*Recent Updates: Since this article was written, a new product designed specifically for trying-to-conceive women (called "FertileCM") has been introduced to encourage the production of "fertile-quality" cervical mucus. FertileCM can be purchased at Early Pregnancy Tests . com with free same-day shipping.
Additionally, a product called "Pre-Seed" has been introduced to help address issues relating to dryness while trying to conceive. Pre-Seed is the only "sperm friendly" lubricant on the market, and as such, is the only lubricant that should be used while trying to conceive.
At first most people wonder what on earth a cough syrup has to do with fertility, but the logic is easily found in the fact that it is an expectorant and is being used to loosen and thin mucus - just in a different place than the lungs!
The name Robitussin was used in the title of this FAQ as it is a common brand of cough syrup in the United States. It is used on the fertility boards and newsgroups in the same manner as saying Band-Aid for an adhesive strip used to cover a cut. Any expectorant that contains guaifenesin as the only active ingredient is fine to use.
What kind of Robitussin is used to improve cervical mucus?
One should buy the plain kind with no letters after it. The only active ingredient is guaifenesin, and it contains 100 mg per teaspoon. It is very important to avoid the versions that contain decongestants as those may dry up cervical mucus. Also, there is some conflicting information about whether dextromethorphan, the DM in some cough medicine names, may be linked to birth defects such as neural tube defects and cleft palate.
Do I need to use the brand Robitussin?
No. Robitussin is the most common brand name, at least in the U.S., that carries a guaifenesin-only expectorant, but there are other brands and generics available. As long as the only active ingredient is guaifenesin, you can use any variety you find. For those with diabetes or otherwise concerned about sugar intake, there is the brand Diabetic Tussin available.
What is the recommended dose of guaifenesin?
The recommended dose for improving cervical mucus, based on a 1982 article in Fertility and Sterility, is two teaspoons (200 mg) taken orally three times per day. If mucus still appears thick and doesn't have good spinnbarkeit (ability to stretch), one can take as much as four teaspoons (400 mg) four times per day (the maximum dose on this over the counter medication). Each dose should be taken with a full glass of water, and attention should be given to drinking plenty of fluids throughout the day -- one needs water to produce mucus.
What cycle days should one take guaifenesin?
Just as the dose can vary a bit, so can the days. The article linked above had patients starting the guaifenesin on cycle day 5 - five days after the start of menses. This seems rather early as mucus is not an issue until about five days before ovulation - based on the fact that sperm can only live five days at best, and most pregnancies are the result of intercourse in the five days leading up to ovulation. Because of this information, it is now more common for doctors to suggest starting guaifenesin about five days before expected ovulation and continuing through ovulation day (six days total, for those with regular cycles). For those with irregular cycles, one should start taking guaifenesin about five days before the earliest day ovulation might be expected. For those taking Clomid (clomiphene citrate, Serophene) in a 5-day protocol, one can probably wait until the day after the last Clomid pill before starting the expectorant.
Is guaifenesin available in pill form?
Yes, but in most cases a prescription is needed. In the U.S., one can get a 600 mg time released caplet as the generic Guaifenesin CR, or brands Humibid LA, and Fenesin. This is often less expensive than the liquid. Another brand that is available OTC is Mucinex, though it probably is not a cost savings.
How does one diagnose cervical factor/hostile mucus?
Many women try taking guaifenesin after noting little or no egg white (stretchy) cervical mucus while charting their fertility signals, but clinically it is diagnosed when a doctor checks mucus one or two days before ovulation in what is usually referred to as a post-coital test. The doctor does a vaginal exam and takes a sample of mucus to immediately analyze under a microscope to check for live sperm and for a ferning pattern. It is also checked for signs of infection. Quality mucus will be stretchy, fern, lack cellularity, and have live sperm swimming in it.
Why do so many women take guaifenesin while on Clomid?
Clomid (clomiphene citrate, Serophene) can cause hostile mucus in 30 percent or more of women using it. Higher doses tend to be more associated with less cervical fluid and a thinner uterine lining, than the 50 mg dose.
Will guaifenesin help if there is little or no mucus present?
Guaifenesin doesn't actually create mucus, it only thins what is already there. One would need to look into why there is no mucus (infection, not really ovulating), or bypass the mucus issue by doing intrauterine insemination.
Does one need to take guaifenesin when doing intrauterine insemination (IUI)?
It would only make sense to take guaifenesin if one is planning to have intercourse in addition to doing IUI. Those doing donor insemination, for example, wouldn't benefit.
Will taking guaifenesin cause any problems if it isn't needed?
Probably not. Since fertile mucus can be watery, there is probably no harm in taking guaifenesin and thinning it out.
What are some other possible ways to improve cervical mucus?
