Re: clomid and single shot pergonal for first line obgyn's
From: mark decker (mdecker@nconnect.net)
Sat Apr 27 21:07:07 1996
thanks a lot for your advice.
so noted and greatly appreciated.
thanks again.
like your first name too gggggg
Mark
At 05:21 PM 4/27/96 -0500, you wrote:
>This protocol is similar to the clomiphene 3-7 and metrodin 75u 8-10. That
>protocol has about a 16% pregnancy rate. I think these are good techniques
>but have a considerable increased risk of multiple births and I had one
>patient with severe hyperstimulation requiring ICU and multiple para and
>thoracentesis after clom/metrodin.
>Although these complications are rare, I think you best be comfortable
>managing them if you plan to provide this therapy. The risk of multiples
>closer to pergonal rather than clomiphene alone. (Although I think the body
>of data is rather limited). I also think that the clomiphene break point is
>an important time for a more extensive evaluation.
>
>In fact, I evaluate most PCO patients for insulin resistance and have
>pregnancies and normal cycles in a few patients after managing their
>diabetes! I have also found Cushings, severe male factor, stage IV endo in
>the rectovaginal septum and vagina, endometrial polyps, endometrial
>compression due to leiomyoma, premature ovarian failure and more in patients
>who have failed clomiphene. I think you would best be served by discussing
>this option with a local RE who could evaluate the patient and send back to
>you for this management.
>
>As an RE, I find that early consultation with ongoing care provided by the
>OB/GYN generalist, or the establishment of infertility clinical pathways,
>can lead to the best care. I strive to involve the generalist as their time
>and interest permits throughout the course of treatment.
>
>Estradiol values are rarely needed. IUI is reqauired if you are treating
>unexplained infertility. Percoll preps seem to work best.
>
>At 09:25 PM 4/26/96 -0500, mark decker wrote:
>>I would like to hear from reproductive docs or anyone else using a protocol
>>of clomid 100mgs day 3-7 or 5-9 in conjunction with one single dose of
>>pergoanl. with reported successful pregnancy rates of 20% per cycle it is
>>tempting to use it.
>>
>>Is this safe for a primary doc to do or do you need immediate return times
>>on estradiols and the like?
>Mark Perloe, MD
>Atlanta Reproductive Health Centre, 285 Boulevard, NE, Suite 320, Atlanta,
>GA 30312
>voice 404-265-3662
>WWW Homepage: http://www.ivf.com
>I had a life once, now I have a computer
>
--
mark decker md major surgery is done on me
obgyn minor surgery I do one someone else.
west bend wi I need to remember that. <perspective>.
