Does Taking Clomiphene and Estrogen Affect Ovulation Timing?

Does taking Estrogen before ovulation affect ovulation during a happy pregnancy?

Hello Dr.
Tsao.
I am currently 30 years old, with a menstrual cycle of 28 days.
On the third day of my period, which started on April 17, I took Clomiphene Citrate (also known as Clomid) for 5 days and used ovulation test strips to detect ovulation.
The test showed a strong positive on May 2 and a weak positive on May 3.
We had intercourse on April 28, April 30, May 2, and May 3, but I still did not conceive.
On the third day of my next period (May 19), I took Clomiphene Citrate again, three tablets a day, for 5 consecutive days.
On the 11th day, I started taking Letrozole (also known as Femara), two tablets in the morning and two in the evening, for 3 days.
I originally expected my ovulation day to be June 2, but as of today, May 31, the ovulation test strips have consistently shown a completely negative result (one line).

Dr.
Tsao, if I start taking Clomiphene Citrate on the third day of my period for 5 days and then take Letrozole on the 11th day (for three days, two tablets each morning and evening), and if I do not administer an ovulation trigger injection, will I still ovulate this month? If I do ovulate, how long after finishing the 3 days of Letrozole can I expect ovulation to be delayed? Thank you.

Sapphire, 20~29 year old female. Ask Date: 2021/05/30

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, we generally recommend going to the hospital for a transvaginal ultrasound to check for ovulation.
Taking Estrogen is not related to ovulation.
Wishing you good health.

Reply Date: 2021/05/30

More Info

When considering the effects of Clomiphene (Clomid) and estrogen (Estromon) on ovulation timing, it's essential to understand how these medications work and their interactions within the menstrual cycle. Clomiphene is a selective estrogen receptor modulator (SERM) that is commonly used to induce ovulation in women who have difficulty ovulating. It works by blocking estrogen receptors in the hypothalamus, which leads to an increase in the release of gonadotropins (LH and FSH) from the pituitary gland, stimulating ovarian function and promoting ovulation.

On the other hand, estrogen plays a crucial role in regulating the menstrual cycle and preparing the endometrium for potential implantation of a fertilized egg. When Clomiphene is taken, it is typically administered starting on the third day of the menstrual cycle for five days. This timing is strategic, as it coincides with the follicular phase of the cycle when the ovaries are preparing to release an egg.

In your case, you began taking Clomiphene on the third day of your cycle and continued for five days. You monitored ovulation using ovulation predictor kits (OPKs), which indicated a surge around May 2nd, suggesting that ovulation was likely to occur shortly thereafter. However, you mentioned that despite having intercourse during this fertile window, conception did not occur.

After your initial course of Clomiphene, you took it again on the third day of your next cycle, followed by estrogen. The introduction of estrogen (Estromon) after Clomiphene may influence the timing of ovulation. Estrogen is known to play a role in the feedback mechanism of the hypothalamus and pituitary gland, potentially affecting the release of gonadotropins. However, the specific impact of taking estrogen shortly after Clomiphene is not straightforward and can vary among individuals.

Typically, ovulation occurs about 5 to 10 days after the last dose of Clomiphene, depending on individual hormonal responses. If you took Clomiphene and then estrogen, it is possible that the estrogen could delay ovulation, especially if it is administered during the luteal phase or if it alters the hormonal signals necessary for ovulation to occur.

Regarding your question about whether you would still ovulate without an ovulation trigger injection, it is possible that you could still ovulate, but the timing may be affected by the estrogen you took. If ovulation does occur, it may be delayed compared to your initial expectations. The exact timing can vary, and without monitoring hormone levels or using OPKs, it can be challenging to predict.

In summary, while Clomiphene is designed to induce ovulation, the addition of estrogen can complicate the timing of ovulation. It is essential to continue monitoring your cycle and consult with your healthcare provider for personalized advice and potential adjustments to your treatment plan. If you have concerns about your ovulation or fertility, discussing these with a specialist can provide further insights and options tailored to your situation.

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