Hello girls! I want to share with you my course of stimulation with clostilbegit and find out from whom how it was!
I was diagnosed with polycystic ovary syndrome (PCOS), started to work with my husband, not being protected, but nothing happened for 3 months! I went to my gynecologist (before that she had one, she said right away- "Try first yourself, if it doesn’t work out, then you will come and we will be stimulated!"). In the absence of pregnancy, I went to my gynecologist! My periods were never even and lasted 30-42 days, t. *****. Sooooo long cycle! At the time of the meeting with the Gynecologist, I had a delay of 10 days (not pregnant), it was estimated that if they went for 30 days! So, she said that for a start we will call menstruation with Duphaston (drink 5-7 days). When the months come, stop drinking Duphaston and on the 5th day of the cycle, on the 9th day (inclusive), drink Klostilbegit (50 mg), from the 9th day of the cycle, go on folliculometry every other day, monitor the reaction of the ovaries (if anything grows.) To 13 of the day! I did everything according to the recommendation, I arrived at the first ultrasound, it was day 8 (because day 9 was a day off), the uzistka said that silence was not detected in the dominant follicle! I went home without upset, with the thought that it was still day 8 and it was probably too early to grow something! I was looking forward to the next ultrasound on day 11! They said that the right ovary volume 40 set echo (-) from 5 to 10 mm, the size of the left 18 set echo (-) from 5 to 12 mm. T. *****. on my 11th day c. the size of the follicle, with Klostilbegit, should be no less than 15, and I have only 12 and the endometrium is thin-only 4 mm. They said that if on day 13 c. the follicle does not reach at least 16 mm, then it is useless to continue tracking, there will be no ovulation! Girls, I'm so upset, I want kids
, but it doesn’t work right up to tears! Who, as it was, please share your case! They tell me, then a tight capsule in the ovary! And if anyone knows what an Echo is (-).
Why polycystosis affects conception
Polycystic ovary disease is an endocrine (hormonal) pathology characterized by changes in the structure and function of the ovaries. With this pathology, multiple cysts form on the ovary body, which disrupt the egg maturation processes. The main cause of cyst formation is a malfunction in the endocrine system.
The ovary is the main organ responsible for the ovulation process. Any violations of its functions can lead to female infertility. With changes in the hormonal background, the walls of the ovary become denser, so a mature egg can not freely enter the uterine cavity for further fertilization. Being in the ovary, it is filled with fluid - so a small cyst is formed. With repeated repetition of this process over time, numerous cystic formations appear on the ovary, adversely affecting the female reproductive function. Therefore, ovulation with polycystosis is almost impossible.
The main symptom of polycystic, causing a woman to see a doctor is the inability to get pregnant. The processes of egg maturation and the function of reproductive activity depend on the level of hormones in the female body. If a woman is diagnosed with endocrine disorders, the ovaries cannot function normally. In this case, the ovaries produce a large number of androgens (male hormones), which do not allow the eggs to mature, which is characterized by external manifestations.
Symptoms of polycystic ovary:
- accelerated hair growth on the body,
- acne, seborrhea, pigmentation,
- increased oily skin
- menstrual failure
- frequent delays or lack of menstruation,
- scanty discharge
- drawing pains in the lower abdomen
- a sharp increase in weight.
One of the main reasons for the development of pathology is considered genetic heredity, which can contribute to violations in the structure of organs and a predisposition to chronic diseases. Being overweight is also a cause of polycystic, and obstruction of the ovaries can occur due to excess body fat.
After making an accurate diagnosis, depending on the severity of the clinical signs, on the age and complaints of the patient, the doctor draws up a multi-stage restoration of reproductive function and treatment of other female pathologies. The treatment process directly depends on the severity of the disease and the woman's desire to become a mother.
Features of hormonal stimulation
The main problem that prevents conception in polycystic disease is the irregularity or complete absence of ovulation. Stimulation consists in taking hormonal drugs that can restore the production of female hormones that contribute to fertilization.
Medications prescribed to stimulate fertilization contribute to the release of the egg through the dense body of the ovary. If the doctor's recommendations are followed, conception can occur almost immediately, but only if polycystic ovary is the only pathology that prevents a woman from becoming pregnant. Hormonal preparations must be drunk strictly according to the scheme, which is individually compiled.
