When Clomid Fails

December 14, 2008

Clomid - The First Choice

Frequently, the first drug prescribed by a physician when a woman is experiencing difficulty in conception, is Clomid. Clomid is the brand name for a fertility medication called clomiphene citrate which is used to induce ovulation in women who fail to ovulate or have difficulty with irregular ovulation. By increasing the number of mature follicles in the ovaries, Clomid may increase ovulation and promote pregnancy.

If Clomid is going to be effective, then between 70-90% of the time it will have done so within the first three or four cycles. The statistics are very good when the drug is applied correctly, with 80% of women treated with Clomid ovulating and of them, 40% conceiving. It is important that the man undergo a semen test before treatment with Clomid is prescribed to ensure that he has no problems with sperm count or sperm mobility.

What If There Is No Ovulation?

What happens when, after three cycles of Clomid, there is no ovulation? The initial step would be to add something to the routine. Perhaps the physician will decide to add intrauterine insemination (IUI) to the Clomid regimen for the next three cycles. Another option may be to try direct stimulation of the ovaries with an injectable drug. There are several injectables to choose from, for instance, Bravelle, Ovidrelle, or Follistim - all of which come with their own specific list of side effects which are less than desirable. Of primary importance is the need for careful monitoring as all of these drugs, including Clomid, can cause birth defects if they are taken after conception.

Clomid Conception Failure

Clomid Conception Failure is defined as failure to conceive after six documented ovulatory cycles on the drug. If it has not already been done, then a full infertility work-up should be completed. This would include a semen analysis, HSG, post coital test, endometrial biopsy and laparoscopy to check for pelvic adhesions and/or endometriosis.

Unexplained Infertility and Immune System Malfunctions

In many cases of unexplained infertility, more and more evidence is accumulating to support the concept that they are actually the result of an immune system malfunction. Immune problems may range from antisperm antibodies to outright rejection of a developing fetus. There are many new and improved screening and testing protocols to investigate this potential problem. If there has been recurrent pregnancy loss or implantation failure, then a complete immune work-up - which includes about 30 specific tests - is recommended.

There Are Many Possibilities for Conception

There are a wide variety of methods available to treat infertility in both men and women. One treatment which is becoming more recognized is Immunotherapy with IntraVenous ImmunoGlobulin (IvIg). Then, of course, there is IVF, in vitro fertilization. Only about eight percent of couples who are experiencing a barrier to pregnancy take this next step in treatment. This fact may indicate that more than 90 percent of couples experiencing infertility are being assisted with protocols such as ovulation induction drugs, intrauterine insemination (IUI) or a combination of the two.

 

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