We started the first real “fertility treatment” by starting Clomid. Molly will take 50mg of Clomid for 5 days.
Clomid (clomiphene citrate) is an oral fertility drug usually taken on Days 3-7 of the cycle. Although many people think Clomid is an artificial follicle stimulating hormone (FSH), this is actually not how it works. FSH is primarily responsible for the development of follicles in the ovary (each follicle should contain one egg). The presence of FSH in the body, and thus a primary follicle on the ovary, results in negative feedback that tells the body to stop producing FSH – Clomid blocks this negative feedback so the body continues to produce its own FSH. Therefore, multiple follicles are produced, and these follicles produced while on Clomid are a result of the body’s own, natural follicle stimulating hormone. While taking fertility drugs increases the risk of a multiple pregnancy, the risk of twins using Clomid is only about 10%, and the risk of higher-rate multiples is less than 1%.
Ultrasound monitoring is used during Clomid cycles to assess the response to the drugs as well as to better time insemination. The first planned ultrasound is done on Day 12 (in Molly’s case – this may differ for others depending on cycle lengths). They will note how many follicles are present and their size. Future instructions depend on how large the follicles are on the ultrasound and how they are progressing. Follicles should be at least 18mm before the ovulation-stimulating drug Ovidrel is given. Sometimes the instruction is to come back the following day for another ultrasound, and sometimes the instruction is to go ahead and give the Ovidrel – it all depends on follicle size and progression.
One nice thing is that basal body temperature (BBT) monitoring and ovulation predictor kits (OPK) are basically no longer needed – they base all of the timings off of the ultrasound results. If more than one follicle isn’t produced this cycle, the doctor may choose to increase the dose. We’ll see how it works…