Drinking plenty of water should always be considered in addition to any other therapies one might try. Estrogen is sometimes given to help mucus production, though doctors have mixed opinions of its benefit, especially when used with Clomid (and some suggest using Tamoxifen instead of Clomid). Injectable gonadotropins used for controlled ovarian hyperstimulation often have a positive effect on cervical mucus as well. Some home/natural remedies include eating salty foods such as popcorn (mucus is very salty), taking evening primrose oil, avoiding dairy products (they can thicken mucus), eating lots of baby carrots, and also avoiding antihistamines, including high doses of vitamin C. Another suggestion that is increasing in popularity is to drink grapefruit juice in order to improve or increase the amount of cervical mucus. If one is on prescription medications, it is a good idea to look for warning about grapefruit juice consumption (it isn't recommended with several medications for hypertension, for example).
Lubricants aid in intercourse, but not in sperm travel through the cervix. Most over the counter lubricants are not "sperm friendly" -- meaning that using them is likely to kill off some sperm. In most cases, one needs to weigh the benefits against the risks . . . it may well be worth losing a few sperm to make it possible to complete intercourse. That said, there are some friendlier options out there. One is FemGlide, a lubricant you can get from your doctor. You can buy the same product marketed as Slippery Stuff (apparently more available at stores that sell sexual aids than at pharmacies and such). There is also a more recently introduced product called Pre-Seed from Bio-Origyn. Another option discussed on many fertility boards is using raw egg whites at room temperature. There may be some risk of salmonella exposure with egg whites, so some suggest using pasteurized egg whites available in the grocery store. With any lubricant, it is generally best to use as little as possible.
Does guaifenesin do anything for male factor infertility?
It is possible that men with thick semen may benefit from guaifenesin in the same manner it helps with cervical mucus in women. The suggested doses on the newsgroups and fertility boards range from two teaspoons twice per day to four teaspoons four times per day.
I know that Steph used Robitussen one cycle and that she did notice a differance. I tried Mucinex (pill form) with my last cycle, but I don't think I took enough. I didn't notice anything.
I was taking Evening Primrose Oil (EPO) for about 4 or 5 cycles. But since I had never checked CM prior to those cycles, I can't be sure that it helped. I know that when I increased to 2000mg a day I did notice a differance from the 1200mg a day.
I also used Mucinex one cycle and didn't notice a difference. I was on Femara this cycle and it seemed that I had less CM than I do on clomid - weird! I used Pre-Seed once too and it was great. Didn't get me pregnant, but seemed to help when I was on clomid!
I have tried the fertilaidCM.. I bought it with the 2 bottles of Fertilaid... I took for the 2 cycles ater my M/C. They didn't help with getting me a BFP but think they worked a dream for getting my hormones back in check. As for the fertilaidCM... it was brilliant! I was told not to use it with the Clomid though so haven't although was thinking about giving it a go this month along with EPO seeing as I am med free! I tried the cough medicine last month as well as drinking lots of water - I didn't see any difference but I was on Clomid??
Debs - why do you suppose you weren't suppose to take the Fertilaid with the Clomid?
I really believe that taking the EPO helped to regulate my cycles too. I never skipped a beat after the m/c. I stopped taking it last cycle, just because I was so darn sick and tired of taking SO many pills. Vitamins, BP meds, fertility meds, anti-depressants . . . UGH!
Hi Bam, I know what you mean about the pills.. I take loads!! I rattle when I walk!!
I have a condition called Aplastic anaemia which needs medication, rheumatoid arthritis and more recently was diagnosed with Lupas!! I have to take pills to keep all of those under control which I hate doing as it can't be any good for TTC although the dr's have assured me it is safe.
I take a cocktail of other vitamins for my immune system as it is lowered due to the Aplastic anaemia and am taking Clomid (have a month off due to a cyst). I have been taking EPO plus Folic Acid and now Lisa has got me into taking the Magensium!!
A few months ago I was talked into buying some Chinese herbs which are a sachet of 20pills which you take twice a day and as I am off the Clomid this month I thought I would give them a go.... stupid me!!
I was perscribed the clomid from a private fertility specialist and he said NOT to take the FertilaidCM or the Fertilaid at the same time as the Clomid as it messes up your hormones and they conflict. I looked on the bottle and it actually says something about not taking it with fertilitymeds including Clomid.....
LOL!! it is a bit mental!! I almost keeled over when I opened the sachets from the chinese lady which she assures me will 'get you good egg' only to discover there were another 40 pills to take daily!! Ha oh well it beats eating... I am full up after all those!!
Lupas is a strange thing. I was only diagnosed with it a few months ago. I don't really understand it... just another label! There are loads of treatments that I can have though but lots of them are on hold as don't want to mess whilst TTC. I also have steriod injections for the the RA and gamma globulin, platlets and iron transfusions to help with the ApA but have been holding off of those as can't have them in the first 3 months of pregnancy and although I have not been lucky enough to be blessed with another BFP I just know that if I get one scheduled I will find out I am pregnant! My levels aren't too bad at the moment so its not really an issue and I am trying to keep healthy... I have been training for a run I am doing in Oct so thats keeping me busy and my bones moving.
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