Stimulation of ovulation is carried out only after laboratory and instrumental examination. First of all, they differentiate other possible diseases leading to infertility. A woman is necessarily prescribed hysterosalpingography (a study of patency of the fallopian tubes).
Diagnosis before stimulation must be passed to both partners. Nowadays, men often have violations of male reproductive health. Low sperm motility is detected in 40% of men. Therefore, the partner must pass an analysis of sperm (spermogram).
The general scheme of stimulation of ovulation
At the initial stage, the doctor may prescribe a contraceptive. They help regulate the menstrual cycle and restore normal ovulation. The course of treatment with birth control pills lasts from three to six months, after their cancellation, conception can occur. The necessary medicines should be selected only by a doctor.
If birth control pills do not produce the expected result, then the gynecologist decides on drug stimulation of ovulation. It is worth noting that hormonal ovulation is carried out only if a woman can produce healthy eggs that are capable of fertilization. With serious hormonal disorders and the presence of inflammatory diseases, stimulation is contraindicated until the associated problems are completely eliminated. Of course, each case is individual, and the final decision is made only by the attending physician.
At the moment, the drug Klostilbegit is often used for stimulation. This non-steroidal drug enhances the production of gonadotropins, as well as prolactin. With polycystic ovary, clostilbegit, entering the female body, binds to estrogen receptors in the hypothalamus and ovaries, stimulating the growth and further maturation of the follicle, preparing the egg for transition to the uterus and fertilization.
Important! You can take Klostilbegit only after a thorough diagnosis. In the presence of serious disorders in the functions of the thyroid gland, taking the medicine is strictly prohibited. Dosage and duration of treatment are determined strictly by the attending physician!
General stimulation scheme:
- 5-9 days of the cycle - taking Clomiphene, or Clomid, or Klostilbegit (non-steroidal estrogens that stimulate the production of pituitary hormones).
- 11-12 days of the cycle - ultrasound of the pelvic organs to monitor the development of the follicle in the ovary.
- On the 15-16th day of the cycle (by ultrasound) - an injection is made with the hCG gonadotropin hormone (to rupture the follicle and exit the mature egg).
- After 24-40 hours after the injection of hCG, ovulation will come. During this period there should be sexual contact.
- On the 16th day of the cycle and for 2 weeks (by ultrasound) take medications containing progesterone to support the corpus luteum, which maintains pregnancy. Basically, they appoint Duphaston, Utrozhestan, etc.
- On the 17-18 day, a control ultrasound is performed, which should show that the follicle has broken and the egg is released.
The ovulation stimulation protocol is compiled by the doctor individually for each patient. After hormonal stimulation, a woman can become pregnant almost immediately. If conception has not occurred, then treatment continues, the doctor can increase the dosage of the drug used or completely replace it with drugs from another group.
It is worth noting that if ovulation was stimulated several times, a woman significantly increases the level of hormones. Therefore, there is a high probability that the rupture of several follicles at once will occur simultaneously, which will lead to the release of several eggs. In this case, multiple pregnancy and the birth of two or three children at once are likely.
If hormonal stimulation still did not help, do not despair. To restore ovulation, it is necessary to follow the recommendations of the gynecologist, change your lifestyle, remove excess weight, strengthen immunity, and diversify your diet. If drug therapy for more than a year does not give positive results, doctors recommend surgical methods of treatment. The most effective and gentle method is laparoscopy.
According to doctors and patients, hormonal stimulation is the most affordable, safe and effective way to treat infertility. As a rule, almost all women tolerate ovulation stimulation with polycystic well and in about 80% of cases the long-awaited conception occurs.
The effect of polycystosis on conception
The disease, considered an endocrine pathology, causes a change in the structure of the ovaries, on the body of which many cysts form. Formations resulting from a malfunction in the endocrine system lead to disruption of the egg maturation process.
A change in the hormonal background leads to compaction of the walls of the ovary, which, in turn, prevents a mature egg from entering the uterine cavity unhindered for subsequent fertilization. The ovum remaining in the ovary is filled with fluid, resulting in the formation of a small cyst. Repeated repetition of this process leads to the appearance of many cystic formations that impair reproductive function. Therefore, polycystic ovary makes ovulation and further conception virtually impossible.
