Clomiphene ™

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

What are estrogens?

This is a group of steroid female sex hormones that are produced mainly 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 particularly affects estradiol levels in the blood.

Functions of estrogens:

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

Reproduction. A group of estrogen hormones activates the production of mucus in the vagina, as well as its epithelization, which creates the necessary conditions for maintaining the viability of spermatozoa. 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 a sperm. Further, after ovulation, in the event that fertilization occurred, estrogens are responsible for the preservation of the fetal egg, blood supply to the placenta and preparation of the expectant mother’s breast for lactation. If the egg is not fertilized by a 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 the regulation of calcium levels, cholesterol in the blood, 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 gonadotropins (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 processes described above, the use of the drug Clomid leads to the fact that the level of estradiol in the blood increases significantly.

Causes and symptoms of estrogen reduction

• The main reason that the level of estrogens in the blood of a woman 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 (the male hormone) is produced intensively.
• 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 rapid 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 estrogens 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 the 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 decreases, performance, insomnia appears and the skin condition worsens (its elasticity, color, turgor). Stretch marks, pigmentation, and inflammatory rashes appear on the skin. Female infertility and dysfunctional uterine bleeding may occur.

Form of release of the drug Clomid

This medicine is produced in tablet form. Each tablet contains 25mg, 50mg, 100 milligrams of clomiphene. The drug Clomid is intended for oral administration, that is, through the mouth.

Indications for use of the drug Clomid

According to the instructions for use of the drug, it is prescribed for these conditions:

• infertility caused by lack of ovulation;
• galactorrhea is a spontaneous pathological outflow of milk from the breast, which is not associated with feeding a child and occurs as a result of pituitary tumors;
• amenorrhea – absence of menstruation for a long period;
• dysfunctional uterine bleeding (metrorrhagia);
• androgen insufficiency (hypogonadism) – insufficient production of steroid hormones by the sexual glands;
• polycystic ovary;
• oligospermia in men, a condition in which the quality and activity of spermatozoa decreases;
• violation of the pituitary gland.

How to take Clomid

The scheme of application of the drug is different and depends on the pathology. As indicated in the instructions for use of the drug, to stimulate the ovulation process, Clomid is prescribed at a dose of 50 milligrams once a day, before bedtime. The course of taking the drug begins on the fifth day of the menstrual cycle and lasts five days. In situations where there is no menstruation at all, you can start taking the drug at any time prescribed by the doctor. If it is ineffective and there is no ovulation, the dose of Clomid can be increased to 150 milligrams per day, or the course of treatment can be extended to ten days. There is a special indication in the instructions, which says that the total course dose of the drug should not exceed 1 gram.

How to determine whether Clomid is effective

It is necessary to determine the presence of ovulation. To do this, there are several fairly simple methods that a woman can perform herself at home. This is a temperature method or basal temperature measurement, a method of ovulation tests. Additionally, the levels of hormones (luteinizing, progesterone, etc.) are determined.

In cases where the menstrual cycle has improved, but pregnancy does not occur, it is recommended to repeat the course of taking this drug in the same therapeutic dosage.

Contraindications to taking the drug Clomid

• Renal or hepatic insufficiency, which is associated with the way the drug is excreted.
• Neoplasm of the genitals.
• Uterine bleeding of unknown etiology.
• Inflammation of the inner layer of the uterus (endometriosis).
• A tumor or an underactive pituitary gland.
• Ovarian insufficiency on the background of increased prolactin levels in the blood.
• Ovarian cyst.
• Pregnancy.

Side effects of the drug Clomid

During the reception of Clomid, various manifestations from the internal organs may appear.

• Allergic manifestations: vasomotor disorders, allergic dermatitis, rarely-rashes.
• Manifestations from the nervous system: drowsiness, dizziness, headache, depression, insomnia, hyperexcitability, slowing down the speed of motor and mental reactions.
• Possible manifestations of the genitourinary system: an increase in the size of the ovary, cystic ovarian changes, menorrhagia, dysmenorrhea, polyuria, increased urination, pain in the lower abdomen.
• Other possible side reactions include:” flushes ” of blood to the face, alopecia (hair loss), chest pain (breast), decreased visual acuity, weight gain.

Special instructions concerning 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 their 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.

