Active substance: Clomiphene
The ultrasound helps to determine how many mature eggs are forming within their follicles.Together, these hormones are known as releases two hormones: follicle stimulating hormone FSH and luteinizing hormone LH.
In order for ovulation induction to be successful, 2-3 follicles should be visible at this point with just one follicle, we would not be significantly enhancing a woman's chances to become pregnant. When an ovarian follicle matures, it produces the hormone estrogen, which causes the lining to thicken in preparation for an implanting embryo.
Ultrasound monitoring at this stage also serves to measure the endometrial uterine lining and to make sure the clomiphene itself is not having any adverse effects on the endometrium see Clomiphene side effects, At this stage, patients are also asked to use an ovulation predictor kit to test for a surge in LH hormone, indicating imminent ovulation.
In most cases, patients are given an injection of hCG human chorionic gonadotropin also known as Ovidrel.
This hormone initiates the release of the egg ovulation and the development of the corpus luteum, which will help the body to produce progesterone.
Ovulation usually occurs approximately 38-44 hours after the hCG injection. After ovulation, a form of the hormone progesterone is given via vaginal tablets or gel in order to support the endometrial uterine lining and prepare it for the fertilized egg.
If patients start ovulation predictor kit testing on cycle day 9 or earlier, there is a high probability of obtaining a false positive result.
For that reason, we recommend caution in testing too soon. If a patient is not pregnant and menses occurs, the same dose of clomiphene is given after a normal pelvic sonogram. We usually recommend up to 6 cycles for ovulation induction patients and up to 3 or 4 for ovulation augmentation patients.
If the lining is too thin, the embryo cannot implant successfully. This side effect tends to occur with repeated use or with higher doses of medication. Endometrial thinning will stop once clomiphene treatment concludes.
An alternative therapy often recommended in these situations is a medication called Letrozole, which has a milder effect on the hormonal system.
Letrozole temporarily lowers estrogen levels, prompting the pituitary gland to increase FSH and LH production and promote ovulation. While letrozole is not yet FDA-approved for ovulation induction, widely conducted studies indicate that there is no detriment to this treatment option.
This condition is rare in clomiphene treatment, and more common with use of gonadotropin medications. Ovarian hyperstimulation syndrome is marked by abdominal bloating, nausea and diarrhea, and in more severe cases, symptoms including shortness of breath, difficulty with urination and chest pain.
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