Trying to get pregnant? In this month’s Fertility Logia, Dr. Angeline Beltsos, MD reveals 5 things you need to know about fertility medicine.
Fertility Logia: fertility medicine
When couples try to conceive and have difficulty, they may wonder about fertility medicine and if that can help. Read on to learn 5 important things to know about fertility medicine.
1) Can a pill improve the chance of getting pregnant?
The most commonly used fertility drug is called clomiphene citrate or clomid. This pill helps increase the odds of getting pregnant. It works as an anti-estrogen and tricks the body into thinking there is low estrogen. It does this by blocking estrogen receptors in the brain and makes the brain release GNRH hormone, then FSH hormone, which results in possibly more eggs ovulating as well as raising progesterone levels. The pill is given for 5 days starting day 3 to 5 of the menstrual cycle.
Side effects can include:
- Hot flashes
- Night sweats
- Bloating as well as other symptoms
NOTE: Risk of multiple birth is approximately 5-10%.
Another pill is called letrazole (also known as femara), which belongs to a class of medicines called aromatase inhibitor. This drug stops estrogen from being made. It’s actually approved for breast cancer treatment, mainly used for that condition. Although not FDA approved as a fertility medication, it works very well to help with ovulation and is often used with excellent results.
2) How do I know if I ovulated after taking clomid?
After taking clomid, ovulation can occur around the 14th day of the cycle. You can track ovulation with ovulation predictor kits (OPK). OPKs check for the surge of LH hormone. Once this occurs, ovulation typically happens within 1-2 days. Once the OPK is positive, then try for pregnancy with intercourse the day of, the next day and/or the following day.
There are other ways to know if you’ve ovulated. Ovulation can cause physical signs such as egg-white discharge and a twinge of discomfort called mittelschmerz. Track basal body temperature (BBT) using some fun and easy apps. Every morning, check your temperature. When the temperature dips and then goes up, ovulation has occurred. Ultrasound and blood tests can also identify if ovulation has occurred.
3) Is there something to help make an egg pop out of the ovary?
Once the follicle cyst that contains the egg reaches the right size (approximately 17-20 + mm in diameter) then a trigger shot called hCG can be given to make the egg ovulate. It’s like popping a balloon with a needle… pop and then the eggs comes out. This trigger shot can be from a drug called ovidrel (hcg SQ 250) or a drug called hCG (5-10,000 units IM injection). Progesterone can be checked by a blood test/Levels goes up once ovulation happens, and should be over 10.
4) Does clomid annoy the uterus?
The uterine lining needs to be fluffy from estrogen and sticky from progesterone, which creates a lovely landing spot for the precious embryo. Clomid can sometimes make the lining thinner and less sticky. Look at the uterus with an ultrasound after taking clomid to view the lining. Taking estrogen and baby aspirin might help the lining be more ready for the embryo if the clomid really did bother it.
5) Is there any other medicine to help grow eggs?
Another fertility medicine used to help egg grow is an injection of FSH (+/- LH). This is more potent than the pill form and helps eggs develop in the ovary. Since it is stronger than the pill, this medicine must be given with ultrasound guidance and lab work, supervised by a specially trained doctor. The risk of multiple pregnancy with this drug can be 20-30%.
Fertility Logia: words of encouragement
It’s July! I hope that you are on your way to ELLADA to get back to roots, get back to sunshine, get back to family, and what really matters. While you are enjoying July, remember that there is great hope in your efforts to build your family. Everything will work out. There are many opportunities to increase the chances of pregnancy with medications. Come see us at Vios Fertility Institute. We will carefully review things with you. If you have been trying to get pregnant without any luck yet, check your fertility with the VIOS PULSE, a test of your eggs, uterus, and sperm. If all looks good, consider taking medicines as described above to help you get to your goal of beautiful baby. Let’s get you on your way.
Angeline N. Beltsos, MD is CEO and Medical Director of Vios Fertility Institute. She is board certified in Obstetrics and Gynecology and in Reproductive Endocrinology and Infertility (REI), practicing medicine since 1991. Dr. Beltsos is also the Clinical Research Division Director of Vios and participates in a number of research projects and scientific publications. She has received numerous awards in teaching and has been honored as “Top Doctor” from Castle Connelly for several years. She is a popular speaker, both nationally and internationally, and a frequent media resource on the topic of infertility. She is the executive chairperson for the Midwest Reproductive Symposium International, an international conference of fertility experts. Dr. Beltsos is also a contributor to Thrive Global.
As the REI Division Education Director for the Obstetrics and Gynecology residency programs of Illinois Masonic Medical Center, Lutheran General Hospital, and St. Joseph’s Hospital Chicago, Dr. Beltsos helps educate future OB/GYN doctors. She is a Clinical Assistant Professor for the Department of Obstetrics and Gynecology at University of Illinois at Chicago.