How does ovulation stimulation go?
The restoration of reproductive function, impaired due to polycystic, involves the stimulation of fertilization. A woman is prescribed medications that help the egg exit through the dense body of the ovary. Provided that polycystic disease is the only pathology that causes infertility, drug therapy allows a woman to quickly become pregnant.
To treat the disease, hormonal drugs are used, the reception of which is carried out strictly according to the scheme developed individually for each woman by the attending physician.
Before starting treatment, a woman is required to undergo instrumental and laboratory examinations, which will differentiate the causes of infertility. In particular, the patient is prescribed hysterosalpingography, which allows checking the patency of the fallopian tubes. Examination before stimulation of fertilization should be done not only by a woman, but also by her partner, since the inability to get pregnant can be due to a violation of the reproductive function in a man. Given the fact that at present almost 40% of men suffer from low sperm motility, a woman’s partner needs to have a spermogram.
At the preliminary stage of infertility treatment, a woman is prescribed birth control medications, thanks to which she can regulate the menstrual cycle and normalize the ovulation process. The duration of birth control is 3-6 months. If after stopping the medication a woman cannot conceive a child, a decision is made on the feasibility of drug stimulation of fertilization. Before starting therapy, you need to make sure that the ovaries are capable of producing healthy eggs that are ready for fertilization. If during the examination of the woman inflammatory processes or significant hormonal disorders are detected, the stimulation of fertilization should be postponed until the concomitant diseases are eliminated.
A woman preparing to become a mother must have good immunity. Therefore, when planning a pregnancy, it is necessary to take trace elements and vitamin complexes, which increase the body's resistance. The best effect is provided by folic acid, which has a beneficial effect on the development of follicles. In addition, in the first phase of the menstrual cycle, it is recommended to take vitamins C and E, which stimulate the development of eggs. Vitamins A, D and Group B should be taken after ovulation.
With polycystic ovary, fertilization is stimulated as follows:
- Before ovulation, a woman is prescribed hormonal drugs (Klostilbegit, Menopur, Proginova, Gonal).
- On the 11-12th day of the menstrual cycle, an ultrasound is performed, which allows you to find out what condition the follicle is in. Ultrasound control is necessary in order to correctly determine the moment when an hCG injection should be given. If the injection is done at the wrong time, follicle rupture will not occur. In this case, follicle growth will continue, which will cause the formation of a cyst.
- After an injection of hCG, a woman should have unprotected sex. If conception occurs, the doctor should prescribe a pregnancy-promoting hormonal medication that contains progesterone and estrogen.
The drug is a non-steroidal antiestrogenic drug, available in the form of tablets for oral administration. The active substance is clomiphene citrate, which helps accelerate the process of follicular maturation. Klostilbegit can also be prescribed to men in order to improve the qualitative characteristics of sperm.
Taking the drug, you must strictly adhere to the treatment regimen. With a regular menstrual cycle, the drug should be started on the fifth day. However, if the cycle is not regular, the day the drug is started does not matter.
Clostilbegit is recommended to take one tablet (50 mg) overnight for five days. From the 7th to the 11th day of the cycle, the patient is required to undergo an ultrasound scan to check the condition of the follicles and endometrium. If taking the drug provided the desired effect, ovulation occurs on the 11-15th day of the cycle.
In case the reception of Klostilbegit did not produce a positive effect, the dosage is increased by 2 times. The basis for drug withdrawal is considered to be egg maturation. If an increase in dose does not lead to ovulation, you must refuse to take the drug. After a three-month break, Klostilbegit may be resumed. It should be remembered that the total dosage of the drug for the entire time of administration should not exceed 750 mg.However, Klostilbegit is an effective medicine, which in most cases provides a positive result of treatment after the first course.
The hormonal drug is based on luteinizing and follicle-stimulating hormones, taken in equal proportions. The drug is released in ampoules.
At the initial stage of treatment, the doctor prescribes daily intramuscular injections with a dosage of 75 IU. If therapy does not provide the desired result, the dosage of the drug is increased until the number of extragens increases, reaching a normal value.
