Start Ovulation With Fertility Pills

Overview
Infertility affects 10 to 15 percent of American couples who are trying to conceive a child. Reasons for infertility vary, and men and women can have physical problems that lead to reproductive difficulties. After a thorough physical exam and set of lab tests, your doctor can usually tell if a fertility problem exists, which partner has the problem and which treatment has the best chance of success. Oral medication is the treatment prescribed most often when it is determined that a woman is not ovulating regularly.

Time Frame
About 85 percent of couples who have unprotected intercourse for a year will conceive a child. Over the following 3 years, half of the remaining couples will conceive if they continue to have unprotected sex. As a rule of thumb, you should seek medical help for infertility if you have been having sex regularly for 1 year--without using birth control--but have not gotten pregnant. This time lapse doesn't prove that you have a fertility problem, but you should raise the issue with your doctor if you're in this category. Fertility begins to decline after age 30. By the time you're 40, fertility drops off sharply every year. If you are in your 30s or 40s and stop using birth control hoping to get pregnant, ask your doctor about possible fertility problems if you're not pregnant within 6 months or so.

Considerations
There are many causes of infertility in both men and women, and both members of a couple may need testing. Men typically have a general physical exam, hormone testing and a sperm analysis. Women have ovulation and hormone testing to start. Your physician may also suggest tests to determine if your fallopian tubes and uterus are structurally capable of starting and maintaining a pregnancy. One size does not fit all in fertility problems, and an accurate diagnosis is essential before your doctor selects a treatment.

Prevention/Solution
If your doctor determines that you have a problem with ovulation, she may recommend medication to spur the ovary to produce an egg. These medications mimic the way that your natural hormones should be working to produce eggs, and they usually work on the pituitary gland or ovary. Clomiphene, also called by its brand names, Clomid and Serophene, is an oral drug that makes the pituitary gland produce two hormones--FSH and LH--both of which spur the ovary to produce an egg. Clomiphene is the drug used most often to induce ovulation. The other fertility medications are given as injections or nasal sprays.
Clomiphene is taken by mouth starting on day 2, 3, 4 or 5 after your last menstrual period. Your doctor may ask you to use an ovulation prediction kit to help determine if it causes ovulation. Blood tests can also be helpful, and ultrasound exams can show if ovulation has occurred. Alternatively, you may be asked to take your body temperature every morning when you wake. Ovulation is accompanied by a slight increase in body temperature.

If ovulation does not occur, your doctor may increase the clomiphene dose. Treatment usually continues for about six menstrual cycles once it is clear that a given dosage of clomiphene is causing ovulation. If pregnancy has not occurred by this time, it may be necessary to reassess the problem and try another form of treatment.

Benefits
Clomiphene causes ovulation in 60 to 80 percent of the women who use it, about half of whom get pregnant. If clomiphene works, it usually leads to a pregnancy within 3 months.

Warning
Side effects associated with clomiphene are usually fairly mild. You may experience headache, breast tenderness, hot flashes and mood swings. These disappear after treatment stops. About 10 percent of women taking clomiphene have twins. Fewer than 1 percent have more babies (triplets, quadruplets, etc.).

Resources
American Society for Reproductive Medicine
MayoClinic.com
MedlinePlus
U.S. Food and Drug Administration (FDA)
Womens Health.gov
WebMD Infertility and Reproductive Health Center