Clomid in men with low testosterone with and without prior treatment

Clomid in Men: This study aims to investigate whether men with low testosterone due to altered brain regulation of male hormone function who have previously been treated with testosterone may respond in the same way as men who have not been so treated to clomiphene citrate, an agent usually used in female infertility, which has been shown to improve the secretion of male hormones in some cases.

Detailed description clomid in men

Clomiphene, an FDA-approved oral drug for the treatment of female infertility, has been shown to normalize testosterone levels in men with hypogonadotropic hypogonadism. It seems to be safe and well tolerated. This study will compare the response of testosterone to clomiphene citrate in men. Veterans with previously untreated hypothalamic hypogonadism with responses from similar patients already treated with injectable or transdermal testosterone. This is an open, prospective, interventional study that will be conducted in an outpatient specialized medical facility.

Parameter. We will randomize 64 veteran hypogonadal males, equally divided between naive and previous treatment, to be treated with Clomid for 8 weeks, increasing the initial dose from 25 mg to 50 mg/day in those who fail to achieve target testosterone levels (450 ng/dL).

After the first 3 weeks. Endpoint measurements performed in the Phoenix VA Health Care System (PVAHCS) clinical laboratory will be total testosterone as well as bioavailable testosterone and sex hormone binding globulin. Total testosterone levels will be reported after 8 weeks of treatment. as the primary endpoint. Safety measures (complete blood count, liver function, PSA) will be assessed at 8 points. weeks also. This study will help guide the design of future studies of clomiphene in men with hypogonadism.

The effect of testosterone

The effect of testosterone – For a long time it has been considered that testosterone has an adverse effect on the likelihood of the development and course of diseases of the cardiovascular system. This point of view was based primarily on the fact that men are more likely to suffer from such diseases. In addition, it is known that estrogens, historically considered as androgen antagonists, reduce the risk of cardiovascular disorders in women. The latter, in particular, is proved by the increase in the number of such diseases after menopause.

In recent years, this position has been seriously revised. Methodically correct studies have not confirmed the relationship between the level of testosterone in the blood and cardiovascular diseases (CVD) in men. In some studies, it has even been shown that a higher concentration of the hormone can have a beneficial effect.

effect of testosterone

Treatment with testosterone preparations or taking clomid is also not accompanied by an increase in the frequency of myocardial infarctions. Angina pectoris or strokes, moreover, it is assumed that the likelihood of these complications will decrease. A number of studies have also shown that the level of testosterone in the blood of men is inversely associated with mortality from both CVD and from all causes in general.

The effect of lowering testosterone levels

The nature of the negative effect of a decrease in testosterone levels on the development of CVD has not been definitively established. Nevertheless, existing data indicate that the adverse effect of hypogonadism on the cardiovascular system can be carried out through metabolic syndrome (MS). The latter is a well-known combination of various vascular risk factors, including impaired glucose tolerance, obesity, hypertension and dyslipidemia. The risk of MS in patients with hypogonadism is significantly increased.

These data are so convincing that it has even been suggested that it is advisable to include hypogonadism among the criteria for the diagnosis of MS. At the same time, the study of issues arising after the study of these epidemiological data continues. What is the cause and what is the consequence: do MS components lead to suppression of testicular function or does hypogonadism contribute to their development? What are the mechanisms of these relationships? An unambiguous answer to these questions has not yet been received. The most likely is the existence of a bidirectional relationship between hypogonadism and MS.

The effect of testosterone on the health of men

It is also assumed that testosterone and other androgens stimulate the proliferation of endothelial cell precursors in the bone marrow, as well as their release into the bloodstream and connection with areas of endothelial defects. In young men with hypogonadism, a decrease in the concentration of endothelial cell precursors in the blood was noted. While substitution therapy led to a significant increase in these indicators. In addition, the biologically active form of testosterone — dihydrotestosterone also stimulates the proliferation of vascular endothelial cells themselves. A similar effect of dihydrotestosterone has been shown in experiments using the aorta of a bull and human vessels.

Testosterone also affects the release by endothelial cells of various para- and autocrine mediators, as well as cytokines. In particular, it has been shown that hypogonadism is accompanied by an increase in the level of endothelin-1, which has a pronounced vasoconstrictive effect. Treatment with testosterone preparations was accompanied by a decrease in the concentration of this substance. Testosterone also suppresses the synthesis of many cytokines in the endothelium, which have a negative effect on the function of these cells.

