication was a nightmare as it caused severe pain and irritation, I stopped after five days. Now I'm still having some irrtiation and itching and extremely painful sex on penetration and afterwards. My new doc gave me Travogen cream and it has helped a little with the itching but sex is still painful. Is this normal? Is it that I may have something more serious? Can this affect my pregnancy? I'm really worried.... please advise me!

Answer:
Hello Rhonda from Trinidad-Tobago,
 
Congratulations!!! :) :)
 
If you have symptoms, then you need to be checked and have cultures done. It may be a simple yeast infection that can be treated easily, or something else. Don't go the trial and error route like your doctor did previously. Have the cultures done so that he/she knows exactly what to treat, especially since you are pregnant. There are some medications that you don't want to take at this time. Sex should not be painful, but since you are newly pregnant, you might want to avoid sex until you are further along (12 weeks gestational age).
  
Sincerely,
  
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
http://www.montereybayivf.com/

68 comments:

  1. karlene From Trinidad (34 years)
    Hi, I have been trying to get pregnant for the past year,and have been on clomid for the past 5months, have done HSG, did prolactin &fsh testing but still im not ovulating as I should. on glucophage but that makes me sick, heard about the HCG injections for superovulation,what do you think? Please advise me,thanks.

    ReplyDelete
    Replies
    1. Hello Karlene,

      First, you are obviously not seeing the right doctor. It doesn't sound like your doctor has a good treatment plan laid out. By 5 months of Clomid, he/she should know that either you are not responding to this medication and should have changed to a different medication. In addition, in most cases, HCG is given to help with ovulation i.e. to trigger ovulation, but that is only if the ovaries respond by forming appropriately sized follicles.

      I would recommend that you read about how I do ovulaiton induction cycles, in this blog, which will tell you whether or not your doctor is doing it right.

      Good Luck

      Delete
    2. hi am lisa my doctor give me clostilbegyt to take on the 3th day off my period now am bleeding heavier than normal what do u think

      Delete
  2. Thanks so much for replying, it is so frustrating that im not pregnant as yet although I am on clomid. My doc is a gyn/oby & apparently not a infertility specialist.By chance do you do internet consultancy, payment will not be a problem. I have to visit my doc this week & i hope she decides to go the hcg injections way. I will definitely keep you posted & anxiously await your response/advice.
    Have a blessed day.
    Regards
    Michaelene

    ReplyDelete
    Replies
    1. Dear Michaelene, You are very welcome. I do internet consultations via email, as well as phone and SKYPE. You can follow this link to contact me through my website and set up a consultation: http://www.montereybayivf.com/fgc-contact.php

      In the meantime, good luck and don't give up!

      Delete
    2. I good am 28 year old I have been try to get pregnant for 7 years now and nothing as yet

      Delete
  3. Hi Dr. Ramirez
    Since we chatted last time you advised me about HCG shots, so I visited another dr and she wants to start me on fsh injections as soon as possible. Its a bit costly so I told her give me a month to get the money ($1000 us. I also met with a homeopathic/ herbalist/naturalist and she was telling me that my eggs are weak and need to be health & probably my uterus is not alkaline enough. What do you think of my information about the fsh injections & my non alkaline uterus.
    By the way what is the success rate for these injections, and do I need lots of courses/ cycle with these shots.
    Have a blessed day.
    Regards
    Michaelene

    ReplyDelete
    Replies
    1. FSH is a fertility hormone used to stimulate the ovary to either (1) ovulation if you are not ovulatory and not responding to the easy meds such as Clomid or Femara or (2) if you want to get more than one egg per month. It is the main medication used for IVF. I can't comment much more than that without further information about how it is going to be used or why it is preferred. It is expensive.

      As to the recommendations of the homeopath. . . I would disregard all those medications. I know that desperate people do desperate things and will believe anything, and there are many unproven and illegitimate recommendations out there. These are two new ridiculous diagnoses, and as far as weak eggs is concerned, depending on your age, there is a little bit of truth but there is no treatment to make eggs better.

      Delete
  4. Hi
    Thanks again for answering me so soon.By the end of this month I will be able to have the money needed for the fsh shots since it is costly. I wait in anticipation to begin this treatment.I will pray long and hard & start a novena to be successful. I pray that the Lord will continue blessing you and your family always.
    Regards Michaelene

    ReplyDelete
  5. Hai Dr. Edward .R.,

    My name is Chichi, I am 41years plus old. My husband and I have been trying to get pregnant over a year now and it's not working. I have been to series of tests regarding infertility and everything seemed normal.

