The question being asked this time implies that it may well come from a very disappointed woman who has confidence in the drug medication but has become disillusioned by the loss of her prized expectation, that of becoming pregnant which she wants most. She needn’t worry because there are a variety of reasons why this may have happened and also solutions that can be applied to rectify her disappointing results. Let’s have a closer look at this problem.

Not getting pregnant is the problem

For most women, getting pregnant is a miraculous event that brings utter joy so not being able to become pregnant is exactly the opposite and is a very disappointing event.

It’s known in medical circles that approximately one out of four women are unable to ovulate even when they take Clomiphene.

The most likely reason for the mishap for not ovulating while taking Clomiphene is that the dosage may be too low. Typically, the start of a clomiphene treatment dose usually starts with a t50 mg tablet.

This dose in then increased to 100 mg when there is no response to the first dose and in some instances doctors may try increasing the doses until they reach 250 mg.

It’s all about Clomiphene resistance

Knowing that doses can be increased to as much as 250 mg worth of tablets, and after that you find that you are still not ovulatingeven though you are taking a higher dose, the situation is called Clomiphene resistance

Clomiphene resistance is not synonymous to a situation where you are unable to conceive even though you are taking the fertility drug. In that case, what happens is that you actually ovulate but you just don’t get pregnant.

In this present case, you don’t ovulate at all! So what should you do? Should you move on to a higher level of treatment where stronger drugs are available or where the treatment is more complex if you fail to ovulate and they may make you ovulate? Not necessarily so.

What actually cause Clomiphene Resistance

It’s really all up to your doctor to make the correct move in dealing with your case. He/she should be able to think why you are not responding to the treatment. If they can, then you have a partial answer to your predicament.

Some of the possible for Clomiphene resistance are listed below for you:

  • A body mass index (BMI) of over 25 can decrease the chances of Clomiphene of working properly and therefore successfully.
  • Women may also be suffering from the condition of hyperprolactinemia which doesn’t often respond well to Clomiphene especially when the medication also has to deal with the existing condition. Apart from this, it’s also not always clear why Clomiphene does not help to induce ovulation.
  • Women who have PCOS usually have difficulties with Clomiphene resistance especially women who have been diagnosed to be resistant to insulin or who have hyperandrogenic levels or high levels of DHEAs as well as male hormone levels).

Is it possible to overcome Clomiphene Resistance?

For women who have polycystic ovarian syndrome (PCOS), a treatment with the insulin resistant drug metformin, which is also known as Glucophage may assist. This drug is usually prescribed over a period of 3 to 6 months before retrying Clomiphene once more.

Studies show that taking the two drugs clomiphene and metformin together has the desired result of improving the rates of ovulation and also has the potential to increase rates of pregnancy and a decline in the risk of miscarriage.

Another possible substitute to metformin is N-acetyl-cysteine (NAC), an antioxidant and amino acid that operates as an insulin-sensitizing agent. A few studies have found that a combination of Clomiphene and NAC can be of help in treating Clomiphene resistance.

If your BMI is over 25, you may be told by your doctor that you need to lose some weight before you can have another try at using Clomiphene again. If you can manage to lose even just 10% of your total body weight, the effect of Clomiphene in treating your condition may improve.

Another method of dealing with Clomiphene resistance is ovarian drilling which is an older method of combating resistance in women who have PCOS. However it’s not a common method used today due to the risks involved.

If your doctor suggests the use of ovarian drilling, you should ask for the reasons why the method has been suggested. This is necessary since there are other options that can and should be tried out first before ovarian drilling is used.

What about using birth control pills for treating infertility?

A novel and interesting way of addressing Clomiphene resistance is by taking birth control pills for about 1 to 2 months before trying a new cycle of Clomiphene. This treatment should be recommended for women who have high levels of the DHEAs hormone.

Some see this approach as somewhat counter-productive by wondering —how on earth can birth control pills possibly help you get pregnant? Despite this dilemma, studies have shown good results.

One study on the use of birth control pills, a remarkable result of over 65% of women who were resistant to Clomiphene ovulated simply by orally taking birth control pills for two months before the start of the treatment cycle with clomiphene!

If Clomiphene still doesn’t work what then?

Sometimes, the growth of the follicles in the ovaries can be monitored by ultrasound as they grow in response to the clomiphene treatment.

But sometimes also, the mid-cycle LH surge which heralds the occurrence of ovulation fails to materialize as expected.

If that happens, your doctor may suggest a prescription of Clomiphene together with an injection of hCG, such as the Ovidrel drug should administered to trigger ovulation and boost the surge of the mid-cycle LH.

If you find after the administering of these measures that you continue to fail to ovulate while taking clomiphene, your doctor may recommend other ovarian stimulation medications.

One option is the drug treatment Letrozole (also called Femera), for women who fail to ovulate while taking Clomiphene. It has been found in studies that Letrozole can induce ovulation in some women with PCOS that do not respond to Clomiphene treatment.

Some women who suffer from unexplained infertility and Clomid resistance also respond favorably to a treatment of the drug Letrozole.

In one study, it was found that women with Clomiphene resistance and PCOS showed more likelihood of ovulating when they took the medication Letrozole (79.3% ovulated).

It was also found that 23% of the women who took Letrozole became pregnant while 14% became pregnant following treatment with Clomiphene and two injections of the low-dose FSH combination.

Nevertheless despite these encouraging results, the medication Letrozole is not sold as a fertility drug because the safety of using it has become a controversy.

It can cause birth defects when taken during pregnancy. Even so, many argue that the medication is safe saying that the drug should disappear from your system before the start of pregnancy but more research is needed to confirm this viewpoint.

Conclusion

To most women, any obstacle that impedes pregnancy represents a hurdle that needs to be cleared and there are certainly many avenues to pursue this course of action. In most cases, Clomiphene has been proven time again it’s the right medication for infertility and many avenues have been explored to enhance its efficacy in this field such as its use in combination with other drugs which have proven very effective and successful.