Testosterone Preparations

The testosterone preparations are also able to have a direct beneficial effect on the cardiovascular system. In particular, testosterone has been shown to cause dilation of the coronary arteries. A similar effect has been demonstrated both in experimental and clinical conditions. It is assumed that this is due to the activation of potassium channels.

The possible clinical significance of these data was demonstrated in a randomized double-blind study of the effect of testosterone. On the results of a physical activity test in men with stable angina pectoris. In the group receiving testosterone, an increase in exercise tolerance was noted, which was assessed by changes in the electrocardiogram. The degree of improvement was greater in patients who initially had more severe hormonal disorders. The existence of such an effect has been confirmed in a number of other works. Interestingly, for the first time the beneficial effect of testosterone on angina pectoris was described more than 70 years ago.

Superovulation: what is the difference from ovulation and how is it caused?

The path to conceiving a child can be difficult and require the use of assisted reproductive technologies . In order for IVF to be successful, it is necessary to obtain several eggs. With natural ovulation, one, rarely two follicles ripen. And superovulation is a process when several mature in the ovary at the same time. It is created in the protocols of assisted reproductive technologies with the help of medicines. After receiving the eggs, they are fertilized and the embryos are transferred to the uterus.

Why do we need superovulation?

In in vitro fertilization, there is an IVF-EC protocol, or IVF in a natural (natural) cycle, when an egg is removed for fertilization during normal ovulation. This option is shown with a reduced ovarian reserve, when the number of immature follicles ends.

Indications for IVF-EC are also considered thrombophilia, antiphospholipid syndrome, habitual miscarriage, a history of oncopathology, contraindications to hormonal stimulation or poor quality of oocytes in response to it.

In IVF-EC, the frequency of pregnancy after embryo transfer is significantly lower, which is due both to the initial health conditions of the patients and to the peculiarity of the procedure – there is no possibility to choose an oocyte.

superovulation

At the age of 40, according to world research, IVF EC is successful in 3-6% of cases, under 39 years of age, indicators vary in the spectrum of 11-53%.

Superovulation (ovarian stimulation protocol) allows you to achieve success much faster. With this phenomenon, 8-14 follicles mature in the ovary. And it’s not so much: some of them will be empty, some of them will be of poor quality. On average, 5-6 of the 10 follicles obtained during superovulation are selected for fertilization. The more oocytes, the higher the probability of success.

How is it stimulated?

To stimulate the maturation of a dozen follicles at once, hormonal drugs are used. They temporarily suppress their own hormones – luteinizing and follicle–stimulating (LH and FSH) and artificially stimulate the growth and maturation of follicles in the ovaries – with almost the same hormones created with the help of genetic engineering. Why do they do this?

The process of suppressing the production of the patient’s own hormones is necessary to control ovulation, otherwise there will be no eggs in part of the follicles at the puncture stage. In the natural cycle, the peak of LH production, the instigator of ovulation, occurs spontaneously. And without control over it, the eggs may not be in the follicles, but already outside – it will not be possible to get them from where.

At the final stage of maturation of oocytes, hCG hormone is injected, which affects the same way as luteinizing. This is how they achieve simultaneous and complete maturation of cells and their readiness for fertilization. As a rule, the injection of chorionic gonadotropin is carried out in the afternoon and after 36 hours a puncture with egg collection is prescribed.

25 signs of pregnancy

Do you know the first signs of pregnancy? Below is a list of 25 signs of pregnancy. Signs of pregnancy, depending on their reliability and informativeness, are usually divided into 3 categories: possible (the presence of these signs indicates that pregnancy is possible), probable (the presence of these signs indicates that the probability that you are pregnant is very high) and accurate (the presence of these signs always indicates the presence of pregnancy).

pregnancy

Possible signs of pregnancy:

1. Absence of menstruation

In the absence (delay) of menstruation, pregnancy is primarily suspected. It is customary to talk about the delay of menstruation in cases when, against the background of a regular menstrual cycle, menstruation did not occur in the expected time.

Pregnancy, however, is not the only reason for the absence (delay) of menstruation. Other possible reasons for the absence of menstruation are:

  • Stress
  • Strong physical activity (for example, fitness classes)
  • Illness
  • Changes in the mode of life, work (for example, switching to night shift work)
  • Taking certain medications (for example, hormonal drugs)
  • Overweight
  • Underweight
  • Incorrect counting (in case of irregular menstrual cycle)
  • The period close to menopause
  • Menopause

2. Unusual menstruation

A menstrual cycle that differs in any way from the usual one: longer, or vice versa, shorter; begins earlier or later, is accompanied by more or less abundant discharge – any of these variations and their combinations may indicate pregnancy.

