Clomid & Hypothyroidism: Impact on Periods & Fertility

Question
I am a 27 year old female. My periods have always been irregular. I had 3 rounds of clomid to get pregnant with my daughter. After I gave birth they discovered that my thyroid was low and that I am hypothyroid. After 8 months of breastfeeding- my doctor said if I want to get pregnant- I should go on clomid again. Previously when I took clomid it made my periods regular- now (month 3 at 100mg)- it's making my periods irregular (35-42 days). I'm wondering if it's been my thyroid all along- and now that it is fixed- the clomid is actually making things worse. Maybe my periods would be regular now without the clomid because my thyroid is fixed. If my periods were regular- could clomid actually make things worse. What should I do- I am about to start month 4 at 150mg

Answer
Dear Jennifer,

Thank you for the question.  Where are you writing from?

No Clomid will not make your cycles worst.  In women that are spontaneously ovulating, the Clomid causes the ovary to mature and release more than one egg, so that if you are back to normal, you have an increased risk of a multiple.

If the thyroid was the problem, and it certainly could have been, your cycles should have returned to regular and you should try to get pregnant on your own.  Then if no pregnancy after 1 year of trying, return to an new evaluation and/or Clomid again.  If your cycles are not regular even after the thyroid medication, then Clomid would be indicated.  Your doc should do ultrasounds starting on cycle day # 10 or 11 to determine if you are responding to that dose of Clomid and to make sure you are not making too many eggs.  You would then have intercourse for four consecutive days.  That also helps with deciding when to start the progesterone.

I hope this helps.

Sincerely,

Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com