Buy Clomiphene Citrate for Women
Ovulation
Ovulation is the monthly process a mature egg is produced by the female reproductive system. During ovulation, the brainâs pituitary gland releases two hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones are known as gonadotropins. FSH acts as a âmessengerâ sent by the pituitary gland to stimulate the development of follicles in the ovaries, every one of that will contain one egg. LH is responsible for triggering the release of the egg (ovulation).
Throughout the first half of the menstrual cycle, the ovarian follicles produce the hormone estradiol, which stimulates the growth of the uterine lining (endometrium) as well as the production of the watery âraw egg whiteâ cervical mucus that functions to help the sperm as it swims up through the uterus to the fallopian tubes. After approximately two weeks, the pituitary releases a surge of LH hormone. During this period, the follicle called the corpus luteum, begins to produce the hormone progesterone, which serves to thicken the uterine lining to prepare for pregnancy that is possible. Two weeks after ovulation, in case a pregnancy hasn’t occurred, progesterone production is stopped by the corpus luteum, the endometrium sloughs off and menstrual bleeding occurs.
Ovulation-Inducing Fertility Drugs. Any number of conditions can hamper the bodyâs ability to ovulate effectively. Among the primary ways is with medications that stimulate the ovarian follicles to produce multiple eggs. The two most common fertility medications used to promote ovulation include Clomiphene Citrate (Clomid or Serophene) and Gonadotropins (Follistim, Menopur, Bravelle and Gonal-F).
Clomiphene is a synthetic chemical, taken orally, that binds to estrogen receptors in the brain and causes pituitary FSH levels to rise (see below). Gonadotropins given by injection, bypass the pituitary gland and stimulate the ovaries and, are identical to human protein hormones FSH and LH.
Clomiphene Citrate treatment
Clomiphene is a trusted oral medication relied upon for low cost, effectiveness and its safety. Clomiphene is used to treat absent or irregular menstrual cycles (ovulation induction), to address a condition called luteal phase defect by increasing progesterone secretion through the 2nd half of the cycle and also to make menstrual cycle lengths more predictable, thus improving the timing of intercourse or artificial insemination. Clomiphene may also be used to enhance ovulation in women that are already ovulating (ovulation augmentation).
How does Clomiphene Citrate work?
Clomiphene triggers the brainâs pituitary gland to secrete an increased amount of follicle stimulating hormone (FSH) and LH (luteinizing hormone). This action initiates ovulation and stimulates the growth of the ovarian follicle.
Within a normal menstrual cycle only one egg is ovulated. The use of clomiphene causes the ovaries to produce three or two eggs per cycle. Clomiphene is taken for 5 days and is active throughout the month it’s taken.
Clomiphene Citrate for ovulation induction. Clomiphene used along using a medication called Provera may be effective in initiating ovulation and menstruation in women who’ve no menstrual cycle:
Treatment begins with a 5-7 day course of Provera, taken orally.
A menstrual period should begin two to three days after Provera is completed.
About the 3rd, 4th or 5th day of menstrual flow, a course of clomiphene is started.
A clomiphene citrate 50 mg tablet is taken for 5 days.
On day 11 or 12 of the menstrual cycle, if an ovarian follicle or follicles have developed ultrasound monitoring is conducted to determine. Also only at that time, patients are asked to use an ovulation predictor kit to test their urine to get a surge in LH (luteinizing hormone) indicating that eggs have matured and ovulation is imminent. If no LH surge is detected, ovulation itself may be triggered having an injection of the medication hCG (Ovidrel), that may cause the release of the mature egg(s) from your follicle(s).
Natural intercourse or insemination is timed to ovulation.
A form of the hormone progesterone is provided via vaginal tablets or gel, if ovulation was assisted by means of an hCG injection. The progesterone hormone serves to support the endometrial (uterine) lining and prepare it for the fertilized egg.
Two weeks after ovulation, patients are asked to have a home pregnancy (urine) test. A blood test is going to be performed to confirm results in the event the test is positive.
If ovulation doesnât occur during this initial clomiphene dosage, another course of provera will undoubtedly be prescribed as well as the dose of clomiphene increased until ovulation occurs. It could possibly be possible to begin another clomiphene cycle immediately or, if residual cysts are present on the ovarian follicles, a ârestâ cycle could possibly be advised before resuming treatment.
If ovulation is unable to be induced even with a higher dose of clomiphene, this form of treatment will probably be discontinued, and ovulation induction could possibly be attempted again using a different form of fertility drug (letrozole or gonadotropins).
Clomiphene Citrate for Ovulation Augmentation. In women that menstruate on their own, clomiphene might be used to help more than one mature egg to be produced by the ovaries. That is sometimes described as âsuperovulation.â The process is as follows:
On Day 3 of the menstrual period, a course of clomiphene is begun. Starting clomiphene in the cycle helps using the recruitment of a lot more than one egg that is mature.
Two clomiphene citrate 50-mg tablets are taken orally for 5 days, to cycle day 7 from cycle day 3.
