Month: November 2020

Clomid is a drug that is used in gynecological practice for the treatment of female infertility. It belongs to the group of antiestrogens. This means that it blocks receptors (nerve endings) in the ovaries and hypothalamus, which leads to a decrease in estrogen production. Also, this drug stimulates the maturation of follicles, ovulation itself and the level of estradiol in the blood.

Female infertility: what are estrogens?

Estrogens are a group of steroidal female sex hormones that are produced primarily in the ovaries. Men also have a small amount of estrogen in their blood, which is produced by the testicles and adrenal glands (in both sexes). Estrogens are divided into three types: estrone, estriol, and estradiol. Clomid has a particular effect on estradiol levels in the blood.

Functions of estrogens:

Feminization. This means that it is thanks to estrogens that a woman has a feminine appearance. During adolescence, these hormones are actively produced and form secondary sexual characteristics (Breasts, buttocks, abdomen, female hair, growth of internal and external genitalia).

Reproduction. A group of hormones called estrogens activates the production of mucus in the vagina, as well as its epithelization, which creates the necessary conditions for maintaining the viability of sperm. Estrogens stimulate the maturation of the egg (follicle) and the onset of ovulation, in which the Mature egg is released from the ovary and it can be fertilized by the sperm. Further, after ovulation, if fertilization has occurred, estrogens are responsible for the preservation of the fetal egg, blood supply to the placenta and preparation of the breast of the expectant mother for lactation. If the egg is not fertilized by the sperm, these hormones activate the detachment of the inner layer of the uterus (endometrium) and, as a result, menstruation begins.

Other effects of estrogens include regulation of calcium levels, blood cholesterol, blood pressure, liver function, and mental activity.

How Clomid works

Clomid contains the main active substance – clomiphene, which blocks the receptors that perceive estrogens in the hypothalamus (the part of the brain that controls the hormonal background of the body). As a result, the production of gonadotropic hormones (follicle-stimulating and luteinizing) increases, which activate maturation and intra-secretory (endocrine) function of the follicle in the ovaries. As a result of all the above processes, the use of the drug Clomid leads to the fact that the level of estradiol in the blood increases significantly.

Causes and symptoms of reduced estrogen

• The main reason that the level of estrogens in a woman’s blood decreases is the lack of activity of the ovaries that produce them. As the body ages, there is also a shortage of them. An important reason may be various pathological changes on the part of the pituitary gland.
• Sometimes there is a decrease in the level of estrogens in women who are engaged in professional sports, when the physical load on the body is excessive. This phenomenon occurs due to the fact that testosterone (male hormone) is intensively produced.
• Another important point is the presence or absence of adipose tissue. It is proved that estrogens are also produced by fat cells. This means that exhaustion or sudden weight loss is extremely dangerous for the female body, namely for its reproductive ability.

Symptoms that occur with estrogen deficiency

• In adolescence, a lack of estrogen leads to insufficient development of secondary sexual characteristics, a decrease in the size of the uterus, late onset and failures in the menstrual cycle.
• In reproductive age, a decrease in the level of estrogens provokes a decrease in sexual desire, sharp mood swings, various violations of the duration and other indicators of the menstrual cycle. In parallel, memory and performance are reduced, insomnia appears and the skin condition (its elasticity, color, turgor) worsens. Stretch marks, pigmentation, and inflammatory rashes appear on the skin. Female infertility and dysfunctional uterine bleeding may occur.

Special instructions for female infertility that apply to the drug Clomid

Taking this medication increases the likelihood of multiple pregnancies.

The development of effective action of the drug is possible only if the patient has a sufficient amount of her own estrogens. The lower their level, the less effective Clomid is.

Treatment with anti-estrogenic drugs, as well as any other, should take place under the careful supervision of a gynecologist. Periodically, the ovarian function is determined and other special examinations, including vaginal ones, are performed.

During the course of therapeutic treatment with Clomid, it is recommended to take special care when working with mechanisms that carry a potential danger, and when driving a car.

