Oral Infertility Medication

Use the details in this section to help make informed decisions about infertility drugs.

Plan Ahead Before Buying Infertility Drugs in Durham, NC

Many pharmacies in Raleigh, Durham, Apex, Cary, Chapel Hill, Fayetteville, South Boston, VA, Danville, VA and nationwide carry the various medications, but their stock is often depleted temporarily. Some pharmacies are not open on the weekends. Plan accordingly. If you are going to use a mail-order company for infertility drugs, allow for delivery times.

We are unable to predict the exact length of the monitoring phase (generally 10 to 14 days of medications), and you may need to get more infertility medication before the follicles are ready for release.

We can get you a prescription for infertility medication to take to an alternate facility if necessary, but please try to plan ahead to avoid having to drive all over the city looking for a pharmacy with infertility drugs in stock.

If you need a prescription for infertility medication called in, have the pharmacy name and phone number available so we can be sure to have the correct pharmacy.

Clomiphine Citrate (Clomid)

Clomiphine citrate (Clomid) is a compound that is very similar in structure to estrogen and other fertility drugs such as Gonadotropins and Bromocriptine. Because of this likeness, Clomid is able to bind to estrogen receptors in the hypothalamus.

This prevents the brain from seeing the negative signal from estrogen that is being released by the ovaries. As a result, the hypothalamus continues to stimulate the pituitary gland to make follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones stimulate follicular growth in the ovary.

Clomid is administered orally in 50 mg increments (50, 100, 150) over five days. There are two common regimens for administration.

Clomid can be used with or without monitoring of follicular growth. Some physicians prefer to monitor follicular growth with ultrasounds, while others argue that regular intercourse around the time of projected ovulation is adequate. Some form of monitoring — LH predictor kits, day 21 progesterone (more accurate if drawn seven days post ovulation), or ultrasound monitoring — may be useful to demonstrate a response to the medication.

Of the pregnancies that occur using Clomid, 85 percent occur in three months, and 99 percent occur within five months. Treatment beyond five months is generally not seen as useful. Some individuals are given a prescription for Clomid to enhance ovulation over three to four months, with a follow-up visit if they are not pregnant.

Using the first day of menses as cycle day one, you will take Clomid on days three to seven or days five to nine. If follicular monitoring is used, an ultrasound is usually done on day 10 (if taken on days three to seven) or day 12 (if five to nine). The actual release of the follicle using human chorionic gonadotropin (HCG) is timed when the follicles reach optimal size.

In general 50 mg is the starting dose. With a poor response, the dose is usually increased in steps. Polycystic ovarian disease and obesity may decrease the response to Clomid, but this is unpredictable and a starting dose of 50 mg is still recommended.

There are various adjuncts that can be used with clomiphine citrate. Among these are:

• Glucocorticoids
• Naltrexone
• Avandia
• Metformin

These therapies are often not utilized to their full potential due to the wide availability of and effectiveness of gonadotropins.

Since Clomid is a drug used for controlled ovarian hyperstimulation (COH), it may be combined with intercourse, cup inseminations, or intrauterine insemination.

Side effects are infrequent but can be serious. Although Clomid is usually not considered as potent as the injectable gonadotropins, it carries the same potential risks. The side effects are seen less often but can be just as severe.

The average cost for clomiphine citrate is $10 per pill or $50 per month. Contact your pharmacy for full pricing information.

Tamoxifen

Tamoxifen is a medication that is primarily used to prevent breast cancer.

However, it can begin ovulation induction by a mechanism similar to clomiphene citrate. The difference is that it is more estrogenic in the cervix and uterus than clomiphene citrate.

The benefit of tamoxifen is its ability to induce ovulation while minimizing the antiestrogenic action of the cervix and uterus.

Typically, tamoxifen is given orally at a dose of 10 to 20 mg per day on either cycle days three to seven or five to nine.

Helping patients from Raleigh, Durham, Apex, Cary, Chapel Hill, Fayetteville, South Boston, VA, Danville, VA and nationwide realize their dream of having a family.