Infertility/Fertility/clomid

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Question
QUESTION: Hello,

My main question is, what do they mean when they say clomid loses its effectiveness after 3-4 months? Does it mean that it actually loses effectiveness chemically or that after that period of time is clear that it won't work for that particular person?

ANSWER: Hello Peggy from the U.S. (Massachusetts),

Clomid does not lose its "effectiveness" per say, rather it causes problems in the reproductive cycle that will inhibit pregnancy.  Clomid works by blocking estrogen receptors thereby tricking the brain into thinking it is not stimulating the ovaries enough (because the receptors are not being stimulated.  The Ovaries produce the estrogen with ovulation).  The problem is that this also blocks estrogen receptors that are crucial to getting pregnant, like growth of the endometrial lining.  It also decreases tubal motility and cervical mucous.  So, the proper approach is to either take a month off between each Clomid cycle or alternate with another fertility medication such as Femara or injectables.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
info@montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.

---------- FOLLOW-UP ----------

QUESTION: Thanks very much for your informative answer, Dr. Ramirez. This is the first I've heard that you're supposed to take a month off between each Clomid cycle. I had heard that you're supposed to try it for three months (and I assumed three straight months) and then go to a different method if it doesn't work. I just did my second straight month of Clomid, so I hope I didn't mess things up. If you take Clomid every other months, how many months total would you recommend it be taken?

Peggy

Answer
Hello Again,

The recommendation for ovulation induction cycles is to try for 6 cycles.  Most patients will be pregnant within that period of time.  If still not pregnant, then either continue the evaluation or proceed to the next level of treatment, IUI.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
info@montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.

Infertility/Fertility

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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 19 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, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

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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