Clomid
Clomid ( clomiphene citrate ) was first synthesized
in 1956 and introduced for clinical trials in 1960. Since then, Clomid
has been widely used as a "first line" treatment to
induce and regulate ovulation.
Clomid is typically administered on either day's three to seven or day's
five to nine of the menstrual cycle with "day one" defined as
the first day of normal menstrual flow.
Clomid works at the hypothalamus, a small gland at the
base of the brain. Clomid stimulates the production of gonadotropin releasing
hormone ( GnRH ), which stimulates the pituitary gland to produce follicle
stimulating hormone ( FSH ). FSH
stimulates the development of the ovarian follicles which contain the
eggs.
Clomid is taken orally and should be taken at the same
time each day. The "fertile time," or the time of ovulation
usually occurs five to eight days after the last Clomid tablet is taken.
Sometimes Clomid is given to stimulate ovulation for
intrauterine insemination, IUI, usually in combination with FSH.
The physician determines how Clomid cycles should be
monitored. Early in treatment, patients usually take clomiphene for five
days each month and return for a follow - up examination after three months
of therapy if they do not become pregnant. Sometimes, the physician may
wish to monitor the Clomid cycles more closely. A combination of ovulation
predictor kits and / or ultrasounds may be used to determine the number
of follicles present, their rate of growth, and to help pinpoint the time
of ovulation.
Clomid has been used for many years and is considered
a safe and effective medication. It does, however, have risks and occasionally
there may be side - effects. Clomid side - effects can include abdominal
discomfort often described as "fullness and / or soreness,"
hot flashes, moodiness, or visual disturbances. Acetaminophen ( Tylenol
) can help with these symptoms. In a few patients, Clomid can cause enlargement
of an ovary; if this occurs, a patient is advised to seek an internal
examination by her physician.
Clomid is associated with a 10% incidence of multiple
births, but the vast majority of these multiple births are twins. There
is no increased risk of birth defects. If Clomid has not produced a pregnancy
within three to six months, alternate modes of treatment should be pursued.
The literature strongly supports that using Clomid beyond six months is
unlikely to result in pregnancy.
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