Ovulation stimulation: indications, possible complications

Unfortunately, some women have difficulties with the production of female germ cells, or with their normal maturation and subsequent fertilization. To solve this problem, such a procedure as ovulation stimulation was developed.

Thousands of married couples today face the problem of conceiving a child, which is due to various negative factors. The absence of ovulation, obstruction of the tubes, abnormalities of the development of reproductive organs – this is not a complete list of reasons that prevent pregnancy. A huge number of women suffering from infertility managed to become happy mothers only with the help of the achievements of modern medicine.

Indications for ovulation stimulation

Hormone therapy aimed at stimulating ovulation is prescribed to women in the following cases:

  • with infertility of unclear genesis (if a woman has no objective reasons preventing pregnancy, but even with regular sexual activity throughout the year, conception does not occur);
  • with hormonal insufficiency that cannot be corrected by other means;
  • when using assisted reproductive technologies that require the collection of eggs from the ovaries (in vitro fertilization, ICSI).

Contraindications to ovulation stimulation

Ovulation stimulation is not prescribed to women who are over 35 years old, who have unsuccessful experience of previous ovulation stimulation (more than six times), as well as patients with structural disorders in the body that prevent conception and the normal course of pregnancy (with obstruction of the fallopian tubes, oncological diseases, acute inflammatory processes, uterine pathologies, etc.).

Reasons for the lack of ovulation

Sometimes the hypothalamic-pituitary system of the body fails, as a result of which a woman has a violation of the menstrual cycle, up to the complete cessation of menstruation.

The reasons for this phenomenon may be:

  • genetic: the presence of certain defects in the sex chromosomes that interfere with the normal hormonal background;
  • pathological: a tumor or inflammatory process prevents the pituitary gland or hypothalamus from producing a sufficient amount of necessary hormones;
  • indirect: the normal course of ovulation is disrupted by dysfunction of the adrenal cortex and thyroid gland, closely related to the pituitary gland and hypothalamus.

Drugs for ovulation stimulation

Currently , ovulation stimulation is carried out with the following medications:

  • menstrual (cyclic) gonadotropin. This hormone is produced by the pituitary gland and is responsible for the various phases of the menstrual cycle. Unlike chorionic gonadotropin, which is produced exclusively during pregnancy, ovulation is stimulated by hormones that regulate a woman’s reproductive cycle in her normal state;
  • artificially created (recombinant) FSH, most often Gonal;
  • Clomiphene, with the help of which the production of gonadotropins is stimulated, due to which ovulation occurs. By binding specifically to the receptors of the hypothalamus and pituitary gland, Clomiphene increases their activity;
  • traditional medicine products. Due to the content of analogues of human body hormones in some medicinal plants, preparations based on them contribute to achieving a stable positive effect in the treatment of infertility.

The dose of a particular drug is determined depending on the initial hormonal background. Each woman is selected an individual schedule of reception (ovulation stimulation protocol).

Ovulation stimulation begins on the 3rd-5th day of the menstrual cycle. To control the maturation of the follicles, ultrasound examination is performed daily, as well as basal temperature monitoring.

In addition, it is periodically necessary to take tests to determine the level of estradiol (a hormone produced by the ovaries responsible for the development of the placenta) and cervical number (studies of mucous secretions from the cervical canal: before menstruation, they acquire a more watery consistency).

In case of ineffectiveness of hormonal treatment, the dose of the drug may be increased.

An adequate reaction can be considered in the case of an increase in the follicle by 2 mm per day. If the follicle grows more rapidly, the dose of hormonal drugs must be adjusted, or stop taking them.

Effects of stimulation

The most common negative consequence of ovulation stimulation is ovarian hyperstimulation syndrome (OHSS), which is accompanied by the formation of cysts, stool disorders, fluid accumulation and deterioration of well-being.

ovulation stimulation

In accordance with the degree of OHSS, the disease may in some cases not require therapeutic measures, in others it may even require surgical treatment.

When conducting ovulation stimulation, a woman should control her well-being and listen to any changes in her health. If signs of malaise appear, you should immediately inform your doctor about them.

Ovulation stimulation often threatens the development of ectopic, as well as multiple pregnancies, due to the maturation of a large number of eggs.

One of the complications is the possible development of an allergic reaction to a particular drug taken.

The effect of ovulation stimulation occurs in 10-38% of cases. With the help of this method, the hormonal background is corrected and the necessary conditions are created for the onset of pregnancy.