    I normally see my periods between 26/27 days a month and it runs for 4-5 days. This month, my doctor gave me Clostilbegyt from my day 2 periods to use for 5days. What are my chances of getting pregnant as the case may be?.

    Please note my husband is diabetic for some years now and he is still on medication.

    Please advice us as we are desperately in need of a child.

    Thank you,

    Chichi

    ReplyDelete
    Replies
    1. Hello Chichi,

      If all the infertility testing has been done, and all is normal, then I would suspect that the major problem is related to your age. As you may know, a woman's fertility declines with increasing age, most dramatically after 35 years old, because the internal quality of the egg declines. We call that the "age factor." Currently there is no technology that can change the quality of eggs so the only option is to try to find the few good eggs that are left. That is statistical issue.

      The chances can be increased using fertility drugs because it increases the number of eggs that one ovulates in each cycle, but the drug you are on is not the best choice. In general, in the U.S., we recommend IVF as the treatment of choice because it is the only method that can obtain the highest number of eggs at a time.

      I would not recommend wasting your time, which is now precious, with the level of treatment you are doing (the lowest level) and go see an IVF specialist as soon as possible.

      Good Luck

      Delete
  6. hi Dr Ramirez,
    Started the gonal f with the pen and since it was my 5th day of the injections my ultrasound showed 3 follicles on the left and one on the right, they were 8,9 and 11mm.Do you think so far so good? From monday my injections will be increased to 150 dosage. How does my chances look?
    Regards
    Michaelene

    ReplyDelete
    Replies
    1. Hello Michaelene,

      CD5 is a little early to be looking for follicles but the findings are good for now. Hopefully they will keep growing and reach ovulatory size. The treatment goal will be to continue the injections and possibly increase the dosage to keep 1-3 follicles growing. Once the lead follicle reaches 20 mms size, HCG should be given to stimulate ovulation and then you should either begin intercouse for four consecutive days or undergo IUI.

      Good Luck

      Delete
  7. hi dr Ramirez,
    Today I went to do my ultrasound since it is my 13 th day of injections and I saw that I had one follicle which was 20mm & the other two 16mm,tomorrow is the day to use the HCG shot and I hope that my follicles still have less than 24hours to grow again. What do you think about that.With my scenario have you ever had a patient getting pregnant with one mature follicle. I really want this first time to be successful.So from Monday till Wednesday I will have intercourse to increase my chances.Does everything look hopeful for me? I do hope and pray for success.
    Do take care and wishing you God's richest blessings.
    Regards
    Michaelene

    ReplyDelete
    Replies
    1. Hello Michaelene,

      By tomorro the follicles should have grown to 22,18 and 18 mms. which will give you three ovulatory sized follicles. That is the usual goal so you have done well. Since the rest of the steps will be natural steps, you'll have to hope that your body does what it is supposed to do. Good luck and God Bless.

      Delete
    2. Hi Dr Ramirez
      Well so far i did what i was supposed to do from monday till thursday (sexual intercourse) so i am anxiously awaiting to see if I am pregnant.Trust me Doc I did even conceivable sexual position just to ensure the sperms meet the eggs.When should I do a pregnancy test because I am so curious? I will keep praying to be successful.
      Do have a great week and God Bless

      Delete
    3. It will take at least 7 days from the point of ovulation before implantation will occur so don't check any sooner than 10 days if you are going to do a blood pregancy test or 14 days if you are going to do a urine pregnancy test.

      Delete
    4. Hi doctor Ramirez I just wanna find out how much days do I have to take clostilbegyt for my doctor told me to start taking it on the third day of period but it has ten tablets on the card

      Delete
  8. Hi Dr. Ramirez
    I am so worried these days because I have pain on both sides of my tubes with lots of back pains and I feel that I did not conceive because these are signs I normally get before my periods. Today Friday has only been nine days after ovulation so I don't know what to think? Are those signs also of implantation? I am so so anxious to do a pregnancy test but as you mentioned before i have to do a urine test till after 14days.Do I need to worry about these pains?
    Have a blessed week and God bless.

