Another frequently used term is " Clomid resistant. In such cases, we need to use injectable gonadotropins like Gonal-F or Follistim to restore the ovulatory cycle. A woman can start taking Clomid tablets between cycle day three and cycle day 5.
Each tablet contains 50mg of Clomiphene Citrate. Typically patients take tablets daily for a total of five days. The medication remains effective in the body even after all tablets are consumed since the half-life is very long.
In some cases, when used as an adjunct to mini-IVF, it can be given over an extended period of time. Typically your physician will bring you back after about a week to evaluate the ovarian follicles with an ultrasound. You might be instructed to test for natural ovulation or might use an ovulation-inducing trigger shot instead.
You will be notified to have timed intercourse or undergo intrauterine insemination. Your doctor might monitor your progesterone blood level. A pregnancy test is done about 14 days after ovulation. Yes, there are other oral medications that can stimulate the ovaries by the gonadotropin-releasing effect.
Some of them are Letrozole and Tamoxifen. They can be utilized instead of Clomid. In-fact, Letrozole has replaced Clomid as the first-line agent for ovulation induction in PCOS patients due to better success rates. A more potent alternative is injectable fertility drugs, typically used in IVF. Your gynecologist or fertility doctor can provide you with a prescription.
Sometimes a general health practitioner can also provide you an order. We recommend seeing a fertility specialist whenever possible. Their expertise in female infertility can ensure that Clomid is the appropriate treatment for your condition.
Fertility clinics are the best places to obtain and monitor Clomid treatment due to their highest expertise in infertility. Clomid is still considered low-tech fertility treatment and is typically a covered benefit by any primary health insurance, including HMO plans like Kaiser Permanente.
Kaiser patients with infertility issues can read more about the Kaiser Permanente fertility treatment options here. Transvaginal ovarian ultrasound monitoring is the best way to evaluate ovarian physiology. In limited circumstances, a diagnosis of ovulatory dysfunction can be made by patient history and presenting symptoms in a remote consultation with an experienced reproductive endocrinologist.
Blood tests can confirm this diagnosis, and Clomid therapy can be initiated remotely. Monitoring ovulation at home might be a challenge since a vast majority of patients with ovulatory dysfunction suffer from PCOS and might have increased baseline Luteinizing Hormone LH levels.
Thus, detecting ovulation becomes somewhat tricky, but a patient can be guided on how to correctly interpret the results and, in some cases, use diluted urine specimens to improve the specificity of urine strip ovulatory tests.
Modern urinary fertility monitors further detect Estroneglucuronide, and this can alert the Clomid user of rising estrogen levels and a developing follicle.
However, no home monitor can provide information on the number of developing follicles or thickness of the uterine lining. In general, unmonitored Clomid therapy might only be justified with patients with irregular or absent periods. Patients with regular periods seeking Clomid therapy are strongly encouraged to have monitored cycles only! Clomid can be used for male infertility. The brain then thinks that estrogen levels are very low so it releases GnRH hormone which goes to the pituitary gland and stimulates release of follicle stimulating hormone FSH.
The job of FSH is to stimulate development of a mature follicle egg containing structure in the ovary. Women that do not ovulate regularly, such as those with PCOS, will often ovulate after taking Clomid. However, this is quite variable and many anovulatory women will not respond to Clomid and ovulate at all.
On the average ovulation occurs about days after completing a course of Clomid pills. This varies quite a bit, depending on whether the woman ovulates regularly on her own or not.
Some women will ovulate before seven days after the last Clomid tablet and some that have very irregular cycles will ovulate much later — as late as two or three weeks after the last clomiphene tablet. The protocol for taking Clomid is somewhat different according to whether the woman ovulates on her own or not.
Please see the Clomid protocols on the appropriate page:. It is best to have intercourse on the day of ovulation possible. The trick is to figure out what day that is. Ovulation generally occurs about 14 days prior to the onset of the next menstrual period. For example, if the woman has a 32 day cycle length on Clomid, then she is probably ovulating on about day A good plan for having intercourse would be to have sex on about days 16, 18 and When follicle scans are used with Clomid along with an HCG injection, the ideal follicle size for getting mature eggs is about 18 to 30 mm diameter at the time of the hCG injection.
Ultrasound and blood testing during Clomid cycles will also show us when no mature follicles are developing in response to the medication.
It is also a preferred choice for women who have PCOS since the dosage can be closely monitored, minimizing the chances of high order multiples triplets or higher. Clomid blocks estrogen production, and this stimulates your hypothalamus and pituitary glands to produce gonadotropin-releasing hormone GnRH , follicle stimulating hormone FSH and luteinizing hormone LH.
The presence of these hormones catalyzes the maturation of the egg follicles, increasing the chances of ovulation.
Thus, Clomid is not an infertility treatment cure-all. Clomid does not increase your chances of pregnancy if you have infertility factors that are unrelated to ovulation, such as blocked tubes, uterine abnormalities, ovarian failure, pelvic lesions, certain male infertility factors, etc. One of the reasons doctors and their patients prefer Clomid is that it has reasonable success rates and minimal low-risk side effects.
Those who do have side effects report bloating, nausea or headaches. Blurred vision and hot flashes have also been reported. Very few women ever experience serious side effects from Clomid.
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