Sunday, June 26, 2011

Hypothalamic Amenorrhea BFP

I've been tracking pregnancies on the fertilethoughts hypothalamic amenorrhea thread for about four years now. I think that the stats are quite interesting, and definitely belie the common wisdom in the RE community that A) women with HA can "gain 50lbs and still not get their cycles back", and B) "Clomid doesn't work if you have HA". To wit:

Total pregnancies: 240

First post-HA pregnancy: 190 pg
Natural*: 54 (28%)
Clomid**: 52 (27%)
Clomid + injectables: 7 (4%)
Injectables: 47 (25%)
IVF: 27 (14%)

HA vets - subsequent pregnancies: 50 pg
Natural: 38 (76%)
Clomid: 3 (6%)
Injectables: 6 (12%)
IVF: 3 (6%) - one first from adoption, one from injects, one from IVF

m/c rate: 20%

Notes:
1. First post-HA pregnancy is not necessarily a first pregnancy as some develop HA after having a child already due to overexercise / underfueling.
2. I have grouped Femara and Clomid together in these stats
3. Due to miscarriages, some people are represented multiple times
4. Injectables is usually Menopur as with HA we need LH in addition to FSH to have the best response to injectable cycles. Some people have used FSH + hcg or Luveris. FSH alone is more likely to lead to cycle cancellation.
5. The proportion of BFP from injectables has decreased to about 17% if you look at the last three years only - since the Clomid extended protocol paper came out.

* 8 were natural after clomid, 5 of those after extended clomid
** 9 were extended clomid

8 comments:

Josey said...

This is incredibly interesting to me, even though I don't have HA. Great information to have out there though - thanks for taking the time to compile it!

Ceejay said...

First of all, I like the new look on your blog! Second, thanks for redoing the stats. This is so interesting. I especially love that 76% of second post-HA pregnancies were natural--I'm definitely planning to add to that number! It goes to show that our bodies can recover from this if we give them what they need. I think many (myself included) did clomid, injects, or IVF the first round because we couldn't take the waiting any more, but probably at least 76% could have done it without the interventions if time wasn't an issue.

Amanda said...

Love the new look! You are amazing for keeping track of all this. Thank you so much Nico.

300 pregnancies!? I love that the majority in both cases were naturally. These stats are very motivating :)

♥ JAM said...

So grateful for your record-keeping!
Love the new colors on your blog!

-Jam

aok said...

Great stats! I used to post on the board as "aok" and wanted to give you an update. After my 6th round of clomid (at 100mg for 5 days), I am now 26 weeks pregnant. The first 5 rounds of clomid resulted in 2 chemicial pregnancies and one D&C miscarriage at 10 weeks. Clomid always made me ovulate even though the doctors thought it wouldn't.

I am still following along your journey and wishing the best for you this round!

Rosebudk said...

Thank you for this! I'm taking Clomid now and was told it wouldn't work for me but the Dr. wants me to prove her a liar and this gives me hope I just might! Thanks:)

Lisa said...

Quite interesting.

Christina said...

Taking clomid now. Hoping I ovulate. Fingers crossed!