Clomid is a very commonly used fertility medication.
Clomid (clomiphene citrate) is a pill that is taken for 5 days in the early part of the menstrual cycle. It has been used in the United States since 1967 to treat infertility and produces good success rates with a low (5-8%) risk of multiple gestation.
Clomid can cause ovulation to occur in women who do not ovulate. Women with an ovulatory dysfunction – even PCOS (polycystic ovary syndrome) – can take this oral pill to cause ovulation and significantly improve their fertility. In certain types of ovulatory dysfunction, the brain does not send the correct signal to the ovaries to get them to ovulate. This signal is conveyed through the hormones FSH (follicle stimulating hormone) and LH (luteinizing hormone). It improves the brain’s release of these hormones and causes ovulation in the ovaries.
Clomid can also cause an increase in the number of eggs that do ovulate.
In women who already ovulate on their own, it can be used to cause “super ovulation”, i.e. the release of more than one egg per month. Women who ovulate regularly typically ovulate only one egg per month. This is why, in the absence of fertility medications, women typically have singleton pregnancies (one baby at a time). Clomid increases the amount of FSH (follicle stimulating hormone) secreted by the pituitary gland. Higher amounts of FSH sent to the ovary may cause more eggs to ovulate. Typically it causes 2 or 3 eggs to ovulate. This improves pregnancy rates, but also increases the likelihood of multiple gestation (twins or triplets). The risk of multiple gestation when taking Clomid is still generally low.
What are the risks of multiple gestation?
Around 5-8% of women who conceive while taking Clomid conceive a multiple gestation. While these pregnancies are almost always twins, about 1% of women who conceive while taking Clomid conceive triplets or more. An ultrasound performed before ovulation can tell you how many eggs you are likely to ovulate and can estimate the risk for multiple gestation. If your physician sees that there are too many eggs starting to develop, we may cancel your cycle and ask you to use contraception until you start your next menstrual cycle. At that time, we will either stimulate you with a lower dose of Clomid or try another medication in order to lessen the risk of a multiple gestation.
What are the side effects?
The most common side effects include hot flushes, night sweats, difficulty sleeping, and moodiness. Sometimes a thinning of the uterine lining occurs while taking Clomid. This is not permanent and indicates that a different medication should be used. If you experience visual changes while taking Clomid, please notify Dr. James or Dr. Munch. You should not take Clomid if you experience vision changes as a side effect of Clomid.
How long should I try Clomid?
Generally speaking, fertility treatments have their best success rates for the first three menstrual cycles, although with Clomid, cumulative pregnancy rates continue to rise through six complete cycles. While you can take Clomid for more than six months, the chance for pregnancy after that time declines significantly. Therefore, most people try Clomid for 3-6 cycles and then try more aggressive treatments if necessary. Fertility specialists don’t recommend using Clomid for more than 12 months.
If you would like to learn more about how we can help you achieve pregnancy please contact our San Antonio Fertility Center to schedule an appointment with Dr. Summer James or Dr. Erika Munch.
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