    Regards
    Michaelene

    ReplyDelete
    Replies
    1. Hello Michaelene,

      The pains could be many things and there is no way to know exactly what they are. I tell my patients not to worry about such pains unless they are accompanied by bright red vaginal bleeding like a period. For now all you can do is wait and see how things turn out.

      Good Luck

      Delete
  9. Hi Dr Ramirez
    So sooo sad but my periods came today and just yesterday as I sent you a message wondering about mt pains but as I say I figured was my periods on its way.I wonder what went wrong if probably the dosage wasn't strong enough.Too bad I cant start another course this month again so I will have to wait till my next periods (mid october).Do you think I should start another set of treatment as soon as possible? Have you any suggestions why this first treatment failed. My dosage with the Gonal F was 75mg for about 7 days then 150 for d remaining 6-7 days.I am so depressed I cried this morning. Take care and God Bless
    Regards
    Michaelene

    ReplyDelete
    Replies
    1. Hello Michaelene,

      I can answer some questions for you but this is not a consultation site so I can't comment on your protocol or treatment plan. That would require reviewing your medical records thoroughly.

      I'm sorry this cycle didn't work but you have to keep in mind that IVF is not a perfect technology and can take multiple attempts before it is successful.

      Delete
  10. Hi Dr Ramirez
    Thanks for replying to me ever so much.By the way how long does the fsh injections remain in your body because I am so hopeful I will get pregnant. I did not have enough money to start the treatment on saturday when my periods came so I will have to wait and see if my periods come next time I will go back on the Gonal F.I keep thinking maybe I did not conceive because I only had one mature follicle. What do you think? I think stimulation of my eggs need to be increased so I can have atleast 3 mature follicles.Do you think I need to use something more along with the Gonal F injections?
    Goodbless.

    Regards
    Michaelene

    ReplyDelete
    Replies
    1. The FSH injection doesn't last more than one day.

      In order to increase the number of follicles, you need to use more medication.

      Delete
  11. Hi Dr
    Hope you are well and in the best of health. You mentioned more medication along the Gonal F, can you give me some examples of such medication I should use.
    Take care and Godbless.
    Regards
    Michaelene.

    ReplyDelete
  12. Hell Again,

    When I say "more medication", I mean that the dosage needs to be increased. Not other medications.

    Good Luck

    ReplyDelete
  13. Hi Dr. Ramirez ,

    I had a miscarriage when i was 8 weeks pregnant.This was in April 2012.The doctor said i had polycystic ovaries and she is treating me for that currently.After trying to conceive again for 4 months i did not get pregnant. After my last visit with the she did not do any test or ultra sound etc and gave me a prescription for clomid. I'm confused because I have been using an ovulation kit for the past few months and i did seem to have an ovulation problem.I usually ovulate on the 11th day, however i took the clomid as the doctor prescribed and its day 12 and i'm still not ovulating...

    Kind Regards
    Trinidad

    ReplyDelete
    Replies
    1. Hello Trinidad,

      First, you need to find a real fertilit specialist because your current doctor is not treating you appropriately. Using Clomid should not be confusing and should be done under some type of treatment plan with surveillance to see if you are responding. Please look up how to use Clomid in this blog. I've talked extensively about it.

      Clomid could possibly change your cycle and so ovulation could be deferred to a later time that CD#11 and closer to CD#14. That is not necessarily unusual.

      Good Luck

      Delete
  14. hi mr ramirez
    i am 25 years old and i have been trying toget pregnant for awhile now and havent been fortunate to do so. and i have realised that my cycle has increased from a 28 days cycle to a 30-37 days cycle. why is this happening and is this the reason that i havent gotton pregnant? i was planing to use clomid on my next menstrual cycle. do you recommend this? thank you in advance for your advice

    ReplyDelete
    Replies
    1. Hello. The irregularity of your cycles indicate some type of ovarian dysfunction. Clomid is certainly a medication that we use to correct this and I would recommend it as long as there are no other reasons that would prevent you from getting pregnant. Before going to a fertility treatment, I recommend an infertility evaluation. In addition, I advocate Clomid or Femara as long as they are used appropriately. You can see through this blog how I recommend Clomid to be used.