The positive outcome of ovulation stimulation depends on strict compliance with medical prescriptions and on the positive attitude of the patient herself.

How to increase the chances of conceive a child

Sometimes it happens that it takes a while to conceive a child, but after several unsuccessful sexual acts, you should not sound the alarm and diagnose yourself with infertility.

Conceive a child. The first rule.

Everyone knows that the male germ cell is the basis of conception, so a certain energy is required from the sperm to ensure its mobility, because an energetic sperm is able to go further, and a weak one should not wait for conception. And if pregnancy does occur, then there is a high risk of DNA damage that leads to a frozen pregnancy or spontaneous abortion. That is why, two weeks before the decisive sexual intercourse, you need to start preparing a man. To do this, you need to start feeding him properly: include more meat, nuts, vitamin E in the diet. Such nutrition will help to increase sperm motility.

It is worth noting that excessive activity of partners for conception is not just useless, but also harmful. Therefore, before the decisive sexual act, a man should abstain for 2-3 days in order to accumulate energy. One couple went to the doctor because they could not conceive a child. During the conversation, it turned out that the couple wants a child so much that they have sex 2-3 times a day. After that, the doctor advised to abstain from sex for a few days. Following the doctor’s recommendation, the couple managed to conceive a child.

Rule number 2

The first intercourse is crucial for conception. All further acts in the evening or night are just for fun. The fact is that after the first sexual intercourse, the concentration of spermatozoa decreases almost twice, so subsequent ejaculations, as experts joke, are one water.

Rule 3, how to conceive a child

Immediately after ejaculation, a man should remove the penis from the vagina to help the sperm penetrate further unhindered, which significantly increases the likelihood of conception.

Rule 4

Female orgasm can prevent conception. This happens for the reason that during orgasm, the cervix rises slightly, so the sperm have to climb to this peak, which significantly reduces the chance of one of them reaching the egg.

conceive a child

Conceive a child 5

The right timing for conception plays a significant role in conception. A woman is more fertile in the middle of the cycle, when the egg matures (ovulation period). 5-6 days before ovulation are also considered favorable: the sperm can live as long as it waits for the egg and remains capable. The period within 6 days after ovulation is also considered favorable, since the female egg remains capable during this period of time.

The sixth rule

Of great importance for conception is the fact whether a woman takes clomid. Clomid stimulates ovulation and promotes conception. You definitely need to consult a doctor.

The last rule

The right choice of posture can significantly increase the chances of conceiving a child. Unfortunately, the choice of the right poses is not great — this is a classic missionary pose. But if you try to get pregnant, for example standing, then the liquid will just pour out. There is really an exception. If a woman has a bend in the uterus, then a pose from behind will do.

Abuse of Clomid, precautions.

Patients should be warned that during therapy with clomid, blurring or other visual symptoms may sometimes occur, such as spots or flashes (scintillation scotomata). These visual symptoms increase with an increase in the total dose or duration of therapy. These visual impairments are usually reversible; however, cases of prolonged visual impairment have been reported, with some occurring after discontinuation of clomid (not abuse of clomid). Visual disturbances can be irreversible, especially with an increase in the dosage or duration of therapy. Patients should be warned that these visual symptoms may render activities such as driving a car or operating equipment more dangerous than usual, especially in variable lighting conditions.

These visual symptoms appear to be caused by increased and prolonged therapy. Symptoms often appear or are accentuated when exposed to a brightly lit environment. While the measured visual acuity was generally not affected, the study patient taking 200 mg of clomid daily developed visual blurring on the 7th day of treatment, which led to a serious decrease in visual acuity by the 10th day. No other abnormality was detected, and visual acuity returned to normal on the third day after discontinuation of treatment.

Ophthalmologically detectable scotomata and changes in retinal function (electroretinographic) have also been reported. A patient treated during clinical trials developed phosphenes and scotomates during prolonged administration of clomid, which disappeared on the 32nd day after discontinuation of therapy.

abuse of clomid

Ovarian hyperstimulation syndrome

Ovarian hyperstimulation syndrome (OHSS) is reported to occur in patients receiving clomiphene citrate therapy to induce ovulation. OHSS can develop rapidly (within 24 hours to several days) and become a serious medical disorder. In some cases, OHSS occurred after cyclical use of clomiphene citrate therapy or when clomiphene citrate was used in combination with gonadotropins. Anomalies associated with nonspecific liver function have been reported that indicate hepatic dysfunction, which may be accompanied by morphological changes during liver biopsy, reported in connection with OHSS.