Today we will talk about ovarian stimulation, ovulation and IVF. One of the main causes of infertility is a woman’s lack of ovulation – anovulation or very irregular ovulatory cycles-oligoovulation. In the natural cycle, in the area of the follicle that has accumulated, a woman of reproductive age is determined by the yellow body, which prepares the endometrium for embryo implantation. Yellow body in IVF, how can you restore the normal ovulatory menstrual cycle?

The causes of ovulatory disorders can be different, they include various endocrine disorders, as well as problems with the Central nervous system. One of the most common causes of anovulation is polycystic ovary syndrome, overweight or underweight, and chronic stress in women.

There are several ways to determine that a woman does not ovulate. The most affordable method is to measure basal (rectal) temperature over several menstrual cycles. To diagnose anovulation, ultrasound is also used in the dynamics of the menstrual cycle, which tracks the absence of a maturing follicle or yellow body on normal days.

They also take a blood test for sex hormones in the dynamics of the menstrual cycle.

When establishing the fact of anovulation, you need to undergo a comprehensive examination to find out the reason for the absence or irregularity of ovulation, as well as to exclude other possible causes of infertility and identify concomitant diseases.

Preparing for ovarian stimulation in IVF

Normalization of weight

Polycystic ovary syndrome in women often leads to anovulation. These women are often overweight. Before starting drug or surgical ovulation stimulation, weight correction is mandatory. Weight loss of only 5-10% of the original in some cases leads to the appearance of independent ovulation, or improves the body’s response to the effects of medications. Weight deficit also needs to be corrected, since it is known that ovulation is possible in women who weigh at least 45 kg (with an average height of 160 – 170 cm).

Treatment of diseases that caused anovulation

It is necessary to treat all identified causes of anovulation – pelvic inflammatory diseases, hormonal disorders such as hyperandrogenism, hyperprolactinemia, etc. Often at this stage, women restore the ovulatory cycle and begin to grow follicles.

Preparation of the endometrium

Preparation of the uterine mucosa (endometrium) for possible implantation of the fetal egg is carried out. Drugs of female sex hormones – estrogens and gestagens-are prescribed in different combinations, under the control of ultrasound. Hormones promote the growth of the endometrium in the first phase of the menstrual cycle and its secretory transformation in the second phase of the cycle.

Ovarian stimulation. Stimulation of ovulation

Ovulation stimulation is an effective means of restoring fertility in many women with anovulation. In women with an absent or irregular ovulatory cycle, ovulation stimulation may be aimed at obtaining multiple eggs during treatment with assisted reproductive technologies. Careful selection of the treatment program for ovulation stimulation, as well as accompanying monitoring, lead to excellent results. It should be understood that not only natural conception, but also IVF in the absence of ovulation is not possible. Therefore, ovulation stimulation is mandatory for the IVF procedure. It is possible that the sensations during stimulation before IVF will not be pleasant, but the joy of motherhood brings more pleasant sensations. Side effects after IVF are minimal.

Medical stimulation of ovulation

Under the condition of normal spermogram parameters and with passable fallopian tubes, treatment usually begins with drug-induced ovulation stimulation. It can be carried out with the drug clomiphene citrate (klostilbegit). The patient takes medication for 5 days from day 3 to day 7 of the menstrual cycle. From day 8 of the cycle, ultrasound is performed to determine the ovarian response to stimulation and control the growth of the dominant follicle. Based on the results of ultrasound monitoring, the patient is assigned a time for injection of chorionic gonadotropin (pregnil), which stimulates the process of egg maturation and ovulation, and then sexual intercourse.

If the ovaries do not respond well to ovulation stimulation with clostylbegit or pregnancy has not occurred after 6 cycles of ovulation stimulation, then gonadotropin stimulation is recommended. These drugs are more effective than clomiphene citrate, but they require more careful monitoring, because the risk of multiple pregnancies increases.

Surgical stimulation of ovulation

In the absence of the effect of medical stimulation of ovulation, laparoscopy and wedge-shaped resection or drilling of the ovaries (piercing the ovary with an electrocoagulator or laser beam) are performed. These methods partially destroy the dense ovarian capsule, which contributes to ovulation. In the first cycle after the operation, ovulation is monitored. If ovulation does not occur, then in addition is appointed clostilbegyt in the usual way.