It should be noted that in addition to the beginning of pregnancy, such menstrual cycle disorders can be observed in some gynecological diseases, therefore, the identification of this sign should serve as a reason to consult a doctor (either for a positive diagnosis of pregnancy, or for the diagnosis and treatment of a disease that violates the menstrual cycle).

3. The “feeling” of pregnancy

At the very beginning of pregnancy, some women feel uterine spasms or even pain. Most of all, uterine spasms resemble premenstrual pain.

What other signs of pregnancy are there?

Nausea and vomiting

These are some of the most common early signs that a woman is expecting a baby. Although nausea and vomiting may appear from the first weeks, most often these signs occur from the 6th to the 12th week. If nausea and vomiting appear for the first time during pregnancy, they are usually considered as signs of early gestosis (toxicosis).

Nausea and vomiting can be observed in a number of other conditions (diseases) that are in no way related to the expectation of a child (gastritis, stomach ulcer, enteritis, enterocolitis, migraine) – however, in such cases, in addition to nausea and vomiting, there are usually other symptoms of the disease that are not characteristic of pregnant women.

Libido changes

Changes in a woman’s sexual desire are caused by a complex of emotional and physical changes occurring in the body of a pregnant woman. These changes can either increase or decrease sexual desire.

Physical changes include increased breast sensitivity (which can also make touching more pleasant or extremely unpleasant), nausea, increased blood flow in the genital area, etc. Psychological changes are associated with the influence of female sex hormones on the nervous system.

Due to the extreme sensitivity of the problem of sexual desire, its changes are usually considered last of all as signs of pregnancy, especially if these changes are selective or chronic.

What else?

Increased urination

It can be observed from an early date. A woman experiences frequent urge to urinate, which usually ends with the release of a small amount of urine. The increased urge to urinate during pregnancy is explained by the fact that the uterus, which is increasing in size, presses on the bladder, reduces its volume, and the ability to accumulate urine.

Also, urination can be observed in diseases of the bladder or urethra – cystitis, urethritis (in such cases, frequent urges are accompanied by pain in the lower abdomen, burning sensation directly during urination, temperature), endocrine diseases such as diabetes mellitus (frequent urination is accompanied by the release of a large amount of urine and intense thirst).

For women who want to get pregnant, we remind you: contact your gynecologist, and if he writes you a prescription for clomid, take the opportunity to buy clomid cheaper through our partner link!

Unusual taste preferences

Despite the fact that many people associate pregnancy with the desire to eat pickles and ice cream, the taste preferences of pregnant women can be different and are not limited to the products described at all. Some studies show that 68% of pregnant women experience unusual taste preferences, which are sometimes of an amazing nature (the desire to eat raw vegetables, chalk, earth, lime, raw meat, etc.).

And although most preferences are safe for health (in a reasonable amount), some pregnancies may have so-called picacism – the desire to eat inedible substances such as chalk, starch, etc.

A change in taste preferences can also be observed in iron deficiency anemia. In the case of anemia, taste preferences are combined with other symptoms: brittle and dry hair, nail stratification, cracks in the corners of the mouth, pale skin, dizziness, increased fatigue.

And a few more signs of pregnancy in women

  • Fatigue
  • Montgomery ‘s Bumps. (Montgomery’s bumps are small bumps on the areola of the breast (the circumscription circle). They do not pose any threat to health, and their appearance is a frequent sign of pregnancy).
  • Skin changes
  • Stretch marks

That’s all for today, and we wish everyone who bought clomid from our link to get a positive pregnancy test!

Pregnancy after 40 years

Nowadays, pregnancy after 40 years is a fairly common phenomenon, however, this is exactly the case when pregnancy should be prepared, and especially carefully.

The ideal age for conception, gestation and birth of a child is entered by specialists in the framework of 22-26 years, it is during this period that the hormonal level is optimal, health is tolerable, there are a lot of eggs and they are healthy. Although at this age, deviations from the norm and problems are possible. Nevertheless, a woman’s reproductive system functions not only during this short period, which means that nature allows her to continue childbirth at an older age, up to the onset of menopause, when the resource of eggs is exhausted and the extinction of all occurs. And taking into account the development of modern reproductive technologies, it is quite possible to give birth to a child after the onset of menopause.

