Take two Clomid and call me in three months

“Take two Clomid and call me in three months”

The prescription Dr. Basic hands you (if you can decipher it) at the end of
your first visit may say “Clomiphene citrate 50 mgm qd X 5 days, #10. Refills
3.” Or it may simply say “CC 50mg qd d 3-7.” What does this mean?
Clomiphene citrate, more commonly called Clomid or Serophene (two brand
names), is given to help you make an egg or to help you make a betteregg; it
may also help sustain a pregnancy by creating an egg whose corpus luteum
(see Chapter 2 for more about the function of the corpus luteum) produces
higher progesterone levels. Normally, you take Clomid for five days. Some
doctors start you on it on day three of your cycle, and others start you on
day four or five. The exact timing isn’t important; the point is to start it
before your ovaries start to develop one dominant follicle.
Usually your doctor will give you one pill a day the first month or two and
then move up to two or three tablets a day if you still don’t seem to be ovu-
lating regularly. Clomid comes in 50 milligram tablets, so if your doctor starts
you at a higher dose, 100 to 150 milligrams per day, you’ll need to take more
than one. After you stop taking the pills, you can check for ovulation by using
your old friends, the basal thermometer and the ovulation predictor kits.
Clomid works by fooling the body into thinking it’s not making enough estro-
gen. When your hypothalamus thinks that you’re low on estrogen, it releases
GnRH (gonadotropin-releasing hormone), which stimulates the release of FSH
(follicle-stimulating hormone) into your blood. The FSH stimulates the ovary
to produce estrogen, so that a follicle will begin to grow.
Eighty percent or so of women taking Clomid ovulate in response to this stim-
ulation. Clomid works best for those whose ovaries are capable of function-
ing normally but need a little tune-up. If you’re already ovulating a mature
follicle regularly, Clomid can help by increasing the stimulation to the ovary,
or even by causing you to ovulate more than one egg. In the latter cases, the
Clomid is generally combined with an IUI.
Your doctor may want you to have an ultrasound before starting Clomid each
month to make sure you don’t have any ovarian cysts. Most pregnancies from
Clomid occur in the first three to six months of therapy if the drug is taken
for anovulation.
Clomid has a few drawbacks, including the chance for multiple births.
Between 5 and 10 percent of all Clomid pregnancies are twins, 1 in 400 is a
triplet pregnancy, and 1 pregnancy in 800 results in quadruplets. Obviously,
you may be delighted to have a twin pregnancy, but triplets or quads may not
be so thrilling. Higher-order multiples (triplets and above) have a very high
rate of premature delivery and significantly higher than normal maternal and
infant complications. Multiples result from Clomid working too well and stim-
ulating more than one follicle to grow.
Some doctors monitor you with ultrasounds while you’re on Clomid to be
sure that you’re not making too many eggs. If you’re making a large number
of eggs, you may develop ovarian hyperstimulation syndrome, which can
cause a very high estradiol level, making hospitalization necessary. If you’re
on Clomid and feel very ill, with a sudden weight gain, severe bloating in your
abdomen, or abdominal pain, call your doctor immediately. This is arare side
effect of Clomid.
Clomid also has some less serious side effects, some annoying, some poten-
tially detrimental to pregnancy. For example:
Because your body has been fooled into thinking that it doesn’t have
enough estrogen, you may have some of the same symptoms women
have when they enter menopause and their estrogen drops: hot flashes,
headaches, nausea, or blurred vision. Some doctors may give you estro-
gen to decrease your symptoms.
Clomid can also interfere with your production of cervical mucus because
it locks into all the estrogen receptors, including those in your cervix,
so they don’t make mucus in response to rising estrogen levels like they
normally do. Because estrogen also builds your uterine lining, some
women on Clomid don’t make a thick lining. If you have either of these
side effects, you may need to take estrogen after you start making a folli-
cle. If your cervical mucus is decreased, an IUI may be in order to bypass
the mucus altogether and deposit the sperm directly into the uterus (see
Chapter 5 for more information on the importance of cervical mucus).