Whenever a couple is thinking about trying for a baby, they usually assume that they will not have any problems with conceiving. In the majority of cases, that is true. In fact, before couples are actively trying to achieve a successful pregnancy, they know it is always best to talk to their doctors before trying to make sure that they are healthy enough to get the green light to start. Claim Your 20 Free Pregnancy Tests – Click Here
• Healthy Weight – Most of the time, couples on their own know that they need to be at a healthy weight before actively trying. This is true, especially for women. That is because women need to be at a healthy weight in order to conceive properly and reduce the risk of developing pregnancy complications such as gestational diabetes or preeclampsia. Men also end up with higher sperm counts as well as better sperm quality if they are at a better weight.
• Fertility Foods – Then, they may even consult a dietician to talk about what foods to eat and what to limit or avoid.
• Manage Stress – They will also be told that finding ways to manage stress is necessary while trying to conceive such as learning how to meditate or take yoga classes.
• Chart Your Cycles – Women are told to chart their cycles. Doctors will also tell the couple that if they have not had a successful conception after a year of trying, to come back to have them evaluated. That is unless certain situations arise within that year such as the woman finding that while trying to chart her cycles that she is not ovulating at all after monitoring several cycles.
If the woman has found that she is not ovulating on a regular basis or not ovulating at all while using various methods to chart such as taking her body basal temperature each morning and checking her cervical mucus consistency, then she will have to see the doctor much sooner and find out why she is not ovulating.
When she visits the doctor to express her concerns about not seeing any signs that ovulation has happened, or if it only happened once in three months, then the doctor will want to run some tests on her or may refer her to fertility specialist to run tests.
There will be blood work done, as well as an ultrasound to check the condition of the reproductive cycle, including a test to see if the fallopian tubes are open to see if there anything causing anovulation or irregular ovulation.
If everything checks out, then the first drug that any specialist would try is an oral drug called clomiphene citrate or Clomid. In fact, it is a mild fertility drug that works for women who have unexplained fertility or polycystic ovarian syndrome (PCOS) which can cause irregular or lack of ovulation.
Women who have PCOS may or may not have signs that are associated with the condition such as excess weight, facial hair, and acne, along with having irregular periods. The cause of the condition is an excess amount of testosterone, which may not always be detected in blood work. But too much testosterone will impede ovulation.
Clomid usually works very well for women who have PCOS or other ovulatory disorders, and it comes in different dosages ranging from 50mg to 200mg.
Women who are prescribed the drug take Clomid for 5 days starting on either day 2, 3, 4, or 5 and a week after their last dosage, that is when ovulation is expected to happen. That is if the dosage is right.
In 80% of women, Clomid jumpstarts ovulation in the first 3 cycles.
The reason Clomid works for many women who have problems with ovulating on a regular basis may sound counter-intuitive. The drug actually lowers estrogen levels, tricking the brain into thinking that there is not enough estrogen so the other hormones responsible for ovulation which is the follicle stimulating hormone (FSH) as well as the lutenizing hormone (LH) are rising and getting to work. Therefore the egg is maturing and will be ready to be released.
As soon as a woman is put on Clomid, she will be told to make sure she monitors her cycle very carefully by checking cervical mucus consistency as well as using ovulation predictor kits which measure the rise in LH.
In some cases, the clinic will monitor her cycle by measuring the LH and FSH through blood work, as well as performing ultrasounds on measuring the egg to see if it is mature enough to be ready to be released. In those cases, the clinic monitors the cycle if intrauterine insemination has to be done due to the man’s low sperm count in order to perform the procedure at the right time, which will be discussed later.
Clomid is also mild as far as not causing side effects to be too extreme.
There may be some hot flashes, some nausea, moodiness, and breast soreness. Clomid can also shorten the luteal phase, which is the phase between ovulation and menstruation due to lowering progesterone levels, and it can also reduce the thickness of the uterine lining due to the same thing. Therefore, women who are on Clomid will have to take progesterone as well and usually are given a shot of hCG right before ovulation in order to keep the progesterone levels in check.
There is no evidence either that Clomid causes any kind of birth defects.
Some women who have PCOS are insulin resistant which means that their insulin levels can get in the way of ovulation. Clomid alone may not work for these women so they will be prescribed a low dosage of diabetes medication called Metformin or Glucophage. Both drugs taken together will result in a successful ovulation.
Unfortunately, a lot of digestive upset can be a common side effect of taking Metformin, even at a low dosage.
Many women with the condition have been happy to report that the Metformin along with taking the right dosage of Clomid gave them excellent results – a baby of their own!