In order to minimize the danger associated with accidental abnormal ovarian enlargement associated with clomid therapy (we remind you, do not abuse clomid in any case), the lowest dose corresponding to the expected clinical results should be used. Maximum ovarian enlargement, physiological or abnormal, may not occur until several days after discontinuation of the recommended dose. Some patients with polycystic ovary syndrome who are unusually sensitive to gonadotropin may have an exaggerated response to normal doses when there is no abuse of clomid. Therefore, patients with polycystic ovary syndrome should start with the lowest recommended dose and the shortest duration of treatment for the first course of therapy.

Abuse of clomid, precautions

Careful attention should be paid to the selection of candidates for therapy. Pelvic examination is necessary before treatment with clomid and before each subsequent course.

Drugs for ovulation stimulation

Ovulation stimulation drugs that help to get pregnant are divided into three main types: follicle-stimulating hormone (FSH) and luteinizing hormone (LH) preparations, HCG preparations and progesterone preparations.

To get pregnant, you need to fulfill three basic conditions:

  1. the woman has ovulated;
  2. the sperm fertilized the egg;
  3. the embryo is securely fixed in the uterus.

Accordingly:

  1. drugs that enhance the production of FSH and LH, which help to get pregnant, stimulate ovulation — the growth of follicles on the ovaries;
  2. HCG helps the largest follicle to stay large enough and release an egg, which the sperm should fertilize;
  3. progesterone prepares the inner layer of the uterus to secure the embryo and helps to carry the fetus.

A little theory: the mechanism of ovulation

Ovulation is the release of a mature egg from the ovary. Then the egg is sent through the fallopian tubes into the uterine cavity. This happens, as a rule, in the middle of the cycle, that is, on the 14th-15th day after the onset of menstrual bleeding. Women with a regular cycle, most likely, do not ask the question “Will I be able to get pregnant?”. With a regular cycle, ovulation usually takes place regularly.

If you come to the doctor with the question “Why can’t I get pregnant” or the complaint “I can’t get pregnant for a year“, then most likely you do not ovulate. Women cannot get pregnant without ovulation.

If you are interested in the question “Why can’t I get pregnant?“, you can do an ovulation test. You can buy it at the pharmacy. Consult a doctor if there is no ovulation for several consecutive cycles.

Drugs for ovulation stimulation 2022

Ovulation may not occur for various reasons: due to hormonal failures, inflammation of the pelvic organs, and so on. If you have not been able to get pregnant for a year because ovulation does not occur, the doctor may prescribe injections and pills that help to get pregnant — stimulating it.

Drugs for ovulation stimulation: Who is shown?

If the question “Why can’t I get pregnant?” is relevant to you, then you need to undergo a checkup. It’s good if your spouse does the same — it would help to establish the cause of infertility.

Ovulation stimulation should be recommended by a doctor after a series of examinations that will give accurate data on the cause of problems with self-conception. The doctor prescribes drugs to stimulate ovulation in cases where:

  • The patient had a rare maturation of the egg and its exit from the ovaries;
  • The couple has been trying to get pregnant for more than a year to no avail;
  • Spouses older than 35-40 years do not get pregnant for 6 months.

At the same time, ovulation stimulation is prohibited in the following cases:

  • Partner infertility;
  • The presence of inflammation of the appendages, with adnexitis;
  • With pathologies of the uterus;
  • In case of poor patency of the fallopian tubes.

FSH and LH preparations. The goal is ovulation

Under the action of FSH, follicles begin to grow on the ovary — “sacs” on the surface of the ovary, in which one egg cell matures. To stimulate the growth of follicles, such drugs are most often prescribed to help get pregnant:

  • Clomid;
  • Fertomid;
  • Drugs that contain Clomiphene;

Drugs that help to get pregnant are selected individually, depending on the results of tests and ultrasound examination. In this article we describe the most famous, but not all existing drugs.

Clomiphene: mechanism of action and possible results

Clomiphene: mechanism of action

Clomiphene belongs to the group of nonsteroidal antiestrogenic drugs that stimulate ovulation. The mechanism of action of this drug is based on the activation of the synthesis of gonadotropins in the pituitary gland: FSH (follicle-stimulating), LH (luteinizing) and prolactin.

