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About Edward Joseph Ramirez, MD, FACOG
Expertise
I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.
Experience
I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 15 years.
Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society
Publications
American Journal of Obstetrics and Gynecology
Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco
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You are here: Experts > Health/Fitness > Women's Health > Infertility/Fertility > clomid resistent
Expert: Edward Joseph Ramirez, MD, FACOG - 10/29/2009
Question
I am 35 (husband is 41) living in WI, USA. I am TTC #2, and would like to avoid injectibles. For my son, we had to do many rounds of injections and IUI's (6) due to unexplained infertitlity/ annovulatory. At that time I was on a seizure drug which substantially decreased my estrogen. I am no longer on this drug- but was unresponsive to clomid. Are there other, non-injectibles that might work? I am trying to avoid the cost of the injectible medications...
Answer
Hello Dana from the U.S.,
The only alternative would be a drug called Femara (Letrozole). It works like Clomid (indirectly) and can be given in doses of 2.5, 5.0 and 7.5 mg. It is taken for five consecutive days just like Clomid.
Another alternative would be a combination regimen where high dose Clomid (250mg) is used in conjunction with Menopur (injectable). The Clomid is taken on day # 3-7 and Menopur is started on day#8 until the follicle is ready to trigger with HCG. This is successful in some PCO patients that do not respond to Clomid alone, and is more cost effective because it is only a few days of injectable medications.
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf
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