Infertility

Infertility can be a very frusterating and challenging time. 

Infertility is the inability for normal couples to become pregnant after trying for at least one year. If you have not reached 12 months of trying you are normal do not stress out. The more you stress about it the more likely you are to inhibit ovulation. 
 
Ovulation generally occurs 14 days prior to the first day of your period. Therefore, you will have to follow a few periods and count backwards to see on what day you ovulate. For example: if there are 30 days between the start of one cycle to the start of another cycle, this person would ovulate on day 16. That is 16 days after the start of her period. (30-14=16)
It is best to have intercourse everyday or every other day starting 4-5 days prior to ovulation and continuing 4-5 days after ovulation. 

You can keep temperature charts or do ovulation kits if you like, but is unnecessary for 8 months if you have regular periods. If your periods are very irregular or greater than 35 days apart, then keeping charts may be helpful. If there is no ovulation, make an appointment for further evaluation. Natural family planning techniques can help identify ovulation as well.

 
Infertility work-up :
Thyroid levels and prolactin levels should be normal prior to starting any infertility treatments from Dr. Beverly in Ogden.

Hysterosapingingogram is a test done in the radiology department to make sure your uterus is shaped normally and your tubes are open. This is done on cycle days 7-10. 
 
Treatments for infertility :
Clomid is a prescription drug that we use to stimulate ovulation. You take the drug on day 3-7 of your cycle. Day 1 is the day you start bleeding. You only take the pill 1 time per day for 5 days. This drug has a low likelihood of twins (<5%) and only very rarely more than twins. This drug can make you moody and irritable, but this only means it is working for you. 

(Most infertility treatments at Ogden Clinic and other facilities are not covered by insurance.)
  
What is Provera (medroxyprogesterone)?

Medroxyprogesterone is a progestin (a form of progesterone), a female hormone that helps regulate ovulation (the release of an egg from an ovary) and menstrual periods.
What happens if I miss a dose?  Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Provera (medroxyprogesterone) side effects 
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
·        vaginal bleeding if you have already gone through menopause;
·        a light-headed feeling, like you might pass out;
·        a breast lump;
·        symptoms of depression (sleep problems, dizziness, mood changes, headache);
·        fever;
·        jaundice (yellowing of the skin or eyes);
·        swelling in your hands, ankles, or feet;
·        heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
·        signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;
·        signs of a blood clot in the lung--chest pain, sudden cough, wheezing, rapid breathing, coughing up blood; or
·        signs of a blood clot in your leg--pain, swelling, warmth, or redness in one or both legs.
Common medroxyprogesterone side effects may include:
·        spotting or breakthrough bleeding;
·        changes in your menstrual periods;
·        vaginal itching or discharge;
·        breast tenderness or discharge;
·        headache, dizziness, feeling nervous or depressed;
·        bruising or swelling of your veins;
·        premenstrual type symptoms (bloating, fluid retention, mood changes);
·        sleep problems (insomnia);
·        itching, rash, acne, hair growth, loss of scalp hair;
·        stomach discomfort, bloating, nausea;
·        weight gain; or
·        vision changes and difficulty wearing contact lenses.

What is Clomid?

Clomid (clomiphene) is a non-steroidal fertility medicine available at Ogden Clinic. It causes the pituitary gland to release hormones needed to stimulate ovulation (the release of an egg from the ovary). Clomid is used to cause ovulation in women with certain medical conditions (such as polycystic ovary syndrome) that prevent naturally occurring ovulation.
How should I take Clomid for women?  Use Clomid exactly as directed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this Ogden female infertility treatment medication in larger or smaller amounts or for longer than recommended.
Clomid for women is usually taken for 5 days, starting on the 5th day of your menstrual period. Follow your doctor's instructions.
You will most likely ovulate within 5 to 10 days after you take Clomid. To improve your chance of becoming pregnant, you should have sexual intercourse while you are ovulating.
In most cases, Clomid infertility treatment at Ogden Clinic should not be used for more than 3 treatment cycles.
Clomid side effects
Get emergency medical help if you have any signs of an allergic reaction to Clomid infertility treatment for women in the Ogden area: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Some women using this infertility treatment medicine in Ogden develop a condition called ovarian hyperstimulation syndrome (OHSS), especially after the first treatment. OHSS can be a life threatening condition. Call your doctor right away if you have any of the following symptoms of OHSS:
·        stomach pain, bloating;
·        nausea, vomiting, diarrhea;
·        rapid weight gain, especially in your face and midsection;
·        little or no urinating; or
·        pain when you breathe, rapid heart rate, feeling short of breath (especially when lying down).
Stop using Clomid and call your doctor at once if you have:
·        pelvic pain or pressure, enlargement in your pelvic area;
·        vision problems;
·        seeing flashes of light or "floaters" in your vision;
·        increased sensitivity of your eyes to light; or
·        heavy vaginal bleeding.
Common Clomid side effects may include:
·        flushing (warmth, redness, or tingly feeling);
·        breast pain or tenderness;
·        headache; or
·        breakthrough bleeding or spotting.
  
  
Metformin protocol

Week 1& 2: 1 500mg tablet everyday (morning or evening)

Week 3 & 4: 1 500 mg tablet in the morning  and evening (2 times per day)

Week 5 & 6: 1 500mg Tablet in the Morning, noon, and night (3 times per day)

Week 7 & 8: 1 500 Mg tablet in the Morning, noon, and 2 tablets in the evening or 2 tablets in the morning, 1 tablet noon and evening (4 times per day)

Week 9 & 10: 2 Tablets in the morning and night, 1 Tablet afternoon (5 times per day)
  
Starting Clomid Instructions:

-Pregnancy test day 31 if negative start Provera for 10 days
-When bleeding starts, start Clomid on day 3-7 of bleeding
-Ovulation predictor kit day 10-17
-Call us with this results of your ovulation testing to let us know if you ovulated in case we need to up your Clomid
-Day 31 pregnancy test
-Repeat from above
-Will start on 50 of Clomid
Inferility Awareness