Microsoft word - clomiphene.doc
Do a pregnancy test before starting clomiphene
Multiple births occur. Clomiphene has caused
even if your period seems normal. There is a
one set of quadruplets, five triplets, and
possibility of birth defects if clomiphene is taken
uncounted twins in 36 years in my practice.
while you are pregnant and possibly if taken the
Side effects such as mood swings, hot flashes,
Take one prenatal vitamin every day all the time.
An exam or ultrasound (sonogram) can be done
Increase to 5 mg of folic acid daily anytime you
when there is pain, fullness or pelvic discomfort
might be pregnant and until you are 8 weeks
to check for a cyst. Clomiphene is stopped with
pregnant to decrease the chance of birth defects.
a cyst. Cysts require hospitalization.
Days 14 to 30 days after ovulation are the most
Clomiphene may interfere with mucus, the lining
or hormones. Fertility may decrease when used
Clomiphene is usually started on day 3 of a cycle
but can be started from day 1 to 5 depending on
There is an increased risk of ovarian cancer in
The lowest dose of clomiphene that works is
usually the best dose. Increasing the dose may
clomiphene. Clomiphene may a marker or it may
be part of the problem. Studies since 1989 have
Ovulation tests and ovulation monitors are
commonly used for timing sex. Clomiphene can
children should be monitored closely, particularly
cause false positive ovulation tests. Start testing
at age 40 to 60, for evidence of ovarian cancer.
Adhesions and endometriosis may be part of the
A PCT (post-coital test / Huhner’s test) is used to
check mucus and sperm interaction. If the mucus
is gummy, estrogen, Robitussin, estrogen or
artificial insemination are considered.
Blood estradiol checks for ovarian production.
A sonogram at ovulation checks on ovarian egg
Progesterone levels on day 21 and 24 can be
There is an increased risk of uterine cancer in
85% of all pregnancies occur in the first three
women who do not ovulate regularly and use
ovulatory cycles. If you are not pregnant in three
multiple cycles of clomiphene. An ultrasound,
to six ovulatory cycles, plans need to be changed.
Other tests such as an X-ray of the tubes or
Infertility is also associated with birth defects.
laparoscopy may be useful if not already done.
Clomiphene may increase the risk of hypospadias
Intrauterine insemination (IUI) or in vitro
fertilization (IVF) can be considered.
If you are concerned about other problems,
be sure to ask as this is not an exhaustive list.
Althuis MD, et al. Uterine cancer after use of
Mosgaard BJ, Lidegaard Ø, Kjaer SK, Schou G and
clomiphene citrate to induce ovulation. Am J
Andersen AN. Infertility, fertility drugs, and
invasive ovarian cancer: a case-control study. FertilSteril
Brinton LA, et al. Causes of infertility as predictorsof subsequent cancer risk. Epidemiology. 2005
Ness, Robert B. Fertility Drugs and Cancer. Am J
Brinton LA, et al. Ovarian cancer risk associated
Piver MS, Recio FO: When is ovarian cancer
with varying causes of infertility. Fertil Steril
Seli E and Arici A. Ovulation induction with
Brinton LA, et al. Ovarian cancer risk after the use
clomiphene citrate. UpToDate 16.2 (May 08)
of ovulation-stimulating drugs. Obstet Gynecol
Shushan A; Laufer N.
Fertility drugs and ovarian
Brinton LA, et al. Breast cancer risk associated with
cancer: what are the practical implications of the
ovulation stimulating drugs. Obstet Gynecol 103:
ongoing debate. Fertil Steril 74:8-9, 2000.
Taymor ML: The use and misuse of ovulation-
Chappel SC, Howles C: Reevaluation of the roles
inducing drugs. Infertility and Reproductive
of luteinizing hormone and follicle-stimulating
Medicine Clinics of North America
hormone in the ovulatory process. Hum Reprod
Woodall Cynthia C; Ke, Raymond W. Intrauterine
Elizur SE, Tulandi T. Drugs in infertility and fetal
insemination (IUI) for the treatment of infertility.
Gysler M, March CM, Mishell DR, Bailey EJ: Adecade's experience with an individualizedclomiphene treatment regimen including its effecton the postcoital test. Fertil Steril
Hartge P, et al.: A case-control study of epithelialovarian cancer. Am J Obstet Gynecol
Hull MGR: Gonadotrophin therapy in anovulatoryinfertility. In Howles CM (ed): Gonadotrophins,Gonadotrophin-releasing Hormone Analogues andGrowth Factors in Infertility: Future Perspectives
Proceedings of a meeting at The Royal BathsAssembly Rooms; Harrogate, England; April 29-30,1991:56-70.
Myers ER, et al. Effectiveness of assistedreproductive technology (ART). Evid Rep TechnolAssess (Full Rep) 167:1, 2008
Orientações Importantes para Pacientes Anticoagulados Temos discutido bastante a respeito de fibrilação atrial, novos anticoagulantes, resultados de estudos, aderência medicamentosa, porém não devemos esquecer das orientações aos pacientes a respeito dos cuidados imprescidíveis ao sucesso da anticoagulação oral que ainda é a nossa principal ferramenta. A falha e os efeitos advers
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