I want to increase my chances of having multiples
Dear Dr Mitchell,I am 36 years old with a daughter and my husband wants one more child — I actually want more than one. My periods are regular. I was prescribed Clomid by my doctor at 50mg with instructions to take it for five days. I wanted to increase my chances of having multiple births. Should I increase the Clomid dose? What would be your advice, and is this okay?
Clomid or Clomiphene Citrate is a drug that is used to induce ovulation in women who do not ovulate regularly and have difficulty becoming pregnant. It is commonly used in women who have polycystic ovaries and older women who do not ovulate regularly to improve the chances of a pregnancy.
If you have regular menstrual periods and your day 21 progesterone level is normal then there is no benefit in using Clomid, and there can be significant side effects.
Clomid is usually given for five days starting either on day three or day five of the menstrual cycle. A blood test is done 21 days counting from the first day of the menstrual period to confirm that the drug is working effectively to induce ovulation.
The dosage starts at 50mg and is increased appropriately to achieve ovulation as confirmed by the blood progesterone done on day 21. This dosage is maintained until conception occurs, but usually not for longer than six months. If it has not worked by six months then you need to be re-evaluated and your partner should also do a semen analysis to confirm that your partner does not have any problems that could contribute to your inability to become pregnant.
There is a small chance of having twins or higher order multiple pregnancies with the use of Clomid. This occurs in approximately 10 per cent of women. Clomid should not be used for the sole purpose of obtaining twin pregnancy. It should only be used when absolutely indicated. There is no benefit in using Clomid in women who are confirmed to be having ovulatory cycles. If you do not conceive you should have an X-ray of the fallopian tubes to confirm that the tubes are not blocked.
Clomid can cause abnormal vaginal or uterine bleeding, breast tenderness, headaches, nausea, vomiting, diarrhoea, flushing, blurred vision and other visual disturbances.
Consult your doctor before modifying the dose of Clomid.
You may take daily folic acid to help to reduce your risk of birth defects in the brain and spinal cord of the baby.
Best regards.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER: The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
