It is much more common than you might think to induce ovulation and still not get pregnant. Clomiphene-based ovulation inducers1 can help, but they are not miracle workers! You can induce ovulation for up to 6 consecutive cycles without success. But do you know why that happens?
When trying to conceive, there’s often a mistaken belief that certain outside factors, such as medication, will speed up the waiting process. But it doesn’t work like that. I have seen many women who try for only a few months, about 3 or 4 cycles, consider using ovulation inducers even without medical guidance. This is not recommended, as doctors only prescribe this medication after thoroughly evaluating the couple. The inducer should be used for a maximum of 3 cycles. If there is no response, it’s best to seek another form of treatment. But what interferes with the use of inducers? Simply taking medication to induce ovulation does not guarantee that a woman will get pregnant. This is due to several factors that can prevent pregnancy from happening. Some possible reasons for failure include:
Lack of response to medication: Sometimes, the hormone dose in the inducer is not enough for ovulation to occur in certain bodies. Sometimes a woman’s reproductive system does not react positively or as expected to inducers. That’s why you must use the medication with medical supervision; if a low dose is suspected, the doctor will recommend gradually increasing the dosage. The most recommended starting dose is 50mg and can be increased up to 200mg (an extremely high dose, with many possible side effects2, used only in extreme cases of anovulation) for 5 days. In other instances, medication stimulation isn’t suitable. Some women only respond to ovulation induction through injectable medication.
Use of medication in the wrong cases: Not all women can or need ovulation inducers. The most contraindicated cases for this type of medication are women with blocked fallopian tubes or with polycystic ovaries3. In the case of blocked tubes, it doesn’t help to ovulate if the tubes won’t allow the sperm to pass through—or if it does, there’s a risk of a tubal (ectopic) pregnancy. With polycystic ovaries, ovulation induction can worsen the condition. That’s why you must be very cautious with ovulation inducers: each case is unique.
Disruption of other hormones: Sometimes, ovulation inducers may interfere incorrectly with other body hormones. They can lower estrogen, considerably increase progesterone, among others. It’s important to know that just using an ovulation inducer does not guarantee that your body will react appropriately.
Having sex at the wrong time: Knowing when to have sex is crucial! Sometimes the fertile period with the inducer is missed and all the efforts your body makes are in vain. The right thing is to have sex between 5 and 20 days after finishing the medication. Having sex every other day (alternate days) increases your chances of conception.
How Does the Ovulation Inducer Work?
Clomiphene-based medications stimulate hormones like FSH, which in turn stimulates the follicles for ovulation. After the medication course, LH (luteinizing hormone) takes over and matures the follicles for ovulation. As soon as hormone levels reach the ideal level for the body, the follicle(s) is released and ovulation occurs. However, some women have hormonal difficulties even with ovulation inducers and do not have this hormonal peak needed for follicle release. In these cases, some doctors prescribe HCG-based medications to help with egg release.
Additionally, ovulation inducers can directly and negatively affect the woman’s endometrium, leaving it unable to receive the embryo if fertilization takes place. There’s no way to know when this happens; however, if the medication is ineffective for 3 or 6 months, you need to consider other induction forms with your doctor.
Is it possible to get pregnant in the first cycle using an ovulation inducer? Yes! But keep in mind this is the exception, not the rule. Even if your friend got pregnant in the first induced cycle, you may not succeed even after 6 months of induction, since every body reacts differently to the medication. In general, the medication works much better in the second and third cycle of induction. That’s because the body has some time to adapt to the new hormone load. Pain is common after using clomiphene. Abdominal, side, and lower belly pains are frequently reported; however, if pains become severe—especially when using more than 50mg per day—it could indicate ovarian hyperstimulation. Pay close attention to the symptoms!
Never use ovulation induction medication without guidance from your doctor.
See also: Ovulation Inducer, Risks vs. Benefits
