Clomid (clomiphene citrate) is a medication used to help regulate ovulation in women who have had difficulty conceiving naturally. It helps to stimulate the production of the follicle stimulating hormone (FSH) and luteinizing hormone (LH) that help women ovulate each month.
Clomid can be taken if:
* Your estrogen and pituitary functioning are normal
* Your partner is fertile
* You are trying to increase ovulation for eggs to be used for in vitro fertilization (IVF)
Depending on what your doctor decides, other medications may be used in conjunction with Clomid.
How Do I Take Clomid?
Clomid is taken orally in pill form. The dosage will be determined by your doctor and may sometimes be adjusted depending on your response to the medication. You will start taking Clomid three to seven days after the first day of your cycle, using the first day of your period as day one. Your doctor may monitor you with an ultrasound and/or blood work, or may just give you some time to become pregnant and have you follow up.
According to the American College of Obstetricians and Gynecologists (ACOG) practice bulletin, most women using Clomid will become pregnant within three to six cycles.
Tell your doctor if you are taking any other medications. Your doctor should review them with you to prevent medication interaction.
Are There Side Effects?
Here are the side effects most commonly reported with Clomid use:
Stay in touch with your doctor and report how you are feeling. If any of the side effects seems to be worsening, stop taking the medication right away. Many women may need support when trying to conceive.
How Successful Is Clomid?
Clomid will jumpstart ovulation in 80% of patients, and about 40% to 45% of women using Clomid will get pregnant within six cycles of use.
Using Clomid for more than six cycles is not generally recommended. If six cycles go by, and pregnancy is not achieved, other alternatives may be considered.
What if Clomid Still Not Work?
Sometimes, ultrasound will show the follicles growing in response to Clomid, but the midcycle LH surge isn't strong enough to bring on ovulation. In this case, your doctor may prescribe Clomid along with an injection of hCG, like the drug Ovidrel, to trigger ovulation and boost the midcycle LH surge.
If after trying these options, you’re still not ovulating on Clomid, your doctor may suggest trying different ovarian stimulating medications. Hopeful studies are emerging about the medication Letrozole, also known as Femara. Studies have shown that Letrozole may induce ovulation in some women with PCOS who do not respond to Clomid, as well as some women with unexplained infertility and Clomid resistance.
In one study, women with Clomid resistance and PCOS were more likely to ovulate when taking the medication Letrozole (79.3% ovulated), than when taking Clomid in combination with two, low dose injections of FSH therapy (56.59% ovulated). Pregnancy rates were also improved, with 23% of the women taking Letrozole achieving pregnancy, and 14% achieving pregnancy with the Clomid and two-injections of low-dose FSH combination.
Letrozole is not, however, sold as a fertility drug, and there is some controversy over the safety of its use. Letrozole can cause birth defