Clomid (Clomiphine Citrate) is a widely used ovulation induction drug and is frequently a first-line fertility treatment for women who have irregular ovulation or who do not ovulate at all.
Lack of ovulation (anovulation) is one of the most common causes for infertility. Once successful ovulation is achieved, fertility is often restored. Clomid is successful in inducing ovulation in about 80% of women. Ultimately, about half of these women will get pregnant.
- Clomid is a tablet taken orally. It works by increasing levels of follicle stimulation hormone (FSH).
- Clomid is usually started at 50 mg. on day 3 or 5 of the menstrual cycle for five days. If this dose does not produce eggs, then the dose can be increased to 100 mg. and then 150 mg.
- Clomid can produce more than one egg per cycle (super ovulation). Despite this, the success rate per cycle is 10-20%. The twinning rate is 8-10%. The triplet rate is about 1%.
In rare cases Clomid can make too many eggs (hyperstimulation). There are times that your fertility program has to be suspended and a birth control pill used for three months to calm the ovaries down. Some women have been hospitalized and have had surgery to drain the ovaries when they make too many eggs.
If ovulation occurs on a dose of Clomid, there is usually no benefit in increasing the dose in a subsequent cycle. In fact, increasing the dose of Clomid could increase the side effects with no increase in successful pregnancy.
Clomid should not be used without close monitoring by your doctor or for more than 6 months. If a patient has not been able to achieve pregnancy in this time, the efficacy of Clomid may have already been maximized. Use of Clomid beyond 6 months is not associated with increased rates of pregnancy, but does delay more aggressive treatment offered by a fertility specialist. This is especially important for mature women with declining ovarian function.
Clomid can produce side effects. Clomid's adverse reactions range from ovarian enlargement (too many eggs), hot flushes, abdominal discomfort and cramping, breast discomfort, nausea, vomiting, visual symptoms (blurring), headache, abnormal uterine bleeding, and multiple births. Clomid's side effects are usually transient and not severe. If you are experiencing severe or persistent abdominal pain, you should consult your doctor immediately.
We now know that over 47% of infertile couples will have a male component. Therefore, semen analysis should always be performed prior to initiating Clomid.
During your fertility treatment please keep a detailed calendar. This calendar should include your period, days you took Clomid, ovulated, had sex, etc.
Many studies show that pregnancy is likely to result sooner when a reproductive endocrinologist is consulted. Your doctor can recommend a specialist if you would like a consultation.