Lesson 3: Your Doctor, Your Options

Ovulation and Clomid

In order for pregnancy to be possible, a woman must release an egg each cycle. There is more to conception and pregnancy than just the release of an egg, but, if there is no egg to be fertilized, nothing else can happen. In Lesson 1, section 5, we discussed the differences between Fertility Charting and OPKs. Most women can detect ovulation using one or the other method.

When ovulation cannot be detected, one of the first things a doctor will evaluate is the woman's hormones for a cycle, and the following cycle, if ovulation did not happen, will be started with Provera, and followed with Clomid. Clomid is the first low-tech fertility medication that doctors will turn to. It is used for the following.

• Lack of ovulation
• Irregular ovulation
• Late cycle ovulation
• Early cycle ovulation
• Luteal phase defects
• Weak ovulation

Clomid, Serophene, and Clomiphene Citrate are all different names for the same medication. To keep confusion to a minimum, this drug will be referred to as Clomid throughout this course. The dosage of Clomid used should always be started at 50mg daily for five days. The dosage can be increased by 50 mg if it did not result in ovulation the previous cycle. The maximum dosage is 200 mg.

This medication works by binding to estrogen receptors. This causes the pituitary and hypothalamus to assume that there is not enough estrogen being developed. These two glands then produce higher levels of FSH and LH, which in turn causes the development of eggs in the ovaries. When the LH surges, one and sometimes two mature eggs are released. It is rare for a double or higher ovulation to occur with Clomid.

Clomid is usually started on day 3 or 5 of the woman's cycle and is taken for five days, as was stated before. About 5 to 9 days after the last dose is taken, ovulation should occur. A woman must be monitored with ultrasound while on any fertility medications, Clomid included.

The reason for monitoring any medicated cycle is to help prevent Ovarian Hyper Stimulation Syndrome, or OHSS for short. Hyper stimulation occurs when the ovaries develop and release too many eggs. When the eggs are released during ovulation, fluid is also released into the abdomen. If too many eggs are released, too much fluid will also be released and the abdomen will swell. This is a serious health risk, and can cause death if not treated properly. This is rarely seen in women that take Clomid.

Some side effects of Clomid that should be immediately reported to your doctor include:

• Seeing spots
• Blurry vision
• Seeing flashes
• Severe migraines

Other side effects of Clomid include:

• Hot flashes
• Breast tenderness or swelling
• Lack of EWCM
• Nausea
• Headaches
• Mood swings

These other side effects are annoying, but are not severe enough to warrant stopping the medication.

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