What we should realize even before we ask the question: What is meant by ovulation-inducing fertility drugs?, is to know first of all, that various conditions can obstruct the way a woman’s body normally functions in ovulating effectively. One very effective way of addressing this interference is by using drug medications such as clomipheneand gonadotropins to stimulate the ovarian follicles to produce multiple eggs in one cycle. In this article we focus on clomiphene as our ovulation inducer.

What is this effective ovulation inducer?

Clomiphene has been a very dependable and therefore trusted oral medication which medical experts have come to rely on for its safety, effectiveness and comparatively low cost.

It’s used to rectify non-existent or irregular menstrual cycles (ovulation induction) responsible for producing eggs in women’s ovaries from which they are released and fertilized by male sperms.

When addressing the menstrual rhythm, clomiphene in fact cures a condition called a luteal phase defect by boosting secretion of progesterone during the second half of the cycle.

In doing so, it makes the lengths of the menstrual cycle more predictable and therefore manageable thereby making possible, the correct timing of intercourse or artificial insemination.

More surprising is the use of clomiphene in enhancing ovulation in women who are already in the process of ovulating, resulting in this process being called ovulation augmentation.

But how does clomiphene actually work?

The first thing clomiphene does is to trigger the pituitary gland in the brain to secrete an increased amount of follicle stimulating hormone (FSH) and Luteinizing hormone (LH).

The motion triggered in the brain enhances the growth of the ovarian follicle ultimately resulting in ovulation.

Normally, only one egg is ovulated during a menstrual cycle, however, when clomiphene is used, a strange thing happens.

The addition of clomiphene and the stimulating of the ovulation process can result in the production of two or three eggs per cycle.

For clomiphene to succeed in its role as ovulation inducer, it should be taken for 5 days and is active only during the month during which it’s taken ready for the release of the ovulated eggs.

A closer look at inducers Clomiphene and Provera

Clomiphene can be used in combination with the Provera drug medication to make possible the initiating of menstruation and ovulation in women who lack the ability to have a menstrual cycle.

The treatment involves the following steps:

  • Start of a 5-7 day treatment course of Provera, taken by mouth.
  • About two to three days following after the end of the Provera course, menstruation should begin.
  • On the 3rd, 4th or 5th day of menstruation, a clomiphene treatment course is commenced.
  • A 50 mg clomiphene tablet is taken orally for a period of 5 days
  • On day 11 or 12 of the menstruation cycle, an ultrasound monitoring is undertaken to ascertain whether or not an ovarian follicle or follicles have emerged. During this time, patients are asked to use an ovulation predictor kit for testing their urine for a luteinizing hormone (LH) surge. A surge indicates that the eggs are matured with ovulation about to happen. If there’s no surge of LH, an injection of hCG (Ovidrel) may take place to trigger the release of the mature eggs.
  • Insemination and sexual intercourse are timed to coincide with ovulation.
  • If an hCG injection has assisted ovulation, a hormone progesterone is inserted through vaginal tablets or gel form. The inserted hormone will prepare the uterine lining for the fertilized eggs.
  • Patients are requested, two weeks after ovulation, to take a urine test. If positive, a blood test will follow to confirm the treatment results.

Should the initial Clomiphene dosage fail to produce expected results, another Provera treatment course will be undertaken along with an increase in the clomiphene dose until ovulation actually occurs. Alternatively, if cysts are present in the ovarian follicles, a “rest” cycle may be introduced before the treatment resumes again.

If the above course of action fails to induce ovulation with the increased clomiphene dose, the treatment may be stopped and ovulation can be performed again with a different type of fertility drug (letrozole or gonadotropins).

Using clomiphene for ovulation augmentation

For women who regularly menstruate naturally on their own, the use of clomiphene may be diverted to help ovaries produce more eggs instead of just one. This process is sometimes called the “superovulation” which has the following steps:

  • On the 3rd day of menstruation, a treatment course of clomiphene is started. An early start with the clomiphene dose has a better chance of producing more than just one egg.
  • Usually, two clomiphene 50 mg tablets are taken for 5 days from cycle day 3 to cycle day 7.
  • Ultrasound monitoring is conducted on day 11 or 12 to ascertain if ovarian follicle or follicles have formed. The monitoring helps monitors to know the number of mature eggs that form in their follicles. For ovulation induction to begin 2-3 follicles should now be seen which would increase a woman’s chances of becoming pregnant than if only one follicle was visible. A mature ovarian follicle produces the hormone estrogen which results in a thickening of the lining in preparation for the embryo.
  • Patients are now asked to test a surge in their LH hormone for ovulation to take place and patients are given an injection of HCG or Ovidrel. The hormone triggers ovulation which usually takes place 38-44 hours after the hCG injection.
  •  Following ovulation a type of progesterone hormone is inserted using vaginal tablets or gel to support the uterine lining and prepare for the arrival of the fertilized egg.
  • Two weeks after ovulation patients are requested to take a pregnancy test (urine test). If the test is positive, a blood test will follow to confirm the results.

Possible side effects of Clomiphene

The side effects of clomiphene can include:

  • Vaginal dryness
  • Flushing or feeling or warmth
  • Headache
  • Ovulation pain and increased sensitivity or “mittelschmerz”
  • Breast tenderness
  • Nausea
  • Blurred or double vision or “traces” that can force the ending of treatment
  • Moodiness which can also cause termination of treatment

Of the more detailed effects that clomiphene has on certain functions associated with pregnancy two stand out as having significant impact such as:

  • Cervical mucus production can be decreased by clomiphene which makes it difficult for sperm to swim through the cervix into the uterus and prevent an implant of the embryo.
  • The production of estrogen can also be impacted by clomiphene which prevents the uterine lining from thickening and may prevent the embryo from implanting itself successfully. This situation occurs with repeated use of the drug or the taking of higher doses.

Conclusion

After reading the information in this article, the mystery surrounding the ovulation inducing fertility drugs becomes less of a mystery and more of a revelation into what actually happens when drugs such as Clomiphene and Provera together with other injections and insertions of other drugs and hormones that facilitate the ovulation processes. All these process of taking tablets, injections and insertions clearly explain what is meant by the ovulation-inducing fertility drugs.