The effect of clomiphene directly depends on its dosage: the larger it is, the more gonadotropin production is suppressed, and vice versa, small doses of the drug enhance the formation of tropic hormones and promote ovulation. In addition, it is worth noting that the mechanism of action of clomiphene is affected by the concentration of estrogens in the blood: with small estrogen levels, it causes moderate estrogenic effect, and with elevated values leads to an antiestrogenic effect. At the same time, it does not affect the gestagenic and androgenic activity in any way.

Nowadays, the drug is widely used in gynecology as part of infertility therapy, because after its absorption, the processes of follicle maturation are activated and accelerated. Clomiphene is available in the form of flat tablets of grayish-white color. Its active ingredient is clomiphene citrate (Klostylbegit), in an amount of 50 mg per tablet. It is absorbed very quickly in the digestive tract after ingestion. The processes of disintegration of the drug occur in the liver, and the metabolites are completely excreted together with bile within 10-14 days.

Klostylbegit is often prescribed for IVF (in vitro fertilization) to stimulate the formation of eggs. There are cases when specialists do not wait for the rupture of the follicle, but immediately punctuate mature female germ cells for the next stage of IVF.

Indications and contraindications

The main purpose of taking klostilbegit (Clomiphene) is to stimulate ovulation, which is carried out in the following situations:

  • Anovulatory cycles;
  • Amenorrhea of various genesis or oligomenorrhea;
  • Polycystic Ovary syndrome (PCOS);
  • Pituitary tumors that cause galactorrhea;
  • Prolonged postpartum amenorrhea and galactorrhea caused by various pathological processes, for example, Chiari-Frommel syndrome;
  • Androgen deficiency.

Klostylbegit is prescribed not only for women, but also for men, since this drug has a positive effect on the quality of sperm, especially with oligospermia (a decrease in the number of sperm in the ejaculate).

Clomiphene and ovulation stimulation

But this drug can cause adverse reactions from other organs and systems, so it is contraindicated in renal and hepatic insufficiency, neoplasms of the reproductive system and pituitary gland, ovarian cysts, renal and hepatic insufficiency. It should not be used with changes in the functionality of the adrenal glands and thyroid gland, hypofunction of the pituitary gland, uterine bleeding of unclear etiology, visual and metabolic disorders. It is also not recommended to use klostylbegit during pregnancy and lactation, with hypersensitivity to the components of the drug.

COVID-19 and the ability to conceive a child

There is still more scientific data on the impact of dangerous microflora on the ability to reproduce offspring relative to men. Cases of testicular inflammation of viral genesis have been recorded. Also, SARS-CoV-2 was detected in male seminal fluid. The ACE 2 protein, which promotes the penetration of the virus to the human cell, is found in large quantities in the testes.

Among women, the age category from 37 years old is the most negatively affected by microorganisms. Factors contributing to damage to the reproductive organs are the severity of the disease and excess body weight. Overweight patients after a severe form of Covid have a 5-fold increased risk of a decrease in the supply of eggs, compared with young girls who have been ill easily or asymptomatically.

Read also: Coronavirus and pregnancy.

The growth of gynecological diseases during the pandemic has not yet been observed. Their structure remains stable. In the leading positions — inflammation of the pelvic organs (per 100,000 – 3,000 cases). Menstrual cycle failures are in second place (per 100,000 – 1300). There are 225 women with infertility per 100 thousand. These are approximate figures, since many girls take birth control pills, others do not live a sexual life, and others are not going to become mothers in the near future. These categories (in the majority) do not know the state of their own fertility. For sure, many of them have a violation of reproductive function.

IVF and coronavirus

During the pandemic period, infertile patients were much less likely to seek medical help due to sanitary and epidemiological restrictions and self-isolation. In 2020, outpatient services were not fully available. From February 2020 to July, assisted reproductive programs were suspended. According to statistics, about 50 thousand infertile couples did not use ART during this six-month period. At the moment there are no restrictions, the procedures are carried out as planned and the indicators have leveled off.

Vaccination during pregnancy

In the USA, 14 thousand women were vaccinated during gestation. Information on 827 vaccinated pregnant women has been published. The following conclusions are made: the complications are the same and occur with the same frequency as in the unvaccinated. The number of spontaneous abortions, premature births, fetal development disorders and other complications are not increased, and do not differ with the general population frequency of pathological changes.

