Trouble Getting Pregnant
Tammy Feldman always assumed that once she and her husband were ready to have a baby, she would simply stop using birth control and get pregnant. For many of her friends, it really was that simple. But for Feldman, like millions of others, the road to pregnancy was difficult.
After a year of trying to get pregnant, Feldman says that she and her husband had a hard time admitting that there may be an infertility problem—but she knew it was time to look for outside help. After a thorough examination by her OB-GYN, she learned she was not ovulating. "I was infertile—and I was devastated," she says.
Feldman is not alone in her infertility. According to RESOLVE, a national infertility association based in Somerville, Massachusetts, more than five million people of childbearing age in the United States experience infertility, which is defined as the inability to conceive a child despite trying for one year. Often a diagnosis of infertility means that becoming pregnant will be a challenge, but this challenge is becoming less difficult for some women with the use of fertility drugs.
Clomid: A Possible Treatment
One of the most commonly prescribed fertility drugs is Clomid. Dr. Scott Roseff, reproductive endocrinologist and director of the West Essex Center for Advanced Reproductive Endocrinology in West Orange, New Jersey, says that Clomid is the brand name for a drug called clomiphene citrate. Two major companies market clomipheneone—one calls it Clomid and the other calls it Serophene. A generic form is also available.
Clomiphene (Clomid) is typically prescribed as a "fertility pill" for women who do not ovulate. "There are many reasons a woman may not ovulate, and she should first be screened by her doctor to assure she is an appropriate candidate for Clomid," Dr. Roseff says.
Clomiphene is thought to work by "faking out the brain into thinking the ovary is not producing an egg," according to Dr. Roseff. The brain responds by pumping out more of the appropriate hormones for stimulating egg development. Clomid is most commonly prescribed when a woman doesn't ovulate properly and if her infertility workup reveals she is an appropriate candidate for Clomid therapy.
Levels of Dosage
Dr. Roseff generally starts patients on 50 milligrams per day for five days during a menstrual cycle. If a woman has her period, she takes one tablet per day for menstrual cycle days three through seven. If she doesn't get her period, then one is brought on (after a negative pregnancy test) in order to be able to start Clomid therapy.
Feldman's doctor determined she was not ovulating regularly so her doctor started her on 50 milligrams of Clomid. "I also took ovulation tests along with taking Clomid," she says. "It really helped me feel more in control—or at least have an idea of if it was working or not."
"It's critically important to assure ovulation has occurred during the Clomid cycle," Dr. Roseff says. "I use sensitive ovulation predictor kits, blood progesterone levels, and an endometrial biopsy to confirm appropriate ovulation and cycle adequacy." If ovulation has not occurred on the 50-milligram cycle, the dosage is often increased to 100 milligrams per day (for five days) the following cycle. If ovulation has occurred, but if pregnancy is not achieved, the dosage that induced ovulation is maintained each cycle thereafter.