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Archive for the ‘cervical mucus’ tag

Is Clomid for You?

By David Kreiner MD

January 16th, 2014 at 6:51 pm

 

 

It has become commonplace for women who have been frustrated with repeated unsuccessful attempts to conceive naturally on their own to see their gynecologist who often times will try clomid therapy on them.

Clomid, the traditional brand name for clomiphene citrate, is a competitive inhibitor of estrogen. It stimulates the pituitary gland to produce follicle stimulating hormone (FSH) which in turn will stimulate the ovaries to mature follicle(s) containing eggs. Estrogen normally has a negative effect on the pituitary: Clomid blocks estrogen and leads to pituitary FSH production and ovarian stimulation.

Infertility patients — those under 35 having one year of unprotected intercourse without a resulting pregnancy and those over 35 having six months without pregnancy — have a two to five percent pregnancy rate each month trying on their own without treatment.

Clomid therapy increases a couple’s fertility by increasing the number of eggs matured in a cycle and by producing a healthier egg and follicle. The pregnancy rate with clomid therapy alone is approximately ten percent per cycle and 12 -15 percent when combined with intrauterine insemination (IUI). Women who are unable to ovulate on their own experience a 20 percent pregnancy rate per cycle with clomid, the equivalent to that of a fertile couple trying on their own.

Clomid and Your Cervical Mucus

Women who are likely to conceive with clomid usually do so in the first three months of therapy, with very few conceiving after six months. As clomid has an anti-estrogen effect, the cervical mucus and endometrial lining may be adversely affected.

Cervical mucus is normally produced just prior to ovulation and may be noticed as a stringy egg white-like discharge unique to the middle of a woman’s cycle just prior to and during ovulation. It provides the perfect environment for the sperm to swim through to gain access to a woman’s reproductive tract and find her egg. Unfortunately, clomid may thin out her cervical mucus, preventing the sperm’s entrance into her womb. IUI overcomes this issue through bypassing the cervical barrier and depositing the sperm directly into the uterus.

However, when the uterine lining or endometrium is affected by the anti-estrogenic properties of clomid, an egg may be fertilized but implantation is unsuccessful due to the lack of secretory gland development in the uterus. The lining does not thicken as it normally would during the cycle. Attempts to overcome this problem with estrogen therapy are rarely successful.

Side Effects

Many women who take clomid experience no side effects. Others have complained of headache, mood changes, spots in front of their eyes, blurry vision, hot flashes and occasional cyst development (which normally resolves on its own). Most of these effects last no longer than the five or seven days that you take the clomid and have no permanent side effect. The incidence of twins is eight to ten percent with a one percent risk of triplet development.

Limit Your Clomid Cycles

Yet another deterrent to clomid use was a study performed years ago that suggested that women who used clomid for more than twelve cycles developed an increased incidence of ovarian tumors. It is therefore recommended by the American Society of Reproductive Medicine as well as the manufacturer of clomiphene that clomid be used for no more than six months after which it is recommended by both groups that patients proceed with treatment including gonadotropins (injectable hormones containing FSH and LH) to stimulate the ovaries in combination with intrauterine insemination or in vitro fertilization.

Success rates

For patients who fail to ovulate, clomid is successful in achieving a pregnancy in nearly 70 percent of cases. All other patients average close to a 50 percent pregnancy rate if they attempt six cycles with clomid, especially when they combine it with IUI. After six months, the success is less than five percent per month.

In vitro fertilization (IVF) is a successful alternative therapy when other pelvic factors such as tubal disease, tubal ligation, adhesions or scar tissue and endometriosis exist or there is a deficient number, volume or motility of sperm. Success rates with IVF are age, exam and history dependent. The average pregnancy rate with a single fresh IVF cycle is greater than 50 percent. For women under 35, the pregnancy rate for women after a single stimulation and retrieval is greater than 70 percent with a greater than 60 percent live birth rate at Long Island IVF.

Young patients sometimes choose a minimal stimulation IVF or MicroIVF as an alternative to clomid/IUI cycles as a more successful and cost effective option as many of these patients experience a 40 percent pregnancy rate per retrieval at a cost today of about $3,900.

Today, with all these options available to patients, a woman desiring to build her family will usually succeed in becoming a mom.

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Did you start out with Clomid? Did you have success with it or did you move on to IVF?

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Could your OTC cough medicine help you get pregnant?

By Tracey Minella

January 10th, 2011 at 12:00 am

When you’re trying to conceive, sometimes you’ll try anything…

When you disclose to the world that you’re having problems conceiving, everyone from your BFF to your great Aunt Gloria has advice to share. Not that you asked for any of it, of course. Sometimes, it’s a referral to an excellent reproductive endocrinologist (which is a medical doctor who is a specialist in helping infertile couples become pregnant). But other times…well…the advice can be a bit … odd.

These seemingly kooky, outlandish ideas about fertility have been around for as long as women have been having babies. And they’re referred to as Old Wives’ Tales. There are people who swear by them. So, try not to laugh in their faces when they share them with you.

I was reminded of one of them this week as I wrestled the last bottle of Robitussin from the hands of an old lady at Walgreen’s. Well no, I didn’t really wrestle it away, but I might have if I really needed to. These are desperate times.

Here in East Coast Fertility country, it’s the dead of winter and it seems like everyone has some kind of cold or flu. It comes, it goes, and it returns with a vengeance two weeks later. OTC meds are flying off the pharmacy shelves. And I’ve been hoarding my share.

Ah…plain old Robitussin. Not the fancy ones that treat 18 symptoms. Just the straight, cough expectorant-only version, which contains only Guaifenesin. It’s the one you take when you need to thin the mucus in your chest.

Well, according to the “old wives”, it may also thin the cervical mucus and make it easier for sperm to swim to the newly-released egg. Legend has it that taking 1-2 teaspoons once per day from a few days before ovulation until the day after you’ve ovulated may help women with thick or poor quality cervical mucus (and no other fertility issues) to conceive. Basically, it gives you that “I-just-laughed-‘til-I-peed-my pants-a-little” feeling for a week.

Now, I’m not a doctor. I don’t even play one on TV. And this isn’t medical advice. It’s merely the sharing of an old wives’ tale. OTC meds are not for everyone. So you should ask your own doctor…not your great Aunt Gloria… for advice on whether this may be okay for you. And if your doctor gives the thumbs-up, remember it’s the plain, expectorant-only version. Avoid the multi-symptom formulas if trying to conceive.

Personally, I only take OTC meds if I’m hacking up a lung. Which I currently am.

So, if you’re hacking one up too this winter, and find yourself in the pharmacy wondering what to grab for relief, you may remember this Robitussin post and smile. And, if you’re also trying to conceive and there’s only one bottle left…

Well, by all means…take out the old lady! Like I said, these are desperate times.

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