Clomid/Serophene/Arimidex
Clomid or Serophene are drugs that are frequently used in treating fertility patients. In general, they change the hormonal balance in the body. This hormonal change is intended to promote ovulation (encourage an egg to ripen and be released from the ovary) or to correct a luteal phase defect (lengthen the second half of the cycle and encourage the uterine lining to grow rich and thick).Most patients will begin by taking the medication once a day from cycle day 3 through 7 or 5 through 9. Cycle day one in any particular month is the first day of true bleeding (not spotting). Your doctor will prescribe the dosage that is appropriate for you but typically; 50 mg (one tablet) per day is the starting dose. This dosage may be changed if your response to the first level of treatment is not adequate.
Monitoring of a patient's response to the medication may be done by blood testing or by ultrasound. If a blood test is ordered, a Progesterone level will be drawn on day 21 of the cycle (give or take a day if lab services are not available, i.e. on a Sunday). Another method of monitoring may include an ultrasound on or around day 13 of the cycle. This gives an accurate look at the ovaries and allows visualization of the actual egg development.
In patients who do not respond to Clomid or Serophene or those that have other conditions such as: insulin resistance, polycystic ovarian syndrome, or failure of the lining to develop, your doctor may prescribe Arimidex. This medication reduces circulating estradiol (a hormone), which in turn causes the pituitary to increase its release of the hormones (FSH) that promote egg development. In most women, this increse in FSH will result in egg development and ovulation. The usual starting dose is 1 mg (one tablet) cycle days 3 through 7.
As with any medication, there are side effects associated with these medications. Most commonly with Clomid and/or Serophene, patients may experience headaches, hot flashes or bloating. These are usually mild and go away when the medication is discontinued. Arimidex may cause GI symptoms, headache, or hot flashes. Although adverse effects are rare, any problems or severe pain/reaction should be reported immediately. With some of the oral therapies, the risk of twins rises from the normal occurrence of 1:89 to a 10% chance. You may want to discuss this risk with your doctor.
If pregnancy does not occur after three to four cycles of responsive therapy to one of these medications, your doctor may suggest other treatment options.
