The Clomid Conundrum

So, I am starting on my third round of Clomid today. I'm sure every couple that has experienced infertility has heard of or had to use this drug at some point during their journey. Let me just say, I HATE Clomid. 

Here is why:

1. You get side effects twice, while you are taking the medicine and then after you ovulate

2. One of the side effects: you become an emotional disaster. The packaging calls this "mood changes", which is a pretty glossed over term for what happens. This side effect didn't really hit me until it was time for my period to start (12 days post-ovulation). I basically spent the next 3 or so days willing myself not to burst out in tears. At work, at home, at the gym, literally ALL day. Nothing would even be happening! I just felt so sad. Trying to contain it only made the next wave worse, but I can't imagine trying to explain my incessant sobbing to co-workers, customers, complete strangers, etc.. I have heard from other girls that this was the major side effect for them as well.

3. All the other side effects: MIMIC pregnancy! Now, I am a pharmacist and I read up on this medicine, so I thought I knew what to expect. But the heart won out over the brain, and when I started to experience extreme breast tenderness, darkened areolas, sore lower back, nausea and fatigue, I was sure I was pregnant. I was so sure that I planned out exactly how I was going to surprise Travis with the positive pregnancy test. My cycle is like clockwork, so when my period didn't show up day 28 at 10am as it always had, I was even more sure. I bought my pregnancy tests that night and planned to take the test in the morning. I got up early, peed on the stick and waited my two minutes. Not pregnant. Two days later my period came. Which leads me to #4.

4. Clomid can make your period late and heavier than normal. What a kick in the vagina! Not only are you not pregnant, but now you must suffer through a longer, grosser (more gross?), more painful period. Rude. I had a LOT of cramping the first couple of days and, to spare too much detail, the bleeding was just not right.

So you ask, why then are you on cycle 3 of this monster drug?

And here is why. I just cannot go through a month thinking that I didn't do everything possible to make this work. I feel like the regret or the "what if's" would be worse than #2, #3 and #4. So I continue on.

Here are some fun facts that I have learned about clomid since starting that I feel might be helpful to others:

1. Clomid essentially makes you a "super-ovulator". This is why it is so successful in women that have difficulty ovulating on their own. For the "unexplained" crowd, this is most likely NOT going to make you get pregnant without utilizing some other therapies. I think this is really important to think about before startung and something my doctor did not tell me. If ovulation isn't your problem, then all this drug is going to do is possibly make you spit out multiple eggs. Kind of a "if it ain't broke, don't fix it" type of thing. For unexplained infertility, it has been shown to be significantly successful only when coupled with other medicines and/or IUI. I took this for the first month without any additional therapies and was really mad when I realized it was probably for nothing.

2. You cannot take Clomid forever. The official labeling states that you should not use it for more than three months, with a MAX of six months. I've seen on other baby blogs that a lot of doctor's prescribe longer, but it can cause serious side effects to your ovaries. Here is official warnings from the FDA website on clomid:

If three ovulatory responses occur, but pregnancy has not been achieved, further treatment is not recommended. If menses does not occur after an ovulatory response, the patient should be reevaluated. Long-term cyclic therapy is not recommended beyond a total of about six cycles
Read more at http://www.drugs.com/dosage/clomid.html#kPz7Ruv2LBuhiF2w.99 

There are other options beyond clomid such as femara and injectables, so ask your doc about switching it up beyond six cycles.

3. One of the side effects of clomid is multiple births. Your chances are raised up to 10%. Now, I welcome this side effect with open arms. After 2 years of trying,  it would be great to pop out some babies all at once and be done with it. 

Here are the questions I still have about it and hope to get insight on through this blog:
1. How successful is it in unexplained infertility when utilized with IUI (which I am starting this month)?
2. Does it mess up your ovulation/cycle after you stop taking it?
3. Do the side effects feel different from actual pregnancy? 

I am hopeful for month three with the added IUI. Maybe then my hatred for Clomid will turn in to love!