Most women tolerate Menopur well. However, the appointment of the drug is allowed only after a full examination. Taking the medicine can cause a side effect - the development of ovarian hyperstimulation syndrome. In this case, Menopur must be canceled immediately.
This drug is often prescribed as an element of complex therapy in the treatment of clostilbegit. Admission Proginova allows you to normalize the level of estrogen. Due to the normalization of hormone levels, it is possible to get rid of thickening of mucus, which is formed in the cervical region and interferes with the penetration of sperm. Proginova also provides a thickening of the endometrium, which increases the chances of a natural conception.
Administration of the drug begins on day 4-5 of the cycle and ends on day 21 of the cycle. Patients taking Proginova are forbidden to take other estrogen-containing drugs, since such a combination of drugs can provoke a violation of ovarian function.
The drug has a gonadotropic effect, stimulating the development of follicles. The drug is considered one of the most effective drugs and is prescribed in a situation where taking other drugs did not have the desired effect.
Gonal released in the form of a syringe pen with a solution for injection or powder for solution.
Gonal's course of treatment lasts a month. At the same time, constant ultrasound monitoring is required to monitor the development of follicles. As soon as it is established that the follicle was able to reach the required size, the woman is given an hCG injection, which allows to violate its integrity. After a day from the moment of injection, ovulation occurs. Statistics show that in 95% of cases, taking Gonal leads to the conception of a child.
In vitro fertilization (IVF) is considered one of the most effective methods of dealing with infertility resulting from obstruction of the fallopian tubes, as well as endometriosis. This method involves the artificial insemination of an egg that occurs outside the mother’s body. The process of fertilization is carried out in laboratory conditions, after which the embryo is carried into the uterine cavity.
In a situation where infertility is due to the lack of ovulation, there is a need for drug stimulation. Drugs are administered to the patient according to the scheme subcutaneously or intramuscularly. Medication usually begins on the fifth day of the cycle. In addition, therapy may include medications that provide an antiestrogenic effect.
After the follicle has matured, the woman is given an injection of hCG, leading to its rupture. After ovulation occurs, the egg is removed for its subsequent fertilization.
The selection of drugs that stimulate ovulation before IVF is performed by a reproductologist for each patient individually. The stimulation process must be monitored by ultrasound.
Consequences for the body
Despite the fact that taking hormones prescribed as part of drug therapy can defeat such an ailment as the lack of ovulation, drugs also provide a negative effect for the female body. Often, patients experience unpleasant symptoms, including:
- hyper excitability
- the appearance of a rash
- disruption of the intestines,
- pain in the area of the mammary glands,
- the appearance of seals in the mammary glands,
- visual impairment.
Very often, the occurrence of side effects indicates an error of the attending physician, who incorrectly selected the treatment regimen for the patient. Also, a negative reaction of the body to taking drugs provokes a patient's non-compliance with the doctor's recommendations.
To get rid of side effects, you should immediately stop taking the medicine.
It must be remembered that stimulation of the ovulation process often leads to multiple pregnancy. In addition, the risk of developing an ectopic pregnancy and enodmetriosis is not excluded. Also, drugs can provoke the growth of already developing uterine fibroids. At the same time, such an effect as the appearance of excess weight as a result of taking hormones is observed quite rarely.
Taking medications that ovulate polycystic ovulation can also cause a significant increase in ovaries. In such a situation, therapy should be stopped immediately. It will be possible to resume taking the drugs only after the ovaries decrease to a normal value.
Errors in determining the treatment regimen can cause serious consequences, such as premature ovarian exhaustion. If this happens, pregnancy will be possible only with the use of the donor's egg. Given the risks and serious consequences for the female body, ovulation should be stimulated no more than five times throughout life.
A medical procedure is not recommended in the presence of such diseases:
- uterine fibroids,
- severe renal failure
- severe liver failure
- pathological changes in the adrenal glands,
- pathological changes in the thyroid gland,
- lactose deficiency and galactose intolerance,
- individual intolerance to the components that make up the drug.
Also, stimulation of ovulation must be abandoned during lactation.
Medicines used to treat infertility in polycystic ovaries cause a decrease in attention and impair the ability to control complex mechanisms. Therefore, during drug therapy, women should pay special attention while driving.