      Delete
  15. Hello Dr. Ramirez,

    Two years ago I had laproscopy for ovarian cysts and the doctor diagnosed me with mild endometriosis. I have been trying to conceive for the past year and on Clomid 100mg from day 3 for the last 5 months. I normally have regular periods of 27-28 days but on clomid it is 29-30 days. This month my period came on day 35. Could the clomid be causing this? I also did two ultrasounds, HSG test, progesterone test and husband did sperm test. Everything came back normal. My gyno advised to increase the Clomid (which is clostilbegyt) to 200mg this month as it seems last month I did not ovulate on 100mg (faint lines on OPK but no surge. It this the correct move or might there be another problem?

    ReplyDelete
    Replies
    1. Hello,

      You are seeing the WRONG type of doctor and therefore, have been wasting your time. First, I would recommend that you go see an Infertility sub-specialist (one that does IVF if needed) instead of a general Gyn doctor. By now your doctor should have recommended transferring you any way if he/she were a good doc. Second, I do not use Clomid month after month, unmonitored. Please seem my entry under "How I Do Clomid cycles". You've obviously not been monitored because your doctor doesn't even know if you have even been responding to that dose of the medication. That's a mistake.

      It is possible that you may need increased dosage but that would only be if you weren't reponding to the previous dose. May be the endometriosis is the culprit and not the Clomid dose?

      Delete
  16. If a person is taking clostibegyt from day 1-5 of the menstrual cycle but doesn't have sexual intercourse until a week or so later will it still result in pregnancy?

    ReplyDelete
    Replies
    1. Clostibegyl (Clomid) is a medcation used for ovuation induction and therefore needs to be monitored to see if (1) you are responding to that dosage of medication (there are five potential dosages), and (2) how many follicles are being stimulated to grow and (3) when to time the HCG injection to stimulate ovulation and (4) when to start having intercourse. Most people will ovulate around CD#14. In general, Clomid is given from CD#3-7 or 5-9.

      If this doens't sound like the protocol that our doctor is using, it might be because your doctor doesn't know how to use Clomid or know anything about fertility treatments. It might be wise to find a doctor that does.

      Good Luck

      Delete
    2. i am on clostibegyt too from day 1-5 i take it on day 2 of my period then must have sex on 12-16 day will that help me to get pregnant?

      Delete
    3. Hi I'm from Trinidad an I suffer with PCOS and my doctor give me clostilbegyt to help me ovalate so i can be able to get pregnant cuz I've been trying over 3yrs now an I'm only 24yrs of age.

      Delete
    4. Keep in mind that there are FIVE dosage levels of clomiphene citrate (clostilbegyt) and each patient will respond differently. In many PCOS patients, the ovaries will not respond to the lower levels and they will require the highest dosage (250 mg). Also, in most PCOS patients, they will be completely resistant to Clomiphene and require injectable medications to induce ovulation. I would make absolutely sure that your doctor knows what he/she is doing, has experience doing this and follows you closely with ultrasound to determine if you are responding or not. Also, if your doctor is a GP or FP,, I would strongly recommend that you ask to see an infertility specialist since they are the most experienced in evaluating and treating infertility, as well as, PCOS patients.

      Good Luck

      Delete
  17. hi, im 26 and trying to get pregnant 8 years or more...i recently did a pelvic ultrasound an was told that i have polysistic ovaries. My gyn prescribed metformin to balance my hormones...1 per night then 2 in 24 hrs then 3 according to how my body responds to it. He also mentioned if im not comfortable with the increase then lower the dosage to 2 per day or 1 if necessary. He also prescribed 10 Clostibegyl 2 per day from day 3 of my menstrual cycle and i have to return on day 12 for another ultrasound to see if im producing eggs. My cycle used to be 1 or 2 days early now its 3-4 days. My cycle is very painful an lasts 3-5 days. I only started the metformin today. should this procedure help?

    ReplyDelete
    Replies
    1. Metformin only works in 30% of PCOD patients so it may or may not work. It depends on whether or not you are one of the PCOD patients with elevated insulin levels. The clostibegyl I believe is clomiphene? It is used with ovulation induction to stimulate the ovaries to ovulate, but many PCOD patients do not respond to low dose treatment. Two pills per day for 5 days is a low dose treatment. Dosages can go as high as 5 tablets per day for 5 days. The only way to know if a particular dosage is working is to give it a try and monitor the response by ultrasound.