When ovulation is stimulated, the following complications are possible: ovarian hyperstimulation syndrome during IVF, multiple pregnancy, and drug-induced liver damage. Signs of hyperstimulation can be different: the state of health worsens when stimulated before IVF, neoplasms (cysts) appear in the ovaries.

All medications are prescribed by the attending physician strictly individually, ovulation stimulation is constantly monitored to avoid possible side effects.

Ovarian stimulation in IVF: discharge, sensations, well-being

Why is ovulation stimulation mandatory for IVF?

Pre-IVF stimulation is performed to simulate the normal cycle that results in the maturation of an egg. As a rule, ovarian stimulation for IVF is performed on the 3rd-5th day of the cycle for several days. Much depends on the type of procedure and treatment method. Gonadotropins are administered to the patient intramuscularly or subcutaneously. Menopur stimulation is often performed during IVF. In some cases, antiestrogens are used.

To increase the probability of fixing the zygote after settling, a progesterone drug is prescribed. It helps to preserve the viability of the egg. If IVF IS positive, progesterone should be taken before the 12th week of pregnancy.

With poor ovarian reviews, ovulation may not occur. In this case, repeated stimulation is required.

It should be taken into account that IVF ovulation stimulation has a certain number of acceptable options and after each procedure, the number of eggs in the body decreases. In addition, the stimulation procedure is quite painful. Patients often have abdominal pain when stimulated before IVF, and discharge during stimulation before IVF is also not uncommon.

When performing ovulation stimulation before IVF, it is necessary to exclude the use of other drugs, to warn against viral diseases, to reduce physical activity, and to avoid changes in body temperature. Doctors also advise you to lead a certain lifestyle when stimulated. IVF is possible if you refuse alcohol, caffeinated beverages and sexual contact.

Double stimulation in IVF

If repeated ovarian stimulation during IVF is performed within the same menstrual cycle, then such stimulation is called double. Double stimulation in IVF is directed at the antral follicles of the follicular and luteal phases. Double ovarian stimulation is performed for women with an insufficient number of eggs or women with a lack of time (for example, it is important to preserve fertility before treating cancer). Double stimulation for IVF allows you to get twice as many embryos as with the traditional approach.

IVF with minimal stimulation

In a standard IVF program, ovarian stimulation is performed very actively to get more cells. At the same time, the choice of embryos of the best quality and their development to the desired stage is more likely. However, there are a number of indications that ovarian stimulation before IVF is better to start with minimal stimulation. Minimal IVF stimulation involves going through the same stages of stimulation as the standard IVF Protocol, with the only difference that:

• lower doses of hormonal drugs are used,
• few follicles Mature during the cycle,
• and there is no risk of ovarian hyperstimulation.

Usually, a woman is prescribed a hCG test after IVF to confirm pregnancy. And if the analysis showed that conception did not occur, then the monthly period after IVF will come necessarily.Usually, monthly periods after a negative IVF result occur on the 3rd — 12th day.Monthly periods during IVF pregnancy (successful conception), it is possible to continue poor menstruation during the first 2-3 months. However, there should be no blood clots or lower abdominal pain.

With age, a woman’s reproductive function declines. This process is accompanied by an increase in the number of anovulatory cycles. Despite this, a woman is still able to get pregnant, as menopause occurs gradually.

Features of ovulation after 40 years:

Age is one of the main factors affecting a woman’s ability to conceive. The supply of oocytes in the body is limited. It lays at the stage of embryonic development. Some of the eggs die in adolescence. The remaining oocytes are consumed with each menstrual cycle. Therefore, by the age of 40, there are very few eggs left. The work of the reproductive organs during this period changes dramatically. This affects the overall well-being of a woman.