Clomid and pregnancy

Clomid and pregnancy: It is very important to remember that each patient has her own, only her inherent reaction to those drugs (for example, clomiphene) that are injected into her body and each subsequent treatment cycle will be different from the previous one.

This means that in reality your reaction not only can and will differ from the reaction of other patients to the same drugs, but also that for each subsequent treatment cycle your body can give a reaction completely different from the previous one. Therefore, it should be understood that your examination, treatment and its results may not be the same as in other patients. We kindly ask you not to compare the results of your examination and treatment with the results of other patients.

Of course, you can find a lot in common with them, but take into account that the use of assisted reproductive technologies (ART) is a purely personal matter for each person and most patients experience great inconvenience when discussing personal problems in public. The information presented here will help you consciously go through the treatment cycle. If you have any questions, be sure to ask your doctor.

Clomid and pregnancy: recommendations before starting treatment

If you have come to an agreement in your family and with your doctor, you need to clarify the specific treatment program. You will sign (wife and husband) a statement of commitment about your intention to undergo treatment using ART techniques and give informed consent to this. Carefully read and understand all the provisions of the statement, clarify what you do not quite understand.

In addition, you will be given to read, understand and sign a financial contract and a checklist, which will indicate exactly the technique that will be used in this treatment cycle. Together with your doctor and nurse, you will review the certificates you have collected, the results of the examination, and other documents and decide on the start of an agreed treatment program.

What should be done to increase the chances of success?

clomid and pregnancy

For women:

  1. If you are prescribed some medications (clomid) by another doctor, you need to inform your doctor before starting the infertility treatment program.
  2. Cancel the use of any alcoholic beverages and do not smoke tobacco.
  3. Limit the use of coffee and caffeinated saturated beverages as much as possible (no more than 2 cups per day).
  4. Do not change the diet during the implementation of ART programs and do not carry out any dietary nutrition for weight loss.
  5. 3-4 days before the scheduled puncture of the follicles, as well as for the transfer of embryos into the uterus of the expectant mother and for tests to establish pregnancy, we strongly advise you to refrain from sexual intercourse and from excessive physical exertion.
  6. A little physical activity will not hurt until, as a result of taking ovulation inducers, a feeling of discomfort in the lower abdomen appears.
  7. For the duration of the ART treatment program, we strongly advise you to refrain from a hot bath, not to go to baths and saunas.

For men:

  1. In any painful condition, especially with an increase in body temperature (this is very important in the conditions of the spread of coronavirus), you should consult a doctor. It should be remembered that medications can negatively affect the quality of sperm.
  2. Two to three months before the start of ART treatment programs, you should use the shower and avoid going to the bath or sauna. High temperature negatively affects the quality of sperm. Like the Ministry of Health, we warn that taking medications, alcohol and smoking tobacco adversely affect the quality of sperm and should be excluded from use before and during ART programs.
  3. In the presence of a herpes infection or symptoms of any disease (malaise, rapid unmotivated fatigue), a married couple can be removed from the ART program.
  4. Within two to three months before the start of the ART program, we recommend reducing the intensity of sports, try to avoid overwork altogether.
  5. Refrain from wearing tight underwear.
  6. Refrain from sexual intercourse three to four days before the ultrasound, but no more than 7 days. Follow the doctor’s advice on behavior during the ART treatment cycle.
  7. Try to find out all the questions from specialists. Remember that the advice of friends is not always really friendly, and self-medication is unacceptable.

The phrase clomid and pregnancy is not a panacea. Remember what we wrote in the first paragraph of our article. Each organism is unique, if clomid helped your friend, it does not mean that it will help you.

The effect of clomiphene on sexual desire

Clomiphene on sexual desire: Sexual desire (libido) is a complex of desires and related experiences, which is based on biological instincts aimed at reproducing life. It includes the desire for sexual intimacy, the severity and direction of which are determined by the genetic set of chromosomes, the diencephalic part of the brain, the development of the endocrine glands and the formation of conditioned reflex complexes under the influence of individual psychosocial experience.

Clomiphene on sexual desire

Libido level is not a permanent condition. The level of sexual desire depends on many current factors.

There is a naked woman nearby – the libido level is high – this is normal, but if it is low – it is not normal.

There is a naked woman next to you and she is your sister – the libido level is low – this is normal, but if it is high – it is not normal.

Although the situations are very similar, but social norms and your upbringing completely kill your libido, although tens of thousands of years ago this would have been the norm, and the situation could have been the opposite.

