Dexamethasone for Ovulation Induction

Anovulation is one of the more common causes of infertility. Clomiphene citrate (Clomid) is a medication that helps with ovulation, but only about 80% of women respond. For the remaining 20%, they will either need to use a combination of medications or switch to a different drug altogether. Dexamethasone is one such option.

This is a medicine that makes Clomid more effective for ovulation.  It acts on the adrenal glands to decrease their production of androgens, hormones that interfere with egg growth and development.  When used together with Clomid, nearly 80-90% of women will ovulate when they had not responded to Clomid alone.

Dexamethasone is given as a single pill (1/2 tablet) at bedtime on a daily basis (unlike Clomid, which is taken for 5 days only).  Most people experience no side effects at all; the most common side effect seems to be a temporary increase in urination.  Other possible side effects include headache, nausea, and fatigue.

If we start dexamethasone in the cycle in which there is no apparent response to Clomid, you may or may not ovulate later in the same cycle.  Call our office if your period hasn’t started within 3-4 weeks after beginning dexamethasone.   We can start your period with either a progesterone injection or an oral medication after checking a blood test.

Once your period begins, you will restart Clomid (often at a higher dose) and the vaginal estradiol.  Call our office to schedule a sonogram to see if you are now ovulating on this combination of drugs.  Once the follicles have reached the right size, you may choose to receive an injection of hCG to trigger ovulation and then undergo an intrauterine insemination (IUI) the following day.