Should there be ovulation in every cycle? What is pathological anovulation and how is it diagnosed? How to stimulate ovulation with medications and what can be done with “home” methods? We will try to answer these questions

What is anovulation?

Lack of ovulation – anovulation) is a violation of the growth and maturation of the follicle, as well as the lack of ejection of an egg from the follicle. Such deviations can occur in women, both with a regular cycle and with its failures.

Let’s remember the sequence of the menstrual cycle. It is divided into two phases: follicular and luteal. The first prepares the body for conception, the second-for pregnancy. These phases are controlled by special hormones produced by the pituitary gland-gonadotropins: follicle-stimulating (FSH) and luteinizing (LH) hormones.

“Conductor” of the first phase of the menstrual cycle-FSH. At the beginning of the cycle, the concentration of this hormone is maximum. It stimulates the maturation of the follicle, inside which a young egg is preparing to meet the sperm. As it Matures, the follicle increases in volume and produces an increasing amount of estrogens (including the hormone estradiol). For the pituitary gland, increasing the concentration of estradiol is like a trigger: it reacts with a strong release of luteinizing hormone. Under the influence of LH, the follicle bursts and ovulation occurs. The remaining follicle turns into a yellow body and begins to produce progesterone and wait for pregnancy.

Difficulties with ovulation begin with insufficient production of gonadotropins, when there is no maturation of the follicle or there is no egg in the follicle, as well as in cases when the egg cannot leave the follicle due to too dense a shell. Unfortunately, anovulation is one of the most common causes of infertility today.

Causes of anovulation

Should ovulation accompany every menstrual cycle? It turns out, no! Normally, several cycles a year in a woman do without ovulation – the reproductive system arranges a kind of”vacation”. The older the woman, the more often her ovaries strive to rest, so the chances of rapid conception decrease after 35-40 years.

Among the pathological causes of ovulation, disorders of the endocrine system, inflammatory diseases, features of the structure of organs and stress conditions are in the first place.

First of all, the reason for the lack of ovulation is changes in the hormonal background. It could be:

• violation of the thyroid gland;
• violation of pituitary function;
• improper production of prolactin levels, which leads to an imbalance of the hormones FSH and LH.

In addition, ovulation may be absent due to inflammatory processes in the body.

How is anovulation diagnosed?

It would be misleading to think that the diagnosis of “anovulation” can be made independently on the basis of basal temperature charts or pharmacy ovulation tests. Their results should serve as a basis for contacting a doctor and passing a medical examination. It is also impossible to make a diagnosis on a single ultrasound – several such procedures will be required.

There are two ways to diagnose anovulation. First, you can conduct a study of the level of progesterone. Secondly, it is possible to conduct ultrasonic monitoring. Usually ultrasound is done 4-5 times during the cycle. This is usually enough to make a diagnosis.

Medical methods of ovulation stimulation

Today there are four main types of medical stimulation of ovulation:

Antiestrogen drugs (of Clostilbegyt, Serafin, Clomid). These drugs in the form of tablets are currently prescribed most often, they are the most available among the means that stimulate ovulation. The main effect of these drugs is to increase the level of FSH and LH. However, the appointment of anti-estrogenic drugs should be approached with great caution: the slightest violation of the dosage can lead to hyperstimulation, which threatens polycystic ovaries, their depletion and early menopause. In addition, it is recommended to conduct no more than six courses of such therapy in a lifetime. And, therefore, the use of these funds should be carried out under very strict control of the doctor.
A milder scheme of influence on the ovaries is considered to be treatment with injections based on human menopausal gonadotropin (for example, Menogon, Pergonal, Menopur). These drugs are synthesized from the urine of menopausal women. They contain the hormones LH and FSH, which are responsible for regulating the menstrual cycle and maturation of the follicles (and therefore contribute to the launch of ovulation).
The most effective and safe to date are considered recombinant FSH (Puregon, Gonal-f). These drugs are the most expensive. They are obtained in the laboratory by genetic engineering, they are almost devoid of impurities and as close as possible in their action to the natural hormone FSH.
In some cases, prescribe injections of drugs containing human chorionic gonadotropin (HCG) (for example, Ovitrel, Pregnil, Choragon, Prophase). This drug is used in a situation when the follicles themselves Mature and develop, but then regress and do not release an egg, as well as in IVF and AI schemes. HCG stimulates the rupture of a Mature follicle, which releases an egg ready for fertilization into the fallopian tube.

