Clomiphene is an active ingredient used in hormonal treatment of women who wish to have children. The drug is a so-called selective estrogen receptor modulator, which is taken in tablet form and is intended to trigger egg maturation at the ovaries. Clomiphene is intended to stimulate the production of eggs and ovulation.
Important prerequisites for treatment with clomiphene
- Evidence must be provided that confirms the absence of ovulation.
- An infection with chlamydia must be excluded
- Verification of vaccination status
- Avoidance of nicotine, drugs and alcohol
- Presence with sperm analysis of the partner in which is confirmed that an infertility of the man is excluded
The prerequisite for fertilization – Ovulation.
Since birth, every woman carries a large number of egg follicles, also called follicles, in her ovaries. From sexual maturity onwards, up to 100 of these follicles mature in the ovaries every month. The follicle-stimulating hormone FSH is responsible for this. This hormone is produced in the pituitary gland. The maturing follicles secrete the female sex hormone estrogen. The concentration of the hormone estrogen rises sharply one to two weeks after the period, i.e. in the middle of the cycle.
The sharp rise in estrogen leads to the release of the hormone LH. Ovulation is then triggered by both together. One or occasionally several matured eggs are released from the follicles and travel down the fallopian tube towards the uterus. The journey to the uterus takes about 12 – 24 hours. During this time, the egg can be fertilized by sperm.
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When is clomiphene used?
Some women have irregular ovulation or none at all. Thus, it will be difficult for these women to become pregnant. In these cases, using clomiphene as a treatment medication has proven to be effective. The active ingredient has a positive effect on a woman’s hormone balance and is thus said to improve fertility. Clomiphene is very popular not only because it is easy to use, but also because it has very few side effects compared to other drugs and still has good results.
How does clomiphene affect hormone balance?
Clomiphene tricks the body into thinking it has a deficiency of estrogen; it is an anti-estrogen. To compensate for this deficiency, hormones are released by the pituitary gland. The follicle-stimulating hormone FSH stimulates the ovaries to produce more eggs and thus more estrogen. The body is fooled into thinking that too little estrogen is being produced. Ovulation is stimulated by the luteinizing hormone. Therefore, 12-24 hours after taking clomiphene, the chance of becoming pregnant is higher.
Treatment with clomiphene
Clomiphene is usually prescribed in the form of tablets. Thus, the treatment can be carried out uncomplicatedly from home. The dosage is determined individually by the doctor. However, it is usually around 25 to 50 milligrams per tablet.
The doctor will observe the size of the eggs in several ultrasound examinations and can thus determine whether egg follicles develop and ovulation occurs. In each cycle, blood is also taken to additionally detect changes in hormone balance.
Each body reacts individually to the treatment. It sometimes happens that hormone therapy takes time to take effect. Usually six cycles are supported in patients with clomiphene. If ovulation cannot be detected after six cycles, clomiphene is usually discontinued.
When does ovulation occur after clomiphene
If clomiphene is started on the 3rd day of the cycle, ovulation usually occurs between the 12th and 14th day of the cycle. Also, from the 12th day of the cycle, an ultrasound is done every other day to check for ovulation. This is the only way the doctor can determine whether ovulation has really occurred.
Side effects of clomiphene
The likelihood of a multiple pregnancy is increased during the period of clomiphene use because several follicles grow at the same time. Twin pregnancies have occurred in about one-fifth of pregnancies assisted by clomiphene. It can happen that the mucous membranes of the cervix change in such a way that it is very difficult for sperm to pass through them. In this case, the chance of pregnancy is reduced. The mucous membrane in the uterus may also be disturbed, so the fertilized egg cannot implant.
You may also experience the following side effects while taking clomiphene:
- Abdominal pain
- Hot flashes
- nausea and vomiting
- visual disturbances
- Gastrointestinal disorders
- Sleep disorders
- skin rashes
Usually, these unwanted side effects disappear on their own after a few days. Therefore, clomiphene does not usually need to be discontinued.
Pregnant after clomiphene treatment
There is no risk of harm or disease in pregnancy after clomiphene treatment. Usually, pregnancies are normal and do not present any major problems. However, the risk of miscarriage is increased by about 20%. For this reason, complete preventive care should be taken during pregnancy. In addition, enlargement of the ovaries may occur. Therefore, after an unsuccessful treatment cycle, an ultrasound should be performed during the menstrual period. If it is found that the ovaries are enlarged, a break in therapy must be taken. Clomiphene must not be taken further after pregnancy has occurred.