      Delete
  18. Hello I have large ovaries my gyno puts me on metformin denk500mg tabs and mycrogynon 30 tabs 21s I want to get pregnant I have been on those from last year then I told her I want to get pregnant as soon as possible.I did some test before like ultrasound to view the walls of my uterus and she said they were fine but I had a small amount of cyst on my ovaries she gave me another pill for that she said that suppose to work I have keep a track on my menstrual and I have seen a period after two days after been off mycrogynon now I am on clostilbegyt 50 mg tabs starting on day three of menses .would this help me to get pregnant .thanks in advance s.b


    ReplyDelete
    Replies
    1. I'm sorry. I would have to review you medical records to figure out what is going on. I have no idea what your doctor is doing since it is not a standard method of treatment, and you don't mention what the "another pill" is by name.

      Delete
  19. Hello, I have been trying to get pregnant for 8 mths now. I am 36 yrs old. I was given clostibegyt last mth however I did not get pregnant. I am given a second dosage by my doctor this mth to be taken on the 3rd day of my menstrual cycle for 5 days. Can you tell me my next Ovulation date, my last 3 periods are as follows, March 15.......April 17 and May 16. Please tell me when I will be ovulating next mth.

    ReplyDelete
    Replies
    1. Hi. I can't tell you what your ovulation date is going to be as I don't have the ability to predict the future. It is something that needs to be monitored either by using an ovulation predictor kit or ultrasound. I prefer the ultrasound because it give more information, such as whether or not you are responding to that dosage and how many follicles you are growing. If your doctor has not been giving you this information then you need to find a better doctor.

      Good Luck

      Delete
  20. This comment has been removed by a blog administrator.

    ReplyDelete
  21. hi i bin trying to get pregnant for the pass 5 years and my friend tell me about clostilbegyt should i try it or see a doctor first

    ReplyDelete
    Replies
    1. It must be used under the direction of a Physician that knows how to use it.

      Delete
  22. I was giving provera 10mg for ten days and then to take clostilbegyt two days after my period starts do i have to take the provera for ten day are i can take them for five day and how long after would my period start after finsh taking the provera

    ReplyDelete
    Replies
    1. Hello. The protocol I prefer is to take the Provera for 5 days then the period should start within 7 days of the last tablet. If the period does not start by 7 days after the last tablet, that usually means that there was not sufficient endometrial lining to induce a bleed, so then I give a birth control pill 3 times per day for 7 days after checking a blood pregnancy test (that is required because another reason for the provera to not induce a period is if you are pregnant).

      Delete
  23. Hello I am 29 and have trying to pregnant over a year. I have been told by my doc that I have small fibroids that are on the lining of my uterus and maybe implantation has not occurred because of this. As well as my progesterone level is low. He had prescribed 50mg clostilbegyt to take on the 3rd day of my period for 5 days after which I should have sex on the 13th day at the start of my cycle. I have been on it for one month now. Still no luck, in fact my menses started late that month.
    Can this treatment work given my situation?

    ReplyDelete
    Replies
    1. Hello,

      The Clostibegyt does nothing for the submucous fibroids. If in fact that is what you have (fibroids that enter into the endometrial cavity), then it or they need to be removed.

      The medication also is not doing much. It is often used by general doctors such as Ob/Gyn's and Family practice thinking it does something to enhance fertility like a "fertility drug" should. In fact, it only helps to either increase the number of eggs you ovulate or to induce your ovaries to ovulate and does nothing for the remaining 8 steps required in the reproductive process.

      Having said that, you also have to know that since you are trying naturally, and not in the best protocol, it can take up to 12 months to achieve pregnancy just as it would if you tried completely naturally.

      Delete
    2. In addition,

      Please look up and ready by post on Clomid ovulation induction within this blog to give you an idea of how I think ovulation induction cycles should be done.

      Delete
  24. Hello, I have been diagnosed with PCOS for the past 10 years.As a result of this I have very irregular period to the point where it doesn't come for four months at times. My gynae have placed me on Provera so that I see my menses regularly . I have been given metformin 500mg that I take daily as he believes that this will help me to stabilize my weight which I must say was out of a control for a while.I recently did a D&C as my period was very heavy and painful and I was bleeding for 12 days non-stop. After the D&C I was placed on contraceptives so that I could have regular menses. I am now 30 and would like to get pregnant as I was told my best option was to be on contraceptives or provera and regularize my period for at least three months then take the Clostibegyt on the fifth day of my menses in the third month then engage in sexual activity 14 days later to increase my chance. Ps: I have done ultra sound and my ovaries are in good condition. What do you think are my chances of getting pregnant doc?....Caribbean girl