After finding the right dosage of Clomid that helps ovulation happen successfully, a conception should happen within 6 cycles. However, if Clomid does not help regulate cycles and does not help with ovulation- there are other drugs that can be used as well.
If Clomid does not work (meaning ovulation did not happen at all), even while at the highest dosage, the next drug of choice which fertility specialists use for women is Femara or Letrozole.
This particular drug is stronger than Clomid. This drug can also treat PCOS as well as unexplained fertility.
This drug is an inhibitor of the enzyme aromatase, which lowers estrogen levels making the brain think the other hormones that are responsible for egg maturation and ovulation need to get to work. Therefore, the FSH and LH output are increased.
The dosage for Femara ranges from 2 to 7.5 mg, and it is also an oral drug like Clomid and it is taken for 5 days, from days 5 to 9 of the menstrual cycle. Ovulation happens roughly a week after the last dosage is taken.
Some women who have taken Femara prefer it over Clomid regardless because there are fewer side effects.
Many women who did not conceive on Clomid even if they did ovulate said they were successful in getting pregnant on Femara.
The only risk associated with taking Femara as opposed to Clomid is that there have been several cases of birth defects noted. As a result of this, not all fertility specialists will prescribe this drug at all and may go right to the next step if Clomid does not work.
If Clomid does not work, even along with Metformin if the cause for infertility is due to insulin resistance due to PCOS, and if Femara fails or if the specialist refuses to use that drug, the next step is more potent.
The next step involves injectable hormones which include gonadotropins, the GnRH pump or FSH which not only are more expensive than the others, but there are more risks involved.
With the previous treatments, the risk of producing multiple eggs is minimal. However, with these treatments, the risk of producing more eggs is high.
That means the risk of ending up with multiple pregnancies is high, and the risk stimulating the ovaries too strong can be dangerous as well.
These drugs are however given to women undergoing in vitro or IVF which will be discussed later. Otherwise, these drugs are used as a last resort when it comes to fertility medication. There is one other drug that is used to help induce ovulation if the known cause for anovulation is high prolactin levels.
If anovulation is due to the high levels of the hormone prolactin, which is the hormone that is responsible for producing breast milk, then a drug called Bromocriptine will help reduce prolactin levels and help regulate cycles and ovulation as a result.
This particular condition that causes infertility is rare but it does happen, and it is treatable.
In most cases, one of those drugs will help women ovulate and conceive at some point. However, if the cause of infertility is due to low sperm count or quality, then more steps will have to be taken.
After all 30% of infertility cases are male-factor, while 30% are female/male combined.
The first thing that fertility doctors will do if a low sperm count is a cause for failure to conceive after a year of trying, whether or not the woman is ovulating regularly, is to do the procedure called intrauterine insemination (IUI).
That involves monitoring the woman’s cycle by taking blood work and through ultrasounds, and specialists will usually put her on Clomid for this whether or not she is ovulating regularly to time the procedure properly so it is done when she is about to ovulate.
If her egg is becoming very large and there is a surge in LH in the blood work then the procedure must be done that day in order to time this perfectly.
The man would give a sample of his sperm to the clinic so that the sample is washed, and only clean and healthy sperm is left to be used for the procedure.
Then the sperm goes through the catheter which is used to pass through the cervix and goes right into the uterus so there is less distance for the small amount of sperm to travel.
Conception through IUI usually is achieved within 6 cycles. If not, then the next step must be used.
IVF for low sperm count which is called Intracytoplasmic Sperm Injection (ICSI) is for either failed IUI attempts or severely low sperm count and has been shown to be successful.
The woman has to go on potent injectable drugs in order to grow many eggs, and once they are mature enough to be released, she will go to the clinic and be sedated so the eggs can be retrieved from the ovaries. Meanwhile, the man gives a sample and the sperm is washed. The eggs are then injected with the sperm directly which will cause fertilization to happen.
Depending on the woman’s age, only one embryo will be placed back into her uterus if she is under 30. If she is over 30, she will have 2 embryos placed just in case one does not implant.
The other embryos will be frozen so they can be used if the attempts fail or if the couple wants to have more kids later on.
If IVF is used for cases where sperm count or quality is not the issue, then the mature egg will be placed in a petri dish along with the washed sperm so they can be fertilized naturally.
In most cases, IVF is successful for couples that have faced years of infertility regardless of the reason. Unfortunately, there is no guarantee for couples facing infertility that they will ever conceive, even with the help of IVF. But the odds are in their favor, and it is a blessing that there are a variety of good and powerful treatments that will help these couples achieve their dreams of having their own kids! Best of luck to you on your journey.
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