By Chioma Umeha
Irregular
or abnormal ovulation accounts for 30 per cent to 40 per cent of all cases of
infertility. Having irregular periods, no periods, or abnormal bleeding often
indicates that you are not ovulating, a condition known clinically as
anovulation.
Although
anovulation can usually be treated with fertility drugs, it is important to be
evaluated for other conditions that could interfere with ovulation, such as
thyroid conditions or abnormalities of the adrenal or pituitary glands.
Getting pregnant with
ovulation problems
Once
your doctor has ruled out other medical conditions, he or she may prescribe
fertility drugs to stimulate your ovulation.
The
drug contained in both Clomid and Serophene (clomiphene) is often a first
choice because it’s effective and has been prescribed to women for decades.
Unlike many infertility drugs, it also has the advantage of being taken orally
instead of by injection. It is used to induce ovulation and to correct
irregular ovulation by increasing egg recruitment by the ovaries.
Clomiphene
induces ovulation in most women with anovulation. Up to 10% of women who use
clomiphene for infertility will have a multiple gestation pregnancy — usually
twins. (In comparison, just 1% of the general population of women delivers
twins.)
The
typical starting dosage of clomphene is 50 milligrams per day for five days,
beginning on the third, fourth, or fifth day after your period begins. You can
expect to start ovulating about seven days after you’ve taken the last dose of
clomiphene. If you don’t ovulate, the dose can be increased by 50 milligrams
per day each month up to 150 mg. After you have begun to ovulate, most doctors
suggest taking Clomid for three to six months before referring to a
specialist. If you have not gotten pregnant by then, you would try a different
medication or get a referral to an infertility specialist.
These
fertility drugs sometimes make the cervical mucus ‘hostile’ to sperm, keeping
sperm from swimming into the uterus. This can be overcome by using artificial
or intrauterine insemination(IUI) -injecting specially prepared
sperm directly into the uterus – to fertilize the egg. It also thins
the endometrial lining.
Depending
on your situation, your doctor may also suggest other fertility drugs such as
Gonal-F or other injectable hormones that stimulate follicles and stimulate egg
development in the ovaries. These are the so-called ‘super-ovulation’ drugs.
Most of these drugs are administered by injection just under the skin. Some of
these hormones may overstimulate the ovaries (causing abdominal bloating and
discomfort). This can be dangerous and require hospitalization; thus, your
doctor will monitor you with frequent vaginal ultrasounds and blood tests to
monitor estrogen levels. About 90 per cent of women ovulate with these drugs
and between 20 per cent and 60 per cent become pregnant.