Pregnancy after 40 years risk factors

At birth, every girl has a certain supply of germ cells that are consumed throughout her life, which means that the older the woman, the older the follicles stored in the ovaries. Every month, one egg matures and leaves the ovaries, but the remaining follicles are susceptible to aging and external factors, just like any other cells in the body.

This fact is associated with an increased risk of giving birth to a baby with chromosomal abnormalities. Merciless statistics show that the anomaly of the development of the 21st chromosome – Down’s disease in the fetus among women who gave birth at 23-25 is about 1 in 1300, and at 40 it is already 1 in 30. Doctors believe that such statistics also indicate that the mechanism of natural rejection of an embryo with genetic disorders fails with age. And this means that with its full-fledged work, even before the implantation of an egg in the uterus, its removal (chemical pregnancy) would have occurred.

The process of conception itself becomes much more complicated in adulthood, since blood flow to the reproductive organs decreases, the sensitivity of the uterus to sex hormones decreases, some chronic diseases and long-term bad habits, such as smoking, prevent conception and implantation.

It will be especially difficult for women who are planning a pregnancy after 40 years with their first child – gynecologists claim that the reproductive organs, which have been in a state of functional insufficiency for many years, age much faster.

How to prepare for pregnancy

It should be understood that clomid for ovulation stimulation will not solve all problems. First of all, it is necessary to give up bad habits six months before the expected conception, first of all, quit smoking, limit the amount of alcohol and completely abandon all kinds of surrogates, such as low-alcohol and energy drinks.

To give up work that requires strong nervous tension – recent research by scientists suggests that stress at work is one of the factors of problems with conception.

pregnancy after 40 years

To go in for sports or, at least, to increase physical activity – thus, we increase the elasticity of the joints and strengthen the muscles, which will help to carry and give birth to a baby.

Walk in the fresh air every day, away from car exhaust.

To undergo a full medical examination, in case of chronic diseases, to choose such drugs that are compatible with carrying a child.

To put the oral cavity in order, to cure the teeth. A visit to the dentist during pregnancy is possible, but not at any time and still the risks remain.

Find a doctor you trust, and who will help you prepare for pregnancy and carry a baby.

Age and fertility

In modern society, infertility associated with age-related changes in the reproductive system has become more common. There are many reasons why many girls start having families only after the age of 30. Age and fertility – today women have more opportunities to take care of themselves and monitor their health, but all this does not exclude an age-related decline in reproductive function. It is important to understand that fertility decreases as a woman ages due to the natural process of reducing the number of eggs in the ovaries. And this process can begin much earlier than most women expect.

Ovulation and menstrual cycle

During the reproductive age, women have regular menstrual cycles, during which the ovulation process occurs monthly. At the beginning of each cycle, follicle-stimulating hormone formed in the pituitary gland stimulates (to stimulate ovulation, you can use clomid, which you can buy online after being prescribed by a doctor.) the growth of a group of follicles in both ovaries. Usually only one of these follicles matures and releases an egg (ovulates), the rest stop growing and are destroyed. Pregnancy occurs when an egg is fertilized and fixed in the lining of the uterus (endometrium). If pregnancy does not occur, the endometrium comes out in the form of menstruation, and the cycle resumes.

At the beginning of adolescence, girls have “walking” ovulation, which leads to irregular menstruation, but by the age of 16, as a rule, a stable periodicity of menstruation is established. From this time on, the female cycle will remain stable, ranging from 26 to 35 days.

Unlike men, whose bodies produce sperm throughout their lives, a woman is born with an unchanged number of eggs with follicles contained in the ovaries. So, at birth, a girl has about a million follicles. By puberty, this number is reduced to about 300,000. Of all the remaining follicles, about 300 reach ovulation during reproductive age. The remaining follicles are not used during ovulation, but are involved only as the natural sequential process of degeneration, called atresia, passes.

As women age, fertility decreases due to natural age-related changes that occur in the ovaries. From about 30-40 years, you can notice that the cycle has become shorter. Over time, ovulation begins to disappear, menstruation becomes more and more rare until it stops completely. It is believed that the menopause stage occurs when a woman has no menstruation for a year. It is believed that women who like to smoke a cigarette or two have menopause a year earlier than non-smoking women.

