Clomid — help for women with fertility issues
INFERTILITY is a common problem for many couples and about half the time, the issue lies with the woman. To rectify this issue, obstetrician-gynaecologist (ObGyn) Dr Anna-Kay Taylor Christmas said many women dealing with infertility may have heard of or been prescribed the medication Clomid, which is the brand name of the drug Clomiphene Citrate.
How does it work? Dr Taylor Christmas said Clomiphene is a medication that is used to boost fertility in women suffering from infertility due to problems with ovulation.
In explaining how ovulation works, Dr Taylor Christmas said it is a monthly process in women, where an egg is produced in the ovary under the control of hormones released from the brain and ovaries.
In a normal situation, the ObGyn explained that the pituitary gland in the brain sends the hormone FSH (follicle stimulating hormone) to the ovary to stimulate the growth of the egg for that month, followed by LH (luteinzing hormone) to stimulate the release of the egg from the ovary. But Dr Taylor Christmas pointed out that several conditions can interfere with the normal hormonal changes needed for ovulation, and can be due to abnormalities with the production of the hormones in the brain, or problems with the ovary being able to respond properly to the hormonal changes.
She said an example of a common hormonal issue affecting ovulation and fertility is PCOS (polycystic ovarian syndrome).
If the desire is to have children, to combat issues like PCOS, Dr Taylor Christmas said Clomiphene is given in tablet form, and acts by getting the brain to produce more of the ovulation hormones FSH and LH, which in turn stimulates the ovaries to produce one or more eggs for ovulation.
“Usually only one egg is produced per cycle, but Clomiphene may cause the ovaries to produce two or three eggs at once,” she said.
Further, Dr Taylor Christmas said Clomiphene is a popular choice of drug because it is relatively cheap compared to other fertility drugs and treatments and is taken orally, unlike other fertility medications that have to be injected.
She also said it is quite effective for many patients and has been proven to be safe, also stating that approximately 70 per cent of women will ovulate with this medication.
For the drug to be effective, the ObGyn said it must be taken properly, at the correct point in the cycle, and for the correct number of days (usually five days), with timed intercourse after.
“It is therefore very important for patients to make sure they understand clearly how it is to be taken before they leave the appointment with their doctor. Ask for it to be written down so you can refer to it at home. Frequently, women with hormonal issues have irregular menstruation or absent periods as well, so Clomiphene is often given with a progesterone hormone to stimulate bleeding and start a regular menstrual cycle. It is usually prescribed at the lower dose for a trial of three months, and then increased to the maximum dose for another three months if no pregnancy has occurred.”
Dr Taylor Christmas said some side effects of Clomiphene include flushing, ovulation pain, blurry or double vision, moodiness, nausea, breast tenderness, headache and vaginal or cervical dryness.
The ObGyn also shared that a rare but serious complication of Clomiphene is ovarian hyperstimulation syndrome, where the ovaries respond too strongly to the medication and cause fluid retention, bloating, abdominal pain, nausea and vomiting.
“This may be quite serious and requires hospital admission for monitoring until it resolves. This only happens rarely, but gynaecologists still remain alert for signs of this issue developing. There is also an increased risk of multiple pregnancy with clomiphene because more than one egg can be released at a time,” she said.
If treatment is unsuccessful after treatment, Dr Taylor Christmas said providing the medication was taken properly, then other means of achieving pregnancy should be tried, as there is no further benefit to continuing Clomiphene.
If you are suffering from infertility, it is important to see your gynaecologist right away and have a detailed discussion about your issues, so that appropriate treatment can be started in a timely fashion. No two women or couples are identical, so do not use someone else’s experience to try and treat yourself or decide how things will turn out for you.