Important: If you have decided to perform medical ovulation stimulation, you need to make sure that your spouse has no problems with conception – the actual results of the spermogram are mandatory!

Home methods of ovulation stimulation

What can you do at home to help your ovaries? We have collected the most popular “home” methods of ovarian stimulation and asked a specialist to comment on them.

Herbage

It is known that many plants contain phytohormones-substances whose action is similar to human hormones. It is these properties of plants that many people use in home practice. We have collected several herbs to stimulate ovulation, which are most often heard in the recommendations.

Sage (broth). Sage contains phytoestrogen, a plant-derived substance similar to human estrogen. It is believed that sage broth promotes the formation and growth of follicles, so it is recommended to take it in the first phase of the cycle.

Rose petals (decoction). This is probably the most romantic and mysterious way to bring ovulation closer! 1 tbsp of rose petals (it is better, of course, to take it from your own garden, rather than buy it in a store), pour a glass of boiling water and stand for 15 minutes in a water bath. Done! Take 1 teaspoon before going to bed in the first half of the cycle. The “magic” properties of this broth are explained by the high content of vitamin E.

Spa procedures

Therapeutic mud. Wraps with therapeutic mud are a well-known sanatorium method of recovery. Therapeutic mud increases hormonal activity, helps to eliminate inflammatory processes and promotes the restoration of reproductive functions. Such wraps and mud applications can be done independently at home-after consulting with your doctor, of course.

Bath with laminaria. Another pleasant home method, which is very often recommended, without explaining, however, the subtleties of the mechanism of its effect – stimulating baths with kelp. Dry kelp can be purchased at a pharmacy, thoroughly steamed and add the resulting infusion to the bath. Among other things, kelp is also an excellent anti-cellulite remedy – so the benefits are guaranteed!

Diet

To normalize the hormonal background, all means (and especially those approved by the doctor) are good! For example, a diet that includes foods that stimulate the production of estrogens. It is worth paying attention to:

• pineapples;
• soy and legumes;
• grenades;
• carrot;
• pumpkin and sesame seeds;
• fat milk;
• spinach;
• sprouted wheat.

Vitamins

We wrote about the undoubted benefits of vitamins during pregnancy planning in a recent review. Taking vitamins such as folic acid, E, and C really increases the chances of successful conception. But it is unlikely that vitamins will help start ovulation in serious pathological disorders.

A woman’s hormonal background changes over the course of a month, and it is influenced by a huge number of factors, including the day of the cycle, contraceptives, stress, and much more. Therefore, it is difficult to determine whether your hormonal background is in order without special tests. For rapid diagnostics, home tests were developed that allow you to determine ovulation and pregnancy. It seems simple, but women began to be interested in the question of whether ovulation tests can show pregnancy, or how it will behave if the egg is already fertilized.

What is ovulation?

This is a natural, monthly process by which a woman becomes capable of procreation. That is, it is directly the process of egg release. This is where conception should occur if a sperm is found on its way.

Women who are at peace with their body are able to feel the approach of ovulation. During this period, sexual desire increases, nature knows when to look for a partner, there may be a slight feeling of pain in the ovaries. All this indicates that the right moment is approaching. To track this favorable period, you can use special tests. But the question is, can ovulation tests show pregnancy? Let’s figure it out together.

How does the ovulation test work?

This is very important to determine the most favorable moment for conception. Many women who are unable to get pregnant for a long time acquire these tests in large numbers, every day tracking the approaching output of the egg. The principle of operation of this test is quite simple. The test strip determines the level of luteinizing hormone (LH) in the urine. Shortly before the follicle breaks, the level of this hormone reaches its maximum level. As soon as you see 2 strips on the test, it means that ovulation will occur in about 12-48 hours. However, don’t forget that any test can fail. Make sure that the brightness of the test strip does not differ from the control one, otherwise the result may be considered unreliable. However, if a woman is planning to conceive, she is always interested in whether ovulation tests can show pregnancy. Numerous examples show that this is possible. Let’s talk about this in more detail.

