Our expert says:
Fertomid treatment is usually a 5-day course, which can be initiated anytime from Day 2 to Day 5 of the cycle. The choice of when to start depends on the gynaecologist’s objective in ovulation induction. The earlier onset will result in a higher number of follicles being recruited whereas if commenced later i.e. Day 5, then the objective is a far more rapid growth of the single follicle that has already been recruited. Therefore in cases were ovulation is occurring at a much later stage in the cycle or is not happening at all, it is ideal to use the Fertomid later in the treatment cycle i.e. Day 4 or 5. Were the objective is multi-ovulation or an increase in the number of eggs from both ovaries then it is advisable to commence early i.e. Day 2 or 3 of the cycle. This latter circumstance is often used in ART cycles i.e. In-vitro fertilization or insemination programs and often creates the risk of multiple pregnancies as well as multiple ovarian cyst formation. Therefore if Fertomid or equivalent drug is used early in a cycle it is important that careful monitoring be undertaken using ultrasound scanning so as to be able to monitor the number of follicles and their rate of growth and as a consequence the likelihood of multiple pregnancies occurring. Were natural intercourse is considered it would be more appropriate to use the drug from Day 4 or 5 of the cycle together with ovulation monitoring.
Answered by: Dr M. I. Cassim
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