Case Study on the Reproductive System You are a columnist for a popular website
ID: 3517816 • Letter: C
Question
Case Study on the Reproductive System You are a columnist for a popular website that deals with women's health issues Visitors to the e can submit their stories and questions through an Ask the Expert" link on the site In this scenario, a 26-year-old woman has posted her story and some questions regarding reproductive health My name is Darlene. 1 am a 28-year-old married woman with no children. My hushand. Pierre and my doctor has suggested that I and I have been trying to get pregnant for over two years now consider fertility drug treatments. The irony of our situation is that I have been taking a birth prevent getting pregnant, and now my doctor suggests that I take control pill for five years to another drug to help me get pregnant. When I went off birth control, about been taking a birth control drug called Ortho Tri-Cyclen. To be perfectly honest. I dont understand how it works because my periods were more regular when I was on the pill than when I went off of it. My doctor told me that the pill works because it tricks your body into thinking that it is pregnant. That just confused me even more. a year ago, my menstrual cycle became very irregular. I had When I looked back on my decision to take birth control pills, I realized that I did not really understand how they work. I just do not want to make that mistake again. Before I consider taking any more drugs, I want to understand more about how they work. The drug we're looking into is called Clomid. I asked my doctor a bunch of questions, but I still feel confused. I looked up some stuff online when I got home. Here is some information that I learned from a website about how Ortho Tri-Cyclen works: Estrogen and progestin work in combination to suppress the ypothalamic-pituitary-gonadal (HPG) axis. This suppression leads to a decrease in the release of gonadotropin-releasing hormone (GnRI) from the hypothalamus and Iuteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the anterior pituitary Maturation of the dominant follicle is inhibited under the decreasing levels of FSH and LH Hormonal contraceptive use also leads to an increase in the viscosity of the cervical mucus, which inhibits sperm penetration and movement through the cervical canalExplanation / Answer
6. Clomid or clomifene is SERM (selective estrogen receptor modulator) as it act as estrogen antagonist in some site but agonist in other side. Clomid act as antagonist on Estrogen receptor on hypothalamus. Under normal condition hypothalamus secrete GnRH (gonadotrophin releasing hormone) which act on anterior pitutary and stimulate release of FSH and LH, which lead to ovulation and production of Estrogen. Estrogen then decrease GnRH thus decrease LH and FSH by Negative feedback. Clomid by acting as amti estrogen on hypothalamus, inhibit negative feedback ie estrogen is no longer able to decrease GnRH, LH and FSH so GnRH, LH and FSH level will rise and lead to ovulation
7. During this time ovaries release follicles which under influence of FSH and LH undergo development and ovulation. Clomid is given during this time as there is maximum chance of follicles release and ovulation which increase chance of fertilization. Clomid wil result in increase LH and FSH level will increase follicle release, maturation and ovulation.
8. Clomid act by inhibition of negative feedback of estrogen on hypothalamus. It thus increase GnRH, LH and FSH. Increased FSH and LH lead to increased stimulation of ovaries. This increase the total number of follicles released and increased number of matured follicles (normally only one follicles matures fully). This increased matured follicles under influence of LH undergo ovulation thus the number of ovum will increase. This will lead to multiple fertilization and pregnancy.
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