Monday, July 9, 2007

STARTING THE BABY TRACK


I have about a good week and a 1/2 before my period starts. This is when I have to start clomid.. I have a friend that is already using it.. I was looking at the information
regarding clomid... looking at the bottom info... I dont want mood swings, headaches...hot flashes..... Gosh.. I will be 37 in about two months...(sept)..


 
Clomid or Sereophene, both brand names for clomiphene citrate, are commonly prescribed oral medications to enhance your chances of getting pregnant. This fertility medication can be prescribed for certain women who are having difficulty with getting pregnant, usually because of ovulation issues, such as infrequent or poor ovulation.

After a proper medical screening to ensure that you are a candidate, your regular OB/GYN, reproductive endocrinologist and sometimes nurse midwife or nurse practitioner can prescribe this medication for you. It is usually taken for five (5) days during your menstrual cycle, starting at the dose of 50 mg. This dosage can be increased, if a need is found.

As with any fertility treatments, side effects associated with the use of Clomid/Serophene include:

  • Mood Issues
    Fertility medications and hormones in general are often blamed for the foul mood of any woman of childbearing age.

 
  • That said, increasing hormones can be a recipe for altered moods or mood swings. Most women find these to be temporary, usually lasting just during the actual days that you take the medication or a day or two later.
  • Headaches
    Headaches are a problem also associated with hormones. Consult your doctor if you experience severe headaches or if you have any complications like visual disturbances with your headaches. If you are prone to headaches, try to talk to your doctor beforehand about the most appropriate treatment.
  • Multiple Pregnancy (Twins, Triplets, etc.)
    The multiple pregnancy rate associated with the use of Clomid and its companions is about 10 percent. Talk to your practitioner to find out your personal risks because these may not all be related to the medication.
  • Hot Flashes
    Hot flashes are annoying, but also a part of the hormone game. You may experience them anytime during therapy but many women find they strike often at night. Cool showers, fans and sleeping in the nude (also good for getting pregnant) can all help you maintain a sense of calm during this period.
  • Ovarian Enlargement
    Ovarian enlargement or hyperstimulation is possible with this medication. This is why your doctor will follow you and watch you for signs of hyperstimulation. It is fairly uncommon but one of the main reasons that good follow up and screening are needed when using medication to induce or increase ovarian function.
  • Hostile Mucous
    Hostile cervical mucous can prevent pregnancy. Your doctor may screen you or ask that you watch your signs of ovulation via your cervical mucous. Some physicians may prescribe aids for issues with cervical mucous, but you should not self-medicate.
While many people think that Clomid is the answer to fertility problems, it is not the magic fertility pill many people assume. Only your doctor or other health-care professional can help you decide if Clomid therapy is right for your type of infertility.

HERE is information regarding - Hyperstimulation
 

Ovarian hyperstimulation syndrome (OHSS) is a complication from some forms of fertility medication. Most cases are mild, but a small proportion is severe

 Symptoms

Symptoms are set into three categories: mild, moderate, and severe. Mild symptoms include abdominal bloating and feeling of fullness, nausea, diarrhea, and slight weight gain. Moderate symptoms include excessive weight gain (weight gain of greater than 2 pounds per day), increased abdominal girth, vomiting, diarrhea, urination darker and less in amount, excessive thirst, and skin and/or hair feeling dry (in addition to mild symptoms). Severe symptoms are fullness/bloating above the waist, shortness of breath, urination significantly darker or has ceased, calf and chest pains, marked abdominal bloating or distention, and lower abdominal pains (in addition to mild and moderate symptoms).

Classification

In mild forms of OHSS the ovaries are enlarged, in moderate forms there is additional accumulation of ascites with mild abdominal distension, while in severe forms of OHSS there may be hemoconcentration, thrombosis, abdominal pain and distension, oliguria (decreased urine production), pleural effusion, and respiratory distress. Early OHSS develops before pregnancy testing, and late OHSS is seen in early pregnancy.

Complications

OHSS may be complicated with ovarian torsion, ovarian rupture, thrombophlebitis and renal insufficiency. Symptoms generally resolve in 1 to 2 weeks, but will be more severe and persist longer if pregnancy is successful. This is likely due to the role of the corpus luteum in the ovaries in sustaining the pregnancy before the placenta has fully developed. Typically, even in severe OHSS with a developing pregnancy, the duration does not exceed the first trimester.

 Pathophysiology

OHSS is characterized by the presence of multiple luteinized cysts within the ovaries leading to ovarian enlargement and secondary complications.

As the ovary undergoes a process of extensive luteinization, large amounts of estrogens, progesterone, and local cytokines are released. It is held that vascular endothelial growth factor (VEGF) is a key substance that induces OHSS by making local capillaries "leaky", leading to a shift of fluids from the intravascular system to the adbominal and pleural cavity. Thus, while the patient accumulates fluid in the third space, primarily in the form of ascites, she actually becomes hypovolemic and is at risk for respiratory, circulatory, and renal problems. Patients who are pregnant sustain the ovarian luteinization process by the production of hCG.

Epidemiology

Sporadic OHSS is very rare, and may have a genetic component. Clomifene citrate therapy can occasionally lead to OHSS, but the vast majority of cases develop after use of gonadotropin therapy (with administration of FSH), such as Pergonal, and administration of hCG to trigger ovulation, often in conjunction with IVF. The frequency varies and depends on patient factors, management, and methods of surveillance. About 5% of treated patients may encounter moderate to severe OHSS.

Mortality is low, but several fatal cases have been reported.  (that makes me feel ok... I think it is important to get as much info as possible)

Treatment

Physicians can reduce the risk of OHSS by monitoring of FSH therapy to use this medication judiciously, and by withholding hCG medication. Once OHSS develops, reduction in physical activity, closely monitoring fluid and electrolyte balance, and aspiration of accumulated fluid (ascites) from the abdominal/pleural cavity may be necessary, as well as opioids for the pain. If the OHSS develops within an IVF protocol, it can be prudent to postpone transfer of the pre-embryos since establishment of pregnancy can lengthen the recovery time or contribute to a more severe course. Over time, if carefully monitored, the condition will naturally reverse to normal - so treatment is typically supportive, although patient may need to be treated or hospitalized for pain, paracentesis, and/or intravenous hydration.

References






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