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Clomid And Menstruation
If a woman is menstruating, even if irregularly, clomiphene is usually effective, particularly if she develops follicles that aren't reaching normal size. Usually, a mature follicle is about 20 millimeters in diameter, or about the size of a small grape, just before it ruptures and releases its egg. Clomiphene may help small, immature follicles grow to maturity.
Do I Need A Menstrual Period Induced Before Taking Clomid?
In theory no, but in practice yes. If you knew for sure you had not ovulated and become very early pregnant, then inducing a menses would not be necessary. The reason most doctors give you progestins or progesterone to induce a menses is to make sure you have not recently ovulated or become pregnant. If you just ovulated, the progestins will usually not induce a menses until 14 days after ovulation. This protects you from inducing an ovulation on top of an ovulation or disrupting an ovulation and potential pregnancy with unneeded clomiphene.
One reason to induce a menses before Clomid is to make sure the lining of the uterus is at the right phase for egg implantation. If a menses is induced, then the endometrial lining has had only 14 days of growth and stimulation at the time of ovulation. When no menses is induced, the endometrium has been growing and been stimulated for 30 or more days and may not be as receptive to egg implantation.
If a menses is induced, the doctor knows for sure that you are not pregnant. Even if you use the most sensitive home pregnancy test you could still be pregnant with a negative test. Thus having a menstrual period is good reassurance that you are not pregnant and that the lining of the uterus is best prepared for an ovulation and potential pregnancy.
Clomid And Estradiol Production
A low estradiol level in a woman's blood correlates with an inadequately stimulated, small follicle. A woman having a spontaneous ovulation cycle (that is, ovulating without the aid of fertility drugs) generally has peak estradiol levels ranging from 100 to 300 picograms (one trillionth of a gram)/ml. A woman may have enough hormones to produce an egg, but if her estradiol production by the follicles is low (less than 100 pg/ml), she may not adequately stimulate her cervix to produce fertile mucus or stimulate her endometrium to get ready to accept a fertilized egg for implantation. Clomiphene could boost the weak signals from the hypothalamus to the pituitary to the ovaries.
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