Ovulation induction is a fertility treatmetn used in women who have irregular or absent menstrual cycles. The most common reason for this is polycystic ovarian syndrome (PCSO). Ovulation is thre release of an egg from a follicle- which are the small fluid filled bubbles in which an egg develops. Follicles are in the ovary.
Clomiphene or Clomid is a fertility drug to help you conceive. The medication stimulates the ovary to produce more follicles and release an egg (ovulation).The standard dose is 50mg (one tablet) daily, from day two – six of your menstrual cycle. You are advised to take the medication at the same time daily for a total of five days.
The treatment will be monitored by ultrasound and consultations with the fertility nurses.
What are the possible side effects and risks of the treatment?
- You may experience headaches, hot flushes, mood swings, breast tenderness, or visual disturbances.
- There is a small risk of multiple pregnancy (10 per cent risk of twins)
There is a minimal risk of ovarian hyperstimulation (OHSS).
The ovaries become enlarged with multiple large follicles, causing abdominal discomfort and distension.
How effective is Clomid?
Most women will ovulate over six months of treatment. The pregnancy rate is approximately 30 per cent.
What is the treatment process?
Day one of your period
Please contact Yvonne on 0207 125 0547 email her here to arrange a scan for btween days 9 and 12 of your cycle.
Day two of cycle
Start the Clomid as advised and take for five days.
Your initial scan may be between days nine -twelve of your cycle. The scans are performed transvaginally. Please empty your bladder before the scans.
At each scan, the endometrium (the lining of the womb) is measured. Each ovary is assessed for the presence of follicles and the follicles are measured. The scan findings will be plotted on a chart and I’ll exlain the findings to you. Its not common to need more than three scans
When the follicle(s) measure 17mm or more, you will be advised regarding intercourse as this is your fertile time. Having intercourse on alternate days during this time is your best chance of conceiving.
Occasionally, some patients may require a trigger injection (HCG injection) to cause the follicle to release the egg.
A blood test to confirm that you have ovulated (progesterone test) will be done seven days from ovulation.
When do I start the Clomid if I have irregular cycles?
Patients who have irregular periods can be given a prescription for medication (Provera) to induce a bleed. A pregnancy test before starting Provera is required
What happens if I do not conceive?
If your first cycle has shown that you have responded well and the blood test has confirmed you have ovulated, you are advised to continue with Clomid in your subsequent cycles. A repeat prescription can be supplied. I normally advise monitoring for at least the first couple of cycles.
What do I do if I have not responded to the Clomid?
If the scans have shown that the ovaries have not responded to the Clomid, the dosage of Clomid will be increased in your next cycle. The treatment will be monitored by scans.
Please do not alter the dosage without instructions from the fertility team.
What do I do if I have over-responded to the Clomid?
If the scans have shown that the ovaries have over stimulated, the dosage of Clomid will be decreased in the next treatment cycle. The current treatment will be discontinued. You are advised to have protected intercourse (use condoms) to avoid the risk of multiple pregnancy. Please inform the fertility nurses if you feel unwell.
What do I do if I have a positive pregnancy test?
Please inform the fertility nurses if you have a positive pregnancy test. A scan to confirm the pregnancy will be arranged at seven weeks.
Fertility consultations including discussion of ovulation induction can be arranged via contacting my PA, Ms Yvonne Baillie on 0207 125 0547 or email her here