If a pregnant woman uses the ovulation test

First of all, we would like to draw your attention to the fact that home tests are much less reliable than laboratory tests performed by doctors in a hospital. That is why quite often litmus tests can give one for another, pregnancy for ovulation, and Vice versa. Both ovulation and pregnancy are determined by the level of the hormone in the urine. Despite the fact that the hormones are different, such simple tests can easily be mistaken for one another. The surge of the hormone during ovulation and during conception looks about the same for them. That is why it is possible to answer the question in the affirmative whether ovulation tests can show pregnancy, but the reliability of this method will always be in question.

Different tests: what we will measure

Theoretically, the ovulation test should only determine the maturation and yield of the next egg. It is clear that if you are pregnant, this is not possible, but there is a huge amount of evidence that the ovulation test shows pregnancy much sooner than a specialized litmus test.

Sometimes women confuse these two types of tests, sometimes the pharmacy mistakenly sells them the wrong thing they ask for. As a result, you can ask whether an ovulation test can show pregnancy , and get an affirmative answer. While pregnant, many girls received a positive ovulation test. Others for the sake of interest, already reliably knowing about their pregnancy, checked the result of the ovulation test, and it also often turns out to be positive.

False indicators

Before you say whether the ovulation test can show pregnancy, you should warn that this is in any case the result of an imperfect diagnostic system, which means that you can not trust such indicators. If you are pregnant, the test result, once positive, will not turn into a negative. If this happens, you should immediately tell your doctor.

In this case, the ovulation test can show pregnancy, but only because the chorionic gonadotropin and luteinizing hormone have similar formulas, and the test has not only high sensitivity,but also a fairly large error.

To summarize

If we talk about whether a pregnancy test after ovulation will show the desired two strips, then any doctor will say that it is unlikely, because it has much less sensitivity. For a reliable result, you must wait for the first day of the delay. For this reason, a pregnancy test is not used to determine the onset of ovulation, its sensitivity is clearly insufficient. They will not be able to detect a slight increase in lutein.

Sometimes, Clomid is used to stimulate pregnancy. However, this is not the case with the second test strip. Whether the ovulation test shows pregnancy, many years in a row are discussed on all forums. Yes, indeed, it does. Therefore, it is possible to use it for the diagnosis of conception, although it is not economically feasible. The cost of such a test is several times higher than the price of the most expensive pregnancy test.

After we have determined that it is possible to get an answer about your interesting position using an ovulation test, the question arises about the accuracy of this method. So it is logical to ask, does the ovulation test always show pregnancy? No, this method does not give 100% accuracy, because initially this litmus strip has other tasks. In order for you to determine the onset of ovulation, a test that is impregnated with reagents is used to detect the LH hormone in the urine. Its maximum concentration is in the urine during the period of egg release. If you get clear two stripes, it means that ovulation has already occurred and the optimal time for conception has arrived.

to determine an interesting position, you need to use another test, impregnated with reagents that react to the hormone HCG. From the first day of delay, you can get clear two stripes, which indicates that you are really pregnant. Thus, it is clear that these two tests respond to different hormones, and therefore, one will not replace the other. Ask any physiologist or doctor about whether ovulation occurs during pregnancy, and prepare for the fact that he will be very surprised. Of course not, the tasks of this mechanism have already been completed. The egg went into the fallopian tube, was fertilized, and implanted in the uterus. Until the birth of a new egg will not be formed.

Ovulation is the natural process of an egg entering the fallopian tube after a Mature follicle is ruptured. Usually occurs 14 days before the start of menstruation. For a number of reasons, the egg may not be released from the follicle. In this case, artificial ovulation stimulation is required.Specialists of the IVF reproductive health clinic use dozens of techniques aimed at maturing the follicle and releasing the egg into the fallopian tube. Doctors prescribe medications (“Clomid“, “Didrogesterone”, etc.), select a diet, eliminate hormonal imbalances, give recommendations for lifestyle correction. As a result of complex therapy, a woman begins to ovulate, which is necessary for the conception of a child.

Features of the ovulatory phase

In healthy women, the rupture of the follicle with the subsequent release of the egg into the fallopian tube occurs without stimulation about 14 days before the onset of menstruation (with a 28-day cycle). Small deviations from the average are often observed and are considered the norm.

On the eve of ovulation, the ovarian follicle increases in size to 2 cm in diameter. At this point, the egg Matures in it. Under the influence of hormones, a gap appears in the follicle. Through it, the egg enters the oviduct (fallopian tube), and then – into the uterus, where fertilization occurs. The duration of the entire process does not exceed 48 hours. However, many women of reproductive age have disorders in the ovulation phase. This makes it difficult to conceive a child.