There is a naked woman next to you, she is your wife and she wants sexual intercourse – the libido level is high – this is normal, but at the same time, if you were fired from work, your car broke down, a disease was diagnosed, which caused serious stress and anxiety – the lack of libido at the moment is also the norm.

clomiphene on sexual desire

In this case, stress and anxiety completely interrupt libido.

Also, the norm may be a more elevated libido at the beginning of a relationship with a new partner, and a decrease in sexual attraction to this partner after 20 years of relationships is also the norm. Lack of sexual attraction to a partner is most likely not the norm, but a decrease is the norm.

A decrease in libido with age is also the norm, I don’t think that at 50-60 years old, wanting the number of sexual acts as at 16-20 years old will be the normal functioning of the psyche. A higher libido in youth is the norm, a drop with age is also the norm.

The main thing to understand is that testosterone is not the only factor affecting sexual desire and its strength. And an increase in testosterone in 100% of cases will lead to an increase in libido.

From libido theory to clomiphene

Consider a number of studies:

The first sufficiently extensive study, with a large number of people and long-term use of clomiphene. The general conclusion is that taking clomiphene does not cause any special side effects.

Results – a total of 12318 men took clomiphene and represented the main study group, whose average age was 37.8 years. In men taking this medicine, there was no increased risk of side effects of clomiphene.

The second study compared the intake of clomiphene and HRT and the effect on symptoms. Studies have shown that HRT is more effective due to a stronger increase in testosterone. At the same time, clomiphene is the preferred method if necessary to preserve fertility. But, those taking clomiphene noted an adverse effect on libido. This is the only study that turned out to be found where a negative effect on libido was noted.

Clomiphene on sexual desire conclusions. Both TC and GC are effective drugs for the treatment of hypogonadism; however, our study shows that TC more effectively increases the level of testosterone in the blood serum and improves the symptoms of hypogonadism. K remains a viable treatment method for men with hypogonadism, but its adverse effect on libido requires further study

When asked about the goals and objectives that a person wants to implement with testosterone-boosting therapy, the top looks like this:

  1. Improvement of general well-being and reduction of general fatigue (chronic fatigue, sleep problems, joint pain.
  2. Stabilization of the psycho-emotional state (anxiety, anxiety, depression).
  3. Increasing the amount of muscle mass. Many still consider testosterone-boosting therapy as an alternative to the course. Although this is not true.
  4. Improved erection.
  5. Improved libido.

Pregnancy after ovulation stimulation

Pregnancy after ovulation stimulation: A necessary condition for the onset of pregnancy is the presence of ovulation. If this physiological process is absent or incomplete, then we can talk about infertility.

However, in the modern world there are ways to deal with this unpleasant phenomenon, and an increasing number of women manage to get pregnant after ovulation stimulation.

Problems with ovulation have become a fairly common cause of infertility, but fortunately modern methods of treatment allow many women who encounter them to become pregnant. Reproductive medicine offers patients to use medications to stimulate natural processes. Pregnancy after ovulation stimulation is possible for women with healthy eggs, which for some reason do not mature in the body on their own. This method is also effective for patients with polycystic fibrosis. However, the procedure for obstruction of the fallopian tubes can cause ectopic pregnancy, so it is prescribed only after laparoscopy. It is pointless to carry out such therapy with the male factor of infertility. Contraindications to ovulation after stimulation also include:

In any case, only a doctor can make a decision about ovulation stimulation!

Diagnosis before starting treatment

Before you start taking medications, you need to undergo a comprehensive examination and establish an accurate diagnosis. A woman needs to take blood tests, do an ultrasound of the mammary glands, check the patency of the fallopian tubes. The last point is especially important for patients with abortions, curettage and pelvic inflammatory processes in the anamnesis. This examination is mandatory for those who have used an intrauterine device for contraception. Immediately before stimulation, a woman’s hormonal background is examined.

Stimulation procedure

Ovulation after stimulation occurs against the background of taking drugs based on gonadotropins (Clostilbegyt, etc.). They are injected into a woman by injections into a muscle or subcutaneously. The doctor determines the doses and duration of use of medicines. As a result of the use of ovulation inducers, the patient’s ovaries produce one or more eggs ready for fertilization. The more they turned out, the higher the chances of getting pregnant. During the stimulation process, a woman is obliged to continuously monitor the basal temperature, hormone levels, and the degree of egg maturity. To do this, she has to regularly take blood tests and undergo ultrasound diagnostics.

