Sex During Fertility Treatment: Monitored Clomid Cycle with Timed Intercourse One of the most basic forms of treatment offered at Shady Grove Fertility is a monitored Clomid cycle with timed intercourse.
During this treatment the female patient takes an oral medication called Clomid aimed to induce ovulation. The cycle is monitored to ensure that a follicle develops and is released from the ovaries through ovulation.
Once ovulation occurs the couple is instructed to have intercourse at home. We generally encourage couples to have intercourse the night of the trigger shot. This ensures a supply of sperm in the fallopian tubes to meet the egg upon ovulation. Abstinence from intercourse or ejaculation is suggested on the day between the trigger shot and the IUI or the day of the trigger shot if the IUI is planned for the next day. This break allows the sperm count to reaccumulate in order to produce a good sample for the IUI, which is usually scheduled approximately 36 hours after the trigger shot is given.
Intercourse is however suggested the evening following the IUI. During some medicated IUI cycles, the female partner will produce too many follicles creating a concern that she potentially may ovulate too many eggs. This would place the couple at too great of a risk for a multiple pregnancy or higher order multiple pregnancy triplets or higher which is an unacceptable risk due to the complications to both mother and babies. When this occurs the stimulation medication is stopped and patients are asked to abstain from intercourse.
In Vitro Fertilization IVF Sex during the stimulation phase of an IVF cycle is acceptable as long as the couple is using a form of barrier contraceptive, such as a condom. In the event ovulation was to occur unexpectedly, especially from multiple follicles, we want to avoid the possibility of multiple pregnancy.
This rest gives the embryo optimal time to implant into the uterine wall. Most IVF patients can resume normal sexual activity a week or two after their embryo transfer, but always check with your doctor or nurse prior.
That way when instructions are given in cycle days everyone understands the timing for the medications and lab tests. Clomid is classically taken for 5 days on cycle day although some doctors prefer to prescribe it on cycle day Clomid works by tricking the brain into seeing estrogen levels drop while the Clomid is being taken and then when the medication is stopped it appears to the brain that the estrogen levels suddenly rise. A drop in estrogen levels early in the cycle followed by a sudden rise stimulates the ovary to make an egg and eventually to ovulate.
When Clomid is taken cyles day , ovulation release of the egg from the ovary is expected around cycle days The ideal frequency of sexual intercourse to achieve pregnancy is every other day. More frequent then that can dilute the sperm, less frequent runs the risk of missing the critical time near ovulation.
It is recommended that patients have intercourse every other day for about 10 days from the last day of Clomid. This helps assure that sperm will be available when ovulation occurs so that the egg can become fertilized.
If the couple is feeling romantic on a day that is not scheduled for intercourse, it is fine to be intimate anyway. If a day is missed, try to have sex on the next day. Progesterone levels increase after ovulation and stay increased throughout pregnancy.
If pregnancy does not occur the progesterone levels will fall and a new cycle will start. Progesterone is checked with a blood test on cycle day A high level confirms ovulation has occurred and that the Clomid has done its job. If the progesterone level on cycle day 21 is low, ovulation did not occur and the dose of clomid may need to be increased for the next cycle. Glucophage is originally a medication used for diabetes but it has been shown to be a very effective addition to Clomid for the anovulatory women.
The typical effective dose of Glucophage is mg three times per day. If started directly at this dose it can cause diarrhea and nausea so it is started at a smaller dose and gradually increased. Once the target dose of mg three times per day is achieved, Clomid cycle can be restarted. The Glucophage is taken every day until pregnancy occurs.
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