On day 11 or 12 of the menstrual cycle, if an ovarian follicle or follicles have developed ultrasound monitoring is conducted to determine. The ultrasound helps to determine just how many mature eggs are forming within their follicles. In order for ovulation induction to be successful, 23 follicles should be visible at this point (with just one follicle, we’d not be significantly enhancing a womanâs chances to become pregnant). It produces the hormone estrogen, which causes the lining, when an ovarian follicle matures. Ultrasound monitoring only at that stage also serves to measure the endometrial (uterine) lining and also to make sure the clomiphene itself isn’t having any adverse effects on the endometrium (see Clomiphene side effects, below),
At this time, patients are asked to use an ovulation predictor kit to test to get a surge in LH hormone, indicating imminent ovulation. Usually, patients are given an injection of hCG (human chorionic gonadotropin) also called Ovidrel. This hormone initiates the release of the egg (ovulation) and also the development of the corpus luteum, that’ll help the body to create progesterone. Ovulation occurs approximately 38 44 hours after the hCG injection.
After ovulation, a form of the hormone progesterone is provided via vaginal tablets or gel so that you can support the endometrial (uterine) lining and prepare it for the fertilized egg.
Patients are asked to have a home pregnancy test (urine test) two weeks after ovulation. A blood test is going to be performed to confirm the results in case the home test is positive.
In case sufficient egg follicles were not produced by the clomiphene cycle, it could possibly be possible to begin another cycle or, if residual cysts are present on the ovarian follicles, a rest cycle could possibly be advised before resuming treatment.
Clomiphene Citrate side effects. If testing begins close to time of clomiphene citrate administration ovulation predictor kits may demonstrate false positive results. There exists a high probability of obtaining a false positive result if patients start ovulation predictor kit testing on cycle day 9 or earlier. In testing because of this, we recommend caution.
Menses occurs and in case a patient isn’t pregnant, the same dose of clomiphene is provided following a pelvic sonogram that was normal. We usually recommend up to 6 cycles for ovulation induction patients and up to 3 or 4 for ovulation augmentation patients.
Possible side effects of Clomiphene include:
Flushing (extremely common)
Ovulation pain and increased sensitivity âalso called âmittelschmerzâ
Blurry vision, double vision or âtraces,â (a complication that might cause treatment to be discontinued)
Moodiness (requiring discontinuation in severe cases)
Nausea
Breast tenderness
Headache
Vaginal dryness
Clomiphene can decrease cervical mucus production, that might allow it to be impossible for the sperm to swim to the uterus through the cervix. To get around this potential problem, intrauterine insemination (IUI) may be advised so that cervical mucus could be bypassed altogether.
In approximately 20% of patients estrogen production, which then prevents the uterine lining from thickening in the time that is necessary may be negatively impacted by clomiphene. The embryo cannot implant in the event the lining is thin. This side effect tends to occur with higher doses of medication or with repeated use. Once clomiphene treatment concludes endometrial thinning will stop. An alternative therapy is a medication called. Letrozole lowers estrogen levels, prompting the pituitary gland to increase LH and FSH production and promote ovulation. (While letrozole isn’t yet FDA-approved for ovulation induction, widely conducted studies indicate that there’s no detriment to the treatment option.)
Less than 5% of women may experience an exaggerated response to treatment. This condition is common with use of gonadotropin medications, and rare in clomiphene treatment. Ovarian hyperstimulation syndrome is marked by abdominal bloating, nausea and diarrhea, as well as in more severe cases, symptoms including shortness of breath, difficulty with urination and chest pain. Adjustments may be made for anyone who hyperstimulate by shortening the treatment cycle and decreasing medication. In 1% of cases, intervention may be required by severe hyperstimulation with intravenous fluids or removal of abdominal fluid to ensure that fertility treatment may continue. The symptoms of hyperstimulation begin in regards to a week after ovulation. Mild cases respond to hydration and careful monitoring and last in regards to a week. Generally speaking, ovarian hyperstimulation is unlikely, given careful monitoring of follicle development.
Multiple pregnancy can be a risk with clomiphene treatment. The incidence of twins is increased to 5%; multiple births higher than twins are rare (12%). When an ultrasound scan reveals 3 or more mature follicles (eggs) indicating a high multiple pregnancy is possible, patients might be advised to consider whether they’d undergo embryo reduction, should a triplet pregnancy occur. Patients could possibly be recommended to conceive with this cycle whether this procedure isn’t desired, or if multiple pregnancies would pose a physical or emotional challenge.
Clomiphene citrate treatment success rates
Of women who are anovulatory (unable to produce an egg each month), approximately 70% will ovulate when treated with clomiphene; and conception rates consistent with a patientâs age ought to be achieved. Women less than 35 can achieve pregnancy rates of 20-25% per month as long as there are no other significant present that are factors. As their declining egg quality will become a factor older patients may not achieve these rates. We stress that success rates depend on a number of factors and are highly individual. The best thing to do is have a thorough discussion with oneâs RE physician to gain a better understanding of the likelihood of success with this or any treatment plan.
You will find alternate fertility treatments for folks who don’t become pregnant. Methods of ovulation induction can be recommended. if 36 full clomiphene cycles don’t result in a pregnancy, Gonadotropins and intrauterine insemination could possibly be recommended. For younger patients, in whom the risk of multiple gestations might be high with IUI and gonadotropins Fertilization may be the next best step which is recommended.