CLOMID FOR OVULATION INDUCTION
Clomid (Clomiphene Citrate) is a fertility drug used for the treatment of ovulation disorders. Clomid may be
used to treat women with complete failure to ovulate or for the treatment of luteal phase defect. Clomid acts
by causing the pituitary gland to produce a higher level of the hormones (FSH
and LH) that control ovulation.
Clomid is taken in pill form from the 5th
through the 9th day of the menstrual
cycle - day 1 is the first day of full
menstrual flow. The dose of Clomid may
vary from 1 to 4 tablets per day
depending on individual patient
response. The usual starting dose is 1
tablet per day. Clomid may be taken at
any time of day and if more than 1 pill is
prescribed, the total dose may be taken
all at the same time.
As Clomid treatment is started we will
often see you for a “mid cycle scan.” At
that appointment we will perform a
sonogram to see how your ovaries are
responding to the drug – how many eggs
have developed. In a small percentage of
patients, Clomid interferes with
endometrial development (the uterine
lining) or with cervical mucous
development. We will check those things
as well.
Clomid may delay ovulation by 1-3 days
– relative to your usual cycle.
At mid cycle you may be given human
chorionic gonadotropin (hCG). hCG is a
hormone, given by injection, that mimics
the pituitary gland message to the ovary
to release the egg. It is helpful in timing
intercourse or artificial insemination. It
also has a beneficial effect on hormone
production during the luteal phase (the
second half of the ovarian cycle).
Occasionally, women taking Clomid have
side effects. Common side effects
include: headache, abdominal fullness or
bloating, hot flashes, blurred vision.
These side effects are usually temporary
and are mild. There are several case
reports of persistent blurred vision after
clomiphene treatment. Occasionally
Clomid causes moodiness or even mild
depression.
Clomid is highly effective in stimulating
ovulation. Approximately 80% of women
who are treated with clomiphene will
ovulate. Pregnancy rates vary depending
on other factors - sperm count, etc.
Many clomiphene pregnancies occur
within 3 or 4 treatment cycles.
There are two recognized risks of Clomid
treatment: multiple pregnancy and
ovarian cyst formation. Approximately
8% of Clomid conceptions are multiple -twins or more. This may occur even on
the lowest dose of Clomid.
Approximately 10% of women who are
treated with clomiphene will develop an
ovarian cyst. For this reason, a pelvic
examination is performed at the end of
each treatment cycle - around the time
of your menstrual period. If an ovarian
cyst is detected, clomiphene treatment is
withheld during the following cycle. The
ovarian cyst usually resolves without
further treatment.
Clomid has been in clinical use for over
30 years. There is a large amount of data
that suggests that babies born as a
product of clomiphene treatment have a
normal risk of congenital anomalies - not
higher and not lower. Clomid is widely
used and is generally accepted as a safe
drug in this regard.
There have been a variety of serious
illnesses reported in association with
Clomiphene treatment. Their frequency
is rare or extremely rare and in some
cases a proven link to Clomiphene
treatment as the cause is not clear.
There have been at least two
publications suggesting there may be a
link between Clomid treatment and
increased risk of ovarian tumors. The
first publication was in 1993 and noted
that women who took " fertility drugs”
seemed to be at increased risk of
developing ovarian cancer -particularly if
they never conceived a pregnancy. A
second study was published in 1994
with long-term follow-up of a large
number of infertility patients. This study
showed an increased risk of ovarian
cancer in women using clomiphene
citrate for treatment of ovulation.
The increased risk was noted only in
women using the drug for 12 or more
treatment cycles (that is - 12 total cycles
not necessarily consecutive). Since
these initial publications, there have
been several larger studies of this issue,
which have concluded that there is not a
link between Clomid (or any other fertility
drug) and an increased risk of ovarian
cancer.
Making Clomid follow up appointments:
a follow up to check for ovarian
enlargement is performed either a week
before the period is due (allowing for a
blood test to check progesterone level)
or at the end of the cycle. We call these
appointments “ovary checks.” Your
fertility specialist will tell you what to
schedule.
KEY POINTS ABOUT CLOMID IN
SUMMARY:
Cycle day 1 is the first day of full
menstrual flow.
Intercourse on the day of ovulation
predictor kit change and/or the following
day or every other day 10 thru 20.
Pelvic exam/”ovary check” at the end of
the cycle or one week after ovulation if a
blood test for progesterone is planned.
No comments:
Post a Comment