    ReplyDelete
    Replies
    1. Hello. The birth control pill will certainly make your cycles regular, because the way that it works is to shut down the ovaries and take over the cycle. It does NOTHING to help you begin ovulating or getting pregnant. Because you have an ovarian dysfunction or some type of ovulation disorder (this is defined based on testing), you will need to use some type of fertility medications to induce ovulation. There are several types PCO can be a difficult problem to treat and so I strongly encourage you to seek out a qualified fertility specialist. Otherwise, your gynecologist may be treating you inappropriately or incorrectly. By the way, if Metformin is going to work, and it only works in 30% of PCO patients, then you need to be at a dose of 1500 mg per day (500 mg three times per day). That makes me wonder about your doc's knowledge about this problem.

      Depending on your age, once you get treated appropriately, you should have a good chance of achieving pregnancy, especially if you are under 35 years old. Over 35 might be a little more difficult because age then becomes a factor.

      Delete
  25. Hello Dr. I am 26 and I have been trying to get pregnant for over a year. Without any success. I have irregular periods which normally comes with excursiating pains.

    My gyno referred me to do pap smear, pelvic ultrasound, Hsg which came back normal. I was then prescribed clostilbegyt 50 mg, 10 tablets 2 per day and tamoxifen ×30 one each day .
    My husband on the other hand did sperm test which proved is sperm count was low and was prescibed ubiquinol coq 10 ×30.

    Can I get your opinion on this so far. I wasn't told to abstain from sex is it safe to have unprotected sex while on the medications.

    Thanks.

    ReplyDelete
    Replies
    1. My first advice is to find a competent fertility specialist. Yours is not! You have two problems going on at this point that you've given in your history. This doesn't exclude other problems but that would require a complete infertility evaluation to check. The two problems are (1) an ovulatory dysfunction or lack of ovulation and (2) a sperm issue (decreased count). The clostilbegyt is to induce the ovaries to ovulate but the dosage given may be too low. Ultrasound surveillance is used to determine your response and to help time ovulation. However, this does not help with the sperm problem. Depending on the count, IUI may be required or IVF with ICSI. This is why you need to see a fertility specialist.

      Delete
  26. Good Day Doctor
    I am 30yrs old and has been trying to concieve for a few months without success.
    My History
    At 29yrs i had a regular light 26day cycle. Experienced slight brown discharge 3days before the period.
    i tried to convive for 5months and my dr stated i had pcos
    one ovary had small cysts the other was free of cysts.
    Was place on birth control for 3months
    This was followed by 100mg of Clostibegyt from day 2 to 6 of my cycle and provera for 20mg a day for 10 days from day 16. Sex is only to occur on days 12, 14 and 16 as recommended by my dr
    this was repeated for 2 cycles
    I am currently on 125mg Clostibegyt and the provera
    and it did not work this month.
    was instructed to repeat again.
    I want to stop as i fo not trust my doctor's advice anymore. I get extream ovary pain at day 10 to 14...it is so bad that it hurts even while having sex.Is this the correct treatment for me?What is your advice?

    ReplyDelete
    Replies
    1. Hello. First, if you have regular and predictable cycles, you DO NOT have PCOD/S. In order to have the diagnosis, you have to have an ovarian dysfunction as a primary criteria which means irregular cycles.

      I think you are wise to question this doctor's methods and recommend that you seek out a proper fertility specialist. Clomiphene cycles need to be monitored to determine the response to the medications, to make sure you are making too many follicles, don't develop ovarian cysts and time ovulation for proper timing of intercourse.

      Good Luck

      Delete
  27. good day.
    i have been trying to get pregnant.
    i am taking Clostibegyt on the 2nd day of my period for 5 days. When taking Clostibegyt is there a possibility that i can ovulate before my regular ovulation time? so that if i have sexual intercourse after my period but before my normal ovulation day would i still have a chance in getting pregnant. how long does the sperms stay alive my body for conception ? thank you in advance for your advice

    ReplyDelete
    Replies
    1. 1. Yes, you could potentially ovulate sooner than usual on this medication. That is why monitoring needs to be done to determine whether or not you are responding to this dose, how many follicles are growing and when they are ready to ovulate. I have written a section on using Clomid (another name for the same drug) so I would recommend that you review it.
      2. The timing of intercourse to achieve pregnancy is completely dependent on when you ovulate. You basically want to have sperm within the fallopian tube at the time the egg is released if possible. No one knows how long the sperm will live within the tube, but it is thought that fertilization has to occur within 12 hours after ovulation.

