Active substances: Clomiphene
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During a normal menstrual cycle only one egg is ovulated.
The use of clomiphene often causes the ovaries to produce two or three eggs per cycle. Clomiphene is taken orally for 5 days and is active only during the month it is taken.
Two to three days after Provera is completed, a menstrual period should begin. On the 3 rd, 4 th or 5 th day of menstrual flow, a course of clomiphene is started.
A clomiphene citrate 50 mg tablet is taken orally for 5 days. On day 11 or 12 of the menstrual cycle, ultrasound monitoring is conducted to determine if an ovarian follicle or follicles have developed.
Also at this time, patients are asked to use an ovulation predictor kit to test their urine for a surge in LH luteinizing hormone indicating that eggs have matured and ovulation is imminent.
Natural intercourse or insemination is timed to ovulation.
If ovulation has been assisted by an hCG injection, a form of the hormone progesterone is given via vaginal tablets or gel. The progesterone hormone serves to support the endometrial uterine lining and prepare it for the fertilized egg.
If the test is positive, a blood test will be performed to confirm results. If ovulation doesn't occur during this initial clomiphene dosage, another course of provera will be prescribed and the dose of clomiphene increased until ovulation occurs.
This is sometimes referred to as "superovulation. Starting clomiphene early in the cycle helps with the recruitment of more than one mature egg. Typically, two clomiphene citrate 50-mg tablets are taken orally for 5 days, from cycle day 3 to cycle day 7.
The ultrasound helps to determine how many mature eggs are forming within their follicles.
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.
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