Oral Medications: Clomid & Letrozole
These are often the first-line treatments for ovulation disorders:
- Clomid (Clomiphene Citrate)
- How it works: Blocks estrogen receptors, tricking your brain into producing more follicle-stimulating hormone (FSH) to grow eggs.
- Typical dose: 50–100 mg daily for 5 days (starting early in your cycle).
- Success: ~70–80% ovulation rate, with a 10–15% pregnancy rate per cycle (higher with IUI).
- Side effects: Mood swings, hot flashes, rare risk of thinning uterine lining with long-term use, and a rare risk of head ache and visual changes that goes away after stopping the medication.
- Letrozole (Femara)
- How it works: Temporarily lowers estrogen made in adipose tissue, prompting your body to produce more FSH naturally. it may also treat silent endometriosis.
- Often more effective than Clomid for PCOS, with higher live birth rates.
- Typical dose: 2.5–7.5 mg daily for 5 days.
- Fewer side effects than Clomid (less uterine lining thinning).
Directed Hormonal Treatments
Some women need additional medications to address underlying hormonal issues:
- Metformin for PCOS
- Improves insulin resistance, which can help restore regular ovulation.
- Often used alongside Clomid/Letrozole for better results.
- Steroids (Dexamethasone/Prednisone)
- Used if high adrenal androgens (like DHEA-S) are suppressing ovulation.
- Dopamine Agonists (Cabergoline/Bromocriptine)
- Prescribed for high prolactin levels, which can block ovulation.
Injectable Hormones (Gonadotropins)
If oral medications don’t work, FSH/LH injections may be the next step:
- How they work: Directly stimulate the ovaries to produce multiple follicles.
- Monitoring is critical: Frequent ultrasounds and blood tests prevent overstimulation (OHSS) and cancellation due to more than 1-2 eggs.
- Success rates: Higher than oral meds (~15–25% pregnancy per cycle with timed intercourse/IUI).
Cycle Monitoring:
Why It Matters
- Ultrasounds track follicle growth to predict ovulation timing.
- Blood tests (LH, progesterone) confirm if/when ovulation occurs.
- Trigger shots (hCG) may be used to perfectly time ovulation for IUI or intercourse.
Which Treatment Is Right for You?
The best approach depends on:
✔ Your diagnosis (PCOS, hypothalamic amenorrhea, etc.)
✔ Your response to medications (some women need dose adjustments)
✔ Your goals (trying naturally vs. combining with IUI/IVF)
Next Steps:
We will tailor a plan based on your hormones, ultrasound findings, and medical history. Many women conceive within 3–6 OI cycles—but if ovulation isn’t happening, we can discuss stronger options.
Remember: Ovulation induction is a powerful tool, but patience and monitoring are key. We’re here to guide you every step of the way!
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