      Delete
  28. Good day Doc,

    I am 28 and my husband is 31.We have actively been trying to conceive since 2013. Last year January i experience a molar pregnancy. Since then we have been seeing our doc in an effort for me to conceive again. We have done all the test and everything came back normal. i have a regular 28 days cycle and my period last for 3 days. Over the past 3 months my doc prescribed clomid. i was to take it on the 5th day of my period for 5 days and was to have sex every other day. I did that but i'm still not pregnant. Doc i don't know what to do next. Thank you in advance.

    ReplyDelete
  29. Good day Dr. I've been told that I have Pcos only since last Thursday when I had an internal ultrasound. I've been trying to conceive since June well my gyne prescribed.... clostilbegyt on the 4th day of my period for 5days and also metformin 500mg 3 a day for 30 days... but he also told me take 1 a day to start of and if I have no side effects then continue with the 3 a day... however where the clostilbegyt is concerned the reason I started on my 4th day is because that's when I decided that I should go to the Dr. So he told me start it one time

    ReplyDelete
  30. Hi am a 34yrs old I have been diagnosed with PCOS I have very irregular periods every 6mths 4mths or 3mths which last up to 10 days even 14days I started seen an obgyn cause I have been trying to get pregnant over over 4yrs I was given Diane 35 which made me start having a period every month I was also given metformin denk 500 3times a day. Now am giving Clostilbegyt to take on the 3rd day of my period for 5days when do I need to have sex after taking closttilbegyt to try to get pregnant?

    ReplyDelete
  31. I have been trying to get pregnant about 2years now I have try Clomid and done a hsg test in April and nothing has happen.when back to my doctor the other day and he recommend clostibegyt and I most take it on day 5 for period I would like to know if it would work and if you have any suggestions.looking forward for your response as soon as possible

    ReplyDelete
  32. hello my name is racquel. i had sugery for block fallaipian tubes , i have been trying for 5 years taking all kind of stuff even clomid pill. i do hsg test, it said my right slighty open and my left block

    ReplyDelete
  33. Hi am 34 will i had sugery for blockage of tubes. i did hsg test showing my tubes slighty open, i have been trying for 5 years, i have one son 14 years old , and i loning for a child again please help me, i on clomib now

    ReplyDelete

  34. I married very late, today I am 46 years old, my husband and I would love to have a child, my health is good is just the age.
    We tried IVF, since I do not produce much eggs, I agree also on a donor with my husbands sperm.
    3 times already we had transfer even the eggs were in healthy and good condition, it did not wok out.i then saw some recommending azuba for infertility problems
    I am very desperate, unhappy about this situation, do not know what to do.
    The doctors are telling they do what needs to be done, but its not working,i then decided to contact Azuba via email(azubaspelltemple@gmail.com)
    I his mail address from a website, who recommend it, azuba did responded with kind words of hope , i did do all the spiritual cleanse and pregnancy spell,just like a miracle i tested and it was confirmed i was pregnant 2months later that was on the 13th of may 2011, and i gave birth to a baby boy named miracle lol,this year now i didnt even try i did august 29 2014 i am also pregnant again thanks to Azuba for the help of making me a mother,,,if you have any infertility and other problems i recommended Azuba for you,,Azuba email azubaspelltemple@gmail.com or tel +2348149271063,website:https://azubaspelltemple.wordpress.com

    Thank you very much.

    ReplyDelete
  35. Hello,
    I am here in need of some help. So it all started last month when I got a positive pregnancy test. Note, I'm suffering with PCOS, though I see my period every month. I'm also 21 years old. The doctor asked if I was trying to get pregnant and I said yes.. He then gave me to take metformin and clostilbegyt. I took the cycle, however I was unsuccessful in getting pregnant. This time, he has put me on metformin, clostilbegyt and prednisolone, in hopes I will get pregnant. Is he overdosing me cause of recently the prednisolone has made me had blurred vision and I'm not feeling so good. I'm thinking my body needs adjusting to it. But I really want to get pregnant. Someone please help me!!!!

    ReplyDelete

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