Indications for the procedure

Doctors of the IVF reproductive health clinic prescribe ovulation stimulation after laboratory and instrumental diagnostics. Therapy is indicated for women who have detected anovulation caused by:

• polycystic ovary;
• hyperandrogenism;
• resistant ovarian syndrome;
• hormonal disorders in diseases of the endocrine system;
• hypothalamic-pituitary dysfunction;
• pathologies of the reproductive system from prolonged use of contraceptives and hormonal agents.

Ovulation stimulation is indicated after undergoing a comprehensive diagnosis, which is aimed at detecting the cause of abnormalities in the menstrual cycle.

Preparing for the procedure

Before ovulation stimulation, it is necessary to undergo a clinical diagnosis. First of all, a woman is assigned to pass laboratory tests. These include:

• venous blood analysis for detection of antibodies to pathogens of syphilis, immunodeficiency virus, toxoplasmosis, chlamydia, cytomegalovirus, rubella;
• urine sampling for the diagnosis of trichomoniasis and vaginal candidiasis;
• vaginal smear to detect mycoplasmosis, Gardnerella, pathologically altered cells;
• urine analysis to determine the indicators of prolactin, estrogen, and testosterone.

Also shown is the conducting of instrumental diagnosis of. Patients are referred to:

• General examination by a therapist;
• Examination by a gynecologist;
• ECG (under load and in a relaxed state);
• Ultrasound of the pelvic organs – this method helps to detect organic pathologies, malignant and benign tumors;
• X-ray of the fallopian tubes-necessary for the diagnosis of obstruction;
• Folliculometry – this method of ultrasound allows you to track the growth and development of follicles in dynamics.

Doctors of the IVF reproductive health clinic select treatment individually depending on the causes that caused the abnormal course of the menstrual cycle.

What is ovulation induction?

This is a procedure in which specialists artificially stimulate the maturation of eggs. During induction, both one and several cells can develop in the follicles of a woman. Such treatment should be performed with IVF or insemination. The more Mature eggs a reproductologist extracts from a woman’s ovaries, the higher the chance of a successful outcome of in vitro fertilization. Induction can be performed with medication.

Methods of artificial stimulation

In medical practice, there are many ways to speed up the process of maturation of the egg and follicle. Particularly effective are:

• drug therapy-involves the appointment of drugs that normalize the production of female hormones, restoring the menstrual cycle;
• diet-nutrition correction helps restore metabolic processes, increase the body’s support forces;
• vitamin therapy-aimed at eliminating the deficiency of vitamins (A, D, C, E, etc.), as well as macro – and microelements (iron, zinc, calcium, phosphorus).

Stimulating the ovulation process in several ways increases the chances of restoring the menstrual cycle and further conception of a child.

Medication

When detecting pathologies in the maturation of follicles and eggs, specialists use drugs to stimulate ovulation. Funds are selected based on the patient’s age and weight, as well as the cause of the violation. In addition, the choice of a specific drug depends on the further method of fertilization of the egg (natural, IVF, ICSI, IMSI, etc.).
Medication prescribed to stimulate ovulation does not give results immediately. Only 15% manage to get pregnant after a short course of medication. Specialists of the IVF clinic psychologically prepare women and introduce them to statistics in order to reduce stress in the event of a failed attempt.

Nutrition for successful ovulation

Food is the main source of nutrients, macro-and microelements. The diet significantly affects the menstrual cycle and the ability to conceive. Women who consume a lot of fat and carbohydrates can suffer from overweight, high cholesterol, and diabetes. Such diseases negatively affect the work of the reproductive system. Lack of body weight is also dangerous – the body reduces the concentration of female hormones (estrogen, progesterone, prolactin, etc.).

Specialists prescribe proper nutrition to stimulate ovulation, recommending that the menu include:

• dairy products (cottage cheese, hard cheeses, milk);
• fruits / vegetables rich in fiber, trace elements and vitamins;
• the wheat germ;
• legumes (chickpeas, beans, peas);
• quail eggs;
• walnut;
• flax, sesame and pumpkin seeds;
• dates.

In the course of treatment, it is necessary to stop using alcohol and Smoking. Certain foods prescribed by the diet may cause alle.