Womens Health

Alternatives to Clomid

TTC Trail

You've long been on the TTC (trying to conceive) trail, and it's been filled with heartbreak alternated with high hopes. Once your husband was cleared for sperm abnormalities, your doctor put you on Clomid and you crossed your fingers, knowing the next step, if there was one, would be expensive, and painful as well.

Then 4 or maybe even 6 cycles went by with no dice, even when your doctor upped the dose, then added IUI, and then tried some injectables. Then you heard about someone who used Tamoxifen or Femara and managed to ovulate and conceive. You're open to trying something new but you're wondering: aren't those breast cancer drugs?

Direct Action

Yes. Tamoxifen and Femara (letrozole) were designed to both treat and prevent hormonally-responsive breast cancer. Tamoxifen is an antiestrogen and works to interfere with estrogen receptors. This tricks your body into thinking its estrogen levels are low. Femara inhibits the enzyme known as aromatase which is responsible for producing estrogen. By this mechanism, Femara serves to block estrogen production in your body. Both drugs can increase fertility and ovulation rates.

Clomid acts on the pituitary gland but Tamoxifen and Femara action is directed right at the ovaries. Some doctors feel this more straightforward course of action may serve to improve follicular development. There are doctors who have found that those women who suffer from polycystic ovarian syndrome (PCOS) fare better with Tamoxifen than with Clomid.

Of course, if you're being treated with Tamoxifen or Femara for breast cancer, you will need to take contraceptive measures because these drugs can cause birth defects if taken while pregnant. Since most women take these drugs for a five year course, these are five years when you wouldn't want to take the chance of getting pregnant.

So, the drugs work well to stimulate the ovaries, but can wreak havoc on embryos. But just about all fertility drugs are harmful to early pregnancies. This is why you will need to undergo constant monitoring for conception while you take any fertility treatment. Sometimes, a five year course of either drug can be suspended for two years if a couple wants to conceive. But don't do this without your oncologist's blessing.

One really great benefit of Tamoxifen and Femara is that they're short-lived. They clear out of your body almost as soon as you've taken your last dose. This minimizes the chance of harming an as yet, undetected embryo. Some doctors think they're seeing more babies with Femara treatment than with Clomid, and it seems to have fewer side effects.

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