A man regularly does a spermogram. When the doctor sees that ovulation has occurred, a woman has a chance to get pregnant naturally or with the help of IVF. In the first case, several eggs will be needed, in the second one or two are enough. The control of the process by the doctor increases the chances of success, since the maximum probability of pregnancy falls on the day of ovulation, and it is quite difficult to determine this moment independently.

Pregnancy after stimulation ovulation

If conception occurs with the help of special treatment, the risk of termination of pregnancy increases markedly, especially if we are talking about early terms (up to 4-6 weeks). Another danger is the development of fetal hypoxia, gestosis and gestation of two or more fetuses. Pregnancy with ovulation stimulation requires the expectant mother to regularly take blood tests for hormone levels and undergo ultrasound. In addition, quite often after the use of the above drugs, ovarian hyperstimulation syndrome occurs, which can have a bad effect on the course of pregnancy. Therefore, everyone who became pregnant after ovulation stimulation needs to undergo a medical examination once a week. The success of the procedure is influenced by the age of the woman, the causes and duration of infertility. The first attempt to get pregnant on drugs gives a positive result to only 10-15% of patients. On the other hand, pregnancy after ovulation stimulation is quite real and it is worth striving for.

Clostilbegyt – stimulation ovulation

Clostilbegyt (clomiphene) is one of the classes of selective estrogen receptor modulators. The mechanism of action of Clostilbegyt is based on the selective effect on estrogen receptors of the hypothalamic-pituitary system, in connection with which the receptors are blocked for estrogens and the feedback mechanism increases the secretion of gonadotropins (follicle-stimulating and luteinizing hormones), which, acting on the follicles in the ovaries, causes stimulation of their function (ovulation stimulation). There are indications that the blockade of the estrogen receptors of the hypothalamus leads to increased production of gonadoliberins, thereby providing a higher level of regulation of the hypothalamic-pituitary-ovarian system.

Clostilbegyt has certain pharmacokinetic features: good absorption by oral administration, a long (up to 7 days) half-life due to active binding to plasma proteins.

Indications for the use of Clostilbegyt

The indication for the use of clostilbegyt is infertility associated with the absence of ovulation. Taking into account the long experience (several decades) of using this drug for the treatment of anovulation, the pros and cons of using this drug have been well studied, various ovulation stimulation schemes have been developed.

Pros and cons of the drug

The main advantages of using clostilbegyt to achieve pregnancy are:

  • low cost;
  • wide availability;
  • oral route of administration;
  • high efficacy (in the absence of clomiphene resistance);
  • a small number of possible complications in the treatment of infertility (low frequency of multiple pregnancies, low frequency of ovarian hyperstimulation syndrome).

However, despite the obvious advantages, clostilbegyt has significant disadvantages that limit its use in the treatment of infertility. The main negative factors when using clostilbegyt are:

  • antiestrogenic effect, which can lead to impaired endometrial function, impaired properties of cervical mucus and vaginal epithelium;
  • in some patients, the hypoestrogenic condition can cause vasomotor reactions (hot flashes);
  • the use of SMER increases the risk of thrombotic complications of any localization.

Returning to the mechanism of ovarian function stimulation when using clostilbegyt (stimulation of gonadotropin secretion against the background of blockade of estrogen receptors of the hypothalamic-pituitary system), it is important to understand that the use of clostilbegyt in hypogonadism (hypopituitarism) is ineffective, since increased gonadotropin secretion will not be observed due to their absence. In this situation, the use of natural gonadotropin preparations is indicated. Thus, stimulation of ovulation with clostilbegyt is effective only with normogonadotropic anovulation.

clostilbegyt

Drug can be a first-line therapy drug if ovulation stimulation is necessary in patients with polycystic ovary syndrome (in the absence of clomiphene resistance).

Clostilbegyt in infertility

Clostilbegyt in the treatment of infertility is an inexpensive, highly effective first-line drug for normogonadotropic anovulation. An important positive aspect of its use is the possibility of oral administration. However, the use of this drug is associated with a certain risk of complications and should be carried out only by a doctor, if possible, using ultrasound monitoring of folliculogenesis and endometrial development. In the vast majority of cases, the negative antiestrogenic effect of the drug on the thickness of the endometrium can be corrected by using estrogen-type drugs after the end of taking clostilbegyt in the planned fertility cycle.