Ovulation after 40 years is much less common than at a younger age. This is due to a physiological decrease in the level of estrogens in the body. The hormone is responsible for the maturation of eggs and increasing the thickness of the endometrium. In addition, it is responsible for preserving youth. When the production of estrogens is disrupted, there is a change in the duration of the menstrual cycle. In some women, it completely disappears. Lack of estrogen in the body is accompanied by the following signs:

• Deterioration of skin elasticity;
• Frequent mood swings;
• Depression libido;
• Changes in the nature of selections.

Life expectancy of an egg after ovulation in a woman’s body after 40 years

Doctors say that ovulation after 40 years rarely leads to a successful pregnancy

This is due to a reduction in the life span of the egg after it leaves the follicular walls. Until the age of 40, it lives an average of 24-48 hours. This figure decreases markedly with age. Pregnancy in this case becomes possible if the man’s spermatozoa are active enough. In other cases, you may need the help of specialists.

Symptoms of ovulation in women 40 years old:

In General, ovulation after 40 years has no special distinctive features. It runs the same way as before. Some women do not notice any characteristic symptoms of the fertile period. It may be accompanied by the following symptoms:

• Increased sexual desire;
• Heaviness in one of the ovaries;
• Flatulence;
• Increasing the volume of vaginal secretions and changing their consistency;
• The increased sensitivity of the mammary glands;
• Increased sense of smell and taste.

Painful sensations in the area of appendages begin 2-3 days before the rupture of the follicle.

Every day they become more intense. The discharge becomes slimy and transparent. Just before ovulation, the cervical mucus is thinned. Libido increases markedly. Mood swings may also occur.

When fertility increases, the position of the uterus changes. It rises high in the vagina and becomes softer. The throat opens slightly. This is necessary for unhindered penetration of seminal fluid into the genital tract. At the same time, the basal temperature index decreases. It can be detected early in the morning, after waking up. Measurements are carried out with a mercury thermometer in the rectal opening.

Ovulation after 40 years and not only is easy to determine by ultrasound. It is recommended to perform monitoring starting from the 12th day of the cycle. The following signs indicate an early rupture of the follicle with a Mature egg:

• Presence of a dominant follicle larger than 18 mm in one of the ovaries;
• The thickness of the endometrium exceeds 10 mm;
• The throat of the cervix opens.

An ovulation test helps you get more information. It responds to an increase in the hormone LH in the body. But the result should be interpreted in conjunction with other signs of ovulation. LH can increase not only during the fertile period, but also in the presence of gynecological diseases.

After the expected ovulation, the woman should visit the ultrasound again. The fact that the follicle has successfully ruptured is indicated by its disappearance and the presence of fluid behind the uterine cavity. In place of the follicle, a yellow body appears, which is characterized by uneven outlines. The absence of characteristic signs of the ovulatory period indicates luteinization of the follicle. This problem requires adjustment of the hormonal background with medication.

How often do women ovulate after 40?

The frequency of ovulation in women 40 years old depends on a combination of factors. These include hereditary predisposition, hormonal background, lifestyle of a woman and concomitant diseases. Some women at this age do not experience significant changes. In others, the frequency of ovulatory cycles may be only 3-4 times a year. To determine the degree of readiness of the egg for fertilization, you should visit an ultrasound examination.

Reasons for the periodic absence of ovulation after 40 years

Ovulation after 40 years may be absent for a long time. This is due to changes in the hormonal background. But in some cases, anovulation is provoked by gynecological diseases or an incorrect lifestyle. Ovarian dysfunction can be caused by excessive alcohol consumption and Smoking. Other possible reasons for the lack of ovulation include:

• Inflammatory process in the small pelvis;
• Sexual infection;
• Polycystic ovary syndrome

If anovulation is triggered by external factors, there is a possibility of artificial stimulation of ovarian function. For this purpose, hormone-based medications are taken.

In any case, you can use clomid to stimulate ovulation.you can find the price list for this drug on our website.

Complete absence of ovulation after 40 years indicates early menopause. Its cause is a genetic disposition. In this case, the probability of conception is reduced. Menopause is characterized by the complete disappearance of menstruation. With the help of specialized drugs, a woman can smooth out the manifestation of the menopausal period. They are prescribed by the attending physician, based on the state of health of the woman.