Age and fertility: Fertility in aging women

The best reproductive years for women are considered to be the age of 20-30 years. Fertility gradually begins to decline by the age of 30, this trend is especially evident after 35 years. Every month, a healthy woman of childbearing age has a 20% chance of getting pregnant. That is, for every hundred childbearing 30-year-old women who try to get pregnant on the first attempt, only 20 will succeed, the remaining 80 will have to try their luck again. By the age of 40, this probability is less than 5%. Thus, less than 5 out of 100 women can successfully conceive during each month.

As we have already said, women remain fertile until the onset of menopause, the average age of onset of which is 51 years. However, most women fail to conceive a baby at the age of forty. These indicators apply both to those who are trying to get pregnant in the traditional way, and to those who are undergoing infertility treatment, including in vitro fertilization (IVF). Stories broadcast in the media can lead women and their partners to the erroneous idea that, no matter what, it is possible to get pregnant using procedures such as IVF. But do not forget that a woman’s age still affects the likelihood of a cure for infertility. The quality and quantity of eggs gradually decrease with age, which causes a decline in female fertility.

Fertility in aging men: Age and fertility

Unlike the early decline in fertility, which is observed in women, in men, the change in reproductive function occurs much later. Although the quality of sperm deteriorates somewhat as a man ages, this is usually not a problem until a man reaches the age of 60. Despite the fact that the problems that arise in men are not as sudden and noticeable as in women, changes in reproductive and sexual functioning also occur as they age.

At the same time, men do not have an age limit at which they cannot become a father, which is proved by gentlemen of 60-70 years of age who managed to successfully conceive offspring with their younger partners. However, as men age, the testicles tend to become smaller and softer, the structure of sperm changes, and sperm motility tends to slow down. Aging men often develop diseases that can adversely affect their reproductive and sexual functions. Moreover, with age there is a higher risk of the appearance of gene defects in spermatozoa. However, it is worth noting that not all men experience significant changes in reproductive or sexual function as they age, especially not men who maintain their health in good condition for many years.

In any case, if a man has problems with sexual desire or erection, he needs to seek treatment from a urologist. Reduced libido may be, among other things, associated with low testosterone levels.

When determining the cause of infertility, doctors can offer special treatment. However, sometimes there are cases in which it is not possible to detect any specific problems and the cause of infertility is considered “unidentified”. In case of unidentified infertility, or when traditional methods of treatment have not worked, assisted reproductive technologies can be used, such as superovulation using intrauterine insemination technology and in vitro fertilization (IVF). In the IUI cycle, infertility treatment is carried out with the help of drugs to increase the number of eggs in the ovaries. When these eggs are ready to ovulate, the selected partner’s sperm is placed directly into the female ovaries. This procedure is called intrauterine insemination (IUI) technology and does not cause any discomfort. IVF is a procedure for taking an egg and fertilizing it with a partner’s sperm in the laboratory, then the finished embryo is placed in the uterus. In each of these procedures, the sperm of the donor can be used instead of the sperm of the woman’s partner.

Conclusion

Fertility naturally declines as we age. Despite the fact that the time of fertility decline and the onset of menopause in women varies significantly, this period occurs in the life of every woman. As a rule, fertility begins to decline around the age of 30 and noticeably decreases at the age of 35. Women who decide to postpone pregnancy until the age of 35 and later should realistically assess the chances of success, have information about the possibilities of conception and, if necessary, the use of infertility therapy. Having familiarized with all the options and being aware of their needs and goals, a woman and her partner will be able to make the best decision.

The use of clomid in women with polycystic ovary syndrome

Clomiphene (aka clomid) is very often used to induce ovulation in women with polycystic ovary syndrome. If ovulation does not occur at a dose of 50 mg, then withdrawal bleeding is caused by prescribing progestin, and the dose of clomiphene increases in the next cycle.

With a newer step-by-step protocol, the dose of clomiphene increases without causing withdrawal bleeding.

The presented study, which took place in the USA, involved 109 patients with polycystic ovary syndrome. The patients were divided into 2 groups:

  1. the first group of 66 patients received clomiphene according to the traditional scheme: initially, a dose of 50 mg was used for 5 days, if there was no response with a documented progesterone level of less than 3 ng/ml on the 21st day of the cycle, then medroxyprogesterone acetate 10 mg was prescribed for 10 days to cause withdrawal bleeding. After that, the dose of clomiphene was increased to 100 mg / day for 5 days. This continued until the maximum dose of clomiphene was 250 mg/day.
  2. the second group of 43 patients received clomiphene according to a stepwise protocol: initially a dose of 50 mg was used for 5 days, then 5-7 days after the last dose of clomiphene, ultrasound was performed to assess the follicular response. If no developing follicle > 10 mm was detected, the dose was increased to 100 mg/day for 5 days. Then, 5-7 days after the last dose of clomiphene, ultrasound was performed to assess the follicular response and if no developing follicle > 10 mm was detected, the dose was increased in the same manner, increasing the dose by 50 mg / day in each step, bringing it to a maximum dose of 250 mg / day.

The primary outcome was considered to be the time before ovulation. Secondary outcomes were considered to be the frequency of ovulation, the frequency of pregnancy, side effects depending on the dose of the drug.

According to the results of the study:

  • the time before ovulation was shorter with the step protocol: 23 days with the step protocol and 48 days with the traditional scheme.
  • cumulative ovulation frequency was higher in the group with the step protocol: 88% versus 39% with the traditional scheme.
  • the frequency of pregnancy was the same in both groups: 18 % vs. 16 %.
  • in the group with the step protocol, mild side effects were more often noted: vasomotor hot flashes, headache, nausea, mastalgia and mood changes.
  • there was no difference in the frequency of serious side effects.

The authors note that for women with polycystic ovary syndrome, the use of clomiphene according to a step-by-step protocol is associated with a reduction in the time to ovulation and an increased frequency of ovulation compared with the traditional regimen of the drug.

Ovarian hyperstimulation syndrome

Ovarian hyperstimulation syndrome is characterized by an increase in the ovaries with the development of numerous cysts (the condition of polycystic ovaries), the accumulation of fluid in the tissues, abdominal cavity and lungs. In 2% of cases, this condition requires immediate hospitalization. The occurrence of ovarian hyperstimulation syndrome is associated with a sharp rise in the level of estrogens (estradiol) under the influence of gonadotropins, which can lead to the rapid development of ovarian cysts.

This disease occurs in 10-20% of cases after ovulation induction, mainly mild and moderate severity. With a mild degree of this syndrome, the ovaries are enlarged to 5 cm in diameter, there is also a slight ascites and weight gain of up to 5 kg. With moderate severity of the syndrome, the ovaries are enlarged from 5 to 12 cm, there is moderate ascites, nausea, vomiting, discomfort in the lower abdomen, and an increase in body weight of more than 5 kg. Severe cases of ovarian hyperstimulation are characterized by an increase in the ovaries, severe ascites, nausea, vomiting, diarrhea, shortness of breath, accumulation of fluid in the lungs, dropsy, blood thickening, and can lead to kidney failure.

ovarian hyperstimulation syndrome

Severe forms occur in young women with irregular rare menstruation, who after the first induction had a condition of polycystic ovaries (more than 15 follicles). Hyperstimulated ovarian syndrome has two phases. The first phase manifests itself from the second to the seventh day after ovulation, and the number of signs of the disease is limited. The second phase occurs after a woman becomes pregnant.

How is hyperstimulated ovarian syndrome treated?

Women with mild to moderate syndrome can stay at home, preferably in bed, strictly controlling the amount of fluid consumed and excreted. If, after the induction of ovulation, a woman has dramatically recovered by 1-1.5 kg, it is advisable to hospitalize such a woman. Severe cases should be treated in hospital conditions, taking into account the condition of the woman.

Prevention

When conducting ovulation induction, it is very important to monitor the reaction of the ovaries to the administration of medications, which can be done using ultrasound. If there is a development of 1-3 follicles up to 18-20 mm in size, such induction can be considered safe. However, with the appearance of 5 follicles or more, as well as with a sharp increase in blood estradiol, it is advisable to stop the induction of ovulation.

Ovulation induction. Part II.

We continue to answer questions related to ovulation induction

How long can the induction of ovulation with clomiphene citrate be carried out?

Induction with this drug can be carried out for 4-6 months. In 40-45% of all women and in 80% of correctly selected women, pregnancy will occur within 6 months. After six months, it is impractical to carry out ovulation induction.

What gonadotropin preparations are used to induce ovulation?

Gonadotropins are hormones that are produced by the pituitary gland, or substances that have a similar effect to pituitary hormones. Modern medicine uses the following gonadotropins to induce ovulation:

  • human menopausal gonadotropin (HMGs)
  • human chorionic gonadotropin (hCG)
  • follicle stimulating hormone (FSH)
  • luteotropic hormone (LH, luteinizing hormone).

What is human menopausal gonadotropin?

Human menopausal gonadotropin is a combination of FSH and LH, mainly created by genetic engineering from mammalian ovarian cells (for example, hamsters). Such combinations have from 60 to 120 units of hormones (depends on the manufacturer). For the first time, FSH and LH were isolated from the urine of menopausal women in 1954, and this combination of hormones was called pituitary human gonadotropins. In menopausal women, the amount of FSH and LH in the urine is increased. The first ovulation induction was performed in 1958, and the first pregnancy after ovulation induction occurred in 1960.

Gonadotropins are most often indicated in cases where the induction of ovulation with clomiphene citrate is unsuccessful, as well as in women with hypothalamic-pituitary factor infertility, when a sufficient amount of FSH and LH is not produced.

Ovulation induction

What is human chorionic gonadotropin?

Human chorionic gonadotropin is produced by the placenta, and it is obtained from the urine of pregnant women. The chemical structure, and therefore the effect, is almost the same with the pituitary gland LH. Since a sharp increase in LH before ovulation contributes to the maturation of the egg, the introduction of hCG before the expected ovulation leads to the rupture of the follicle and the release of the egg.

To get a positive effect with this type of ovulation induction, it is very important to choose the right day of the cycle for the administration of the drug, which many doctors determine using ultrasound and measuring the level of estrogen in the blood. Ovulation occurs within 36-48 hours after HCG administration. This drug is often used to enhance the effects of clomiphene citrate when it is not possible to trace the peak of LH. Since hCG is excreted in the urine, a pregnancy test may be false positive within 10 days after HCG administration.

What are the side effects of using gonadotropins?

Up to 33% of all pregnancies that occur after the induction of ovulation by gonadotropins are multiple (70% are twins, 30% are triplets). Therefore, the rate of premature birth, and hence the mortality rate of newborns, is increased. A dangerous side effect is ovarian hyperstimulation syndrome (when using hCG, this syndrome is less common than when using other drugs for ovulation induction, in this case we are not talking about clomid and its generics). Other side effects are swelling and soreness of the mammary glands, bloating, abdominal pain, mood changes.

Unlike IVF, the level of fetal malformations after ovulation induction does not exceed the level without ovulation induction. Ectopic pregnancies occur more often after ovulation induction (5-8% of cases compared to 1-2% of cases in the general population of women). Miscarriages are observed in 15-21% of women. Pregnant women after ovulation induction are more likely to suffer from hypertension of pregnant women, and the frequency of placental abruption in such women is increased.

Review: The drug Clomid is safer than tamoxifen

Good day to all sports fans. I would like to share with you a review about the antiestrogenic drug Clomid from Balkan Pharmaceuticals (I used it). The review will clarify the issue of using clomiphene to raise the level of natural testosterone in post-course therapy, so it is designed for a very narrow circle of those who understand what they are doing and for what. In this review, I will try to tell you why clomid is a little better than tamoxifen, based on personal feelings from taking both.

Clomid from Balkan Pharmaceuticals costs about $42 for a blister of 20 tablets of 50 mg. The cost of clomid is three times higher than that of tamoximed from the same manufacturer. And it’s not so easy to buy clomid. If tamoxifen from Ebeve can be found in most pharmacies in any city, then Balkan Pharmaceuticals must be purchased only online.

At the top of any blister is the date of final use and a verification code by which you can verify the authenticity of the products.

drug Clomid

By itself, the Clomid tablet has the same size and shape as most of the drugs from this manufacturer. A square white tablet has a dividing ribbon, but in the case of clomid it is not particularly needed, since 50 mg is a fairly low dosage.

We turn to the action of the drug and the question of why it is a little better than tamoxifen. Both of them perfectly bind estrogens and increase testosterone. All the arguments of clomid supporters about blocking in the pituitary gland, hypothalamus and testicles are completely untenable, so the same effect of tamoxifen has been repeatedly proven. Clomid is a little better, but not this.

The advantage of clomid is that it is not so toxic and has absolutely no side effects, because it is a newer drug. From prolonged use of tamoxifen, vision still drops a little. Clomid is devoid of this side effect as well as possible migraines. I took clomid for a month and never had any side effects.

In general, I recommend not saving on health and using clomid for post-course therapy.