Question

Short Answer Questions:

1. In my research, I found that the levels of “gonadotropins” in the body are critical to understanding how the drugs Clomid and Ortho Tri-Cyclen work. What are gonadotropins? What role do they play in fertility?

2. Some of the references talk about how “negative feedback” is involved in understanding how these drugs work. Can you explain what is meant by negative feedback?

3. My doctor told me that birth control pills contain small amounts of estrogen and progesterone, and these hormones prevent me from ovulating. I don’t understand how giving me these hormones in a pill would prevent me from ovulating. I assume that it has something to do with the levels of the gonadotropins that I asked about earlier. Can you explain this to me?

4. In the information about Ortho Tri-Cyclen, it mentions that the hormones in the pill make cervical mucus thicker and stickier. Does this happen during my natural cycle? How are estrogen and progesterone involved in this process?   

5. My doctor also explained that birth control pills “trick the body into thinking it is pregnant.” She explained that women do not normally ovulate when they are pregnant. Can you explain to me why a pregnant woman does not ovulate? How is this related to how the birth control pill works?

6. My doctor explained that Clomid works by “tricking the brain into thinking that estrogen levels in the body are low.” She explained that this is what leads to the extra stimulation of the ovaries to encourage eggs to be released. One of the references for Clomid said this happens because there is less negative feedback. Can you explain to me how this “trick” and the decreased negative feedback are related? Why would these factors lead to the stimulation of the ovaries?

7. My doctor told me that if I take Clomid, I would be taking it on days five through nine of my normal menstrual cycle. She explained that this is when it will have the greatest chance of stimulating the ovaries. What is going on during this part of the menstrual cycle that makes it the best time to take this drug?

8. I read an article that mentioned that women on Clomid may be more likely to get pregnant with twins, triplets, or more! The article said that normally there is a dominant follicle that releases a single egg, but Clomid can potentially make lots of follicles release an egg in a given month. How does Clomid do that?

Answer 1

1. Gonadotropins are two hormones synthesized and secreted by the anterior pituitary gland by the influence of Gonadotropin-releasing hormone (GnRH) from the hypothalamus. Two gonadotropins are luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Gonadotropins stimulate male and female gonads that are testis and ovary.

Gonadotropins stimulates gonads (testis) to secrete male sex hormone testosterone which helps in spermatogenesis (sperm production) in female Gonadotropins stimulates ovaries to secrete female sex hormones that are estrogen and progesterone which help in folliculogenesis ( formation and maturation of follicle and ovum), ovulation and maintaining pregnancy.

2. If any change from controlled condition (homeostasis), negative feedback reverses that change to the controlled condition. For example, Gonadotropins stimulate the secretion of estrogen, progesterone (female sex hormones), and testosterone (male sex hormone). when their level in the blood raise up than normal, these hormones inhibit hypothalamus and anterior pituitary to inhibit the secretion of gonadotropin through a negative feedback system

3. As we know from question number one, Gonadotropins are important for ovulation. Estrogen and progesterone present in the birth control pill inhibit the anterior pituitary and hypothalamus to inhibit the secretion of gonadotropins through negative feedback (when birth control pills are taken, it increases estrogen and progesterone level in the blood- a change from the controlled condition). This inhibition of gonadotropin will help in preventing ovulation