Scared about clomid challenge test before IVF?

[cpalumbo]

Hi everyone. I am new here and I need some advice. I posted this on the general infertility thread and nobody replied so I decided maybe I should place it here instead.

I had a laparoscopy for stage IV endoemtriosis in Sept. 2003 where they ended up having to do a 12 inch bowel resection and an appendectomy because I had the endo so bad. It was also surrounding both ureters and my bladder, my tubes and ovaries were fused to my uterus, etc.... Not good.

Anyway, we went on trying to conceive for the next 2 years and all that has happened is that the endo has returned, I now have chocolate cysts on both ovaries, and I recently learned I also have endometrial polyps - they found some growing outside of my uterus during my annual pap test last month. Did I mention that I also have the hormone imbalance consistent with PCOS (although I do not have all the string-of-pearl type cysts, just the 2 endometriosis cysts (one on each ovary).

We had decided to do in vitro because I am 34 yrs. old and will be 35 yrs. old in November, and I have consulted 2 different docs from different clinics and both agreed in vitro is my best shot. The first step in this is that they want me to do the clomid challenge test. I went yesterday for my day 2 baseline bloodwork and the baseline ultrasound, and the lady found at least one FIBROID, on top of all the other things I already have mentioned above.

My problem is that I am afraid the clomid challenge test will worsen the cysts, polyps and fibroids I currently have. Shouldn't they remove all those things and THEN do the clomid challenge? I have an HSG scheduled for next Tuesday so they can get a better idea of the fibroid/polyp situation.

My doc's plan was to give me the clomid challenge, then give me lupron for 2 months and then go to in vitro. He took 19 vials of blood a couple weeks ago to check all my levels of all hormones and to do the glucose challenge test because they need to see if I have insulin resistance because of my LH/FSH imbalance (the PCOS hormone imbalance I have). I also have an autoimmune thyroid problem (graves disease) that was corrected in 1999 and I now take synthroid and my thyroid levels are all normal, but he did tests to see if I have the autoimmune factor so he can put me on meds to ensure I keep a pregnancy if I ever do get pregnant.

I just feel he should wait until all those test results come back and wait for the results of the HSG test (to see how many fibroids I have and how many polyps I have, and where they are located, and determine if they need to be removed) before I do this clomid thing. I am worried about hyperstimulation and I am so worried all of my other problems will worsen.

The big issue is I am supposed to start the clomid tomorrow (day 5 through day9). I know, I know... way to wait until the last possible minute to do research and ask for advice.....

Sorry this message is so long. Can anyone offer any advice, or tell me their stories about having existing cysts, fibroids, endometriosis, etc.. and how clomid effected their existing conditions?

Thanks so much for any advice or words of wisdom.

[NMC]

I am sorry but I don't have specific info about your condition to help you but I wanted to say that if you feel strongly about your concerns regarding the clomid, then you should definitely call your RE and talk about it. Tell him about your concerns and maybe he can help put your mind at ease or even postpone the test. I don't really know what the clomid challenge test is for. Maybe someone else on here knows more about it. My advice is to speak to your RE ASAP!!!!!!

Good luck with everything!

[SomedayMommy]

cpalumbo - from Cleveland! There are a lot of us here from Ohio. I'm guessing that you either go to Cleveland Clinic or University Hospitals? You will find company on this board at both clinics!

Clomid is pretty mild and works indirectly, so I would not be too awful worried about the clomid. You've got a lot going on!

As for your fibroid - it depends on where your fibroid is located. If it is on the outside of the uterus, or if it is sandwiched it your uterine wall, then they will most likely leave it be. However, if it's protruding into the uterine cavity, then yes, they will maybe want to do soemthing about it.

As for the polyps - yep, if the hsg shows the polyps are in the lining as well, then they will want to remove those with hysteroscopy before the IVF.

And, as for the cysts, sounds like RE is hoping the lupron will do the trick there. I don't know much about "chocolate cysts" - I've heard of them, but don't know much about them, but if they are similar to other types of cysts, the lupron should do the trick, and if not, they could be aspirated?

But I don't see anything wrong with doing the clomid challenge test now.

ETA that you may want to change the title of your message to "scared about clomid challenge test before IVF" - a lot more women on this board have experience with that test than do using clomid to ttc, which is what some may think you post is about.

Best wishes to you!!!

[BC-KarenS-MI]

SomedayMommy gave you some good advice. I changed the title of your post so that perhaps it would catch more people's attention. I would definitley call your RE's office & discuss your concerns with them. They'll tell you what they think.

I never had to do the CCT, but I do know that you won't get OHSS with Clomid.

Good luck! Let us know what you decide to do, ok?

Karen

[cpalumbo]

Thank you both very much for your words of wisdom. I am so glad I found this board. It helps so much to know that you are not alone.

Yes, I have been regularly going to the Cleveland Clinic but the doc just kept pushing the IVF without even asking me if I wanted to do it. Plus I would ask questions and he would just give one word answers instead of expanding and my friend talked me into seeing a doc at University Hospitals because he is supposed to be very thorough and will do all sorts of testing to see what is really going on before just rushing to IVF. My friend was right, he ended up talking to me for 2 hours during my first visit and then he took 19 vials of blood (no kidding!!!) so he could get a clear picture of what is happening, especially with the PCOS-related hormone imbalance. I feel like I am in good hands.

Thanks for making me feel better about the clomid. I have so much going on in my head and I have read so many horror stories on the internet. I need to force myself to stop researching and just listen to the darn doctor!!

I will attempt to change the title of my post too. I am not too computer savvy so hopefully I'll be able to figure it out!!

Baby dust to all of you!

Char
Cleveland, OH

[cpalumbo]

Originally Posted by BC-KarenS-MI

SomedayMommy gave you some good advice. I changed the title of your post so that perhaps it would catch more people's attention.

Thanks, Karen!! I appreciate it!

[SomedayMommy]

Char, you are in great hands at either place! Oh, and there is nothing wrong with research! Nothing at all! In fact, I think it's real good to be informed!

[BC-KarenS-MI]

Where's that fainting smilie??? There have been SOOO many times that I've wanted to use it!! ANy way, I was like when I saw that you had 19 vials of blood taken!! I really WOULD have fainted!!! I'm only good for about 5 vials before I start to feel like I'm going to pass out!!! They certainly would've been scraping me up off the floor!!

I hope that you feel just a little bit better about things. Your RE has only your best interests in mind & wouldn't do anything that would negatively impact your odds of success. After all, a success for you is a success for them & that's the reason they are in this business!!

Hang in there!!

Karen

[cpalumbo]

Yeah, I was pretty shocked myself at the amount of blood. The lady kept saying "he wants me to take a lot of blood" while she was looking at the orders, and people have said that to me before and they only ended up taking 4 or 5 vials, so when I saw her taking out all these empty vials, I was going, "holy #&*#&@*!!!" and she said not to worry because they can safely take a whole pint and apparently the 19 vials didn't quite equal a pint.

Whelp, I have decided, after reading your comforting words, that I AM going to take the clomid. In fact, I am going to run to the pharmacy on my lunch hour to get it filled. I would have done it last night but I had originally decided I wasn't going to take it. You all have changed my mind.

Thanks again for everything! I love this board. ;-)

[SomedayMommy]

Char, I don't know what I would do WITHOUT this board!!!

Stick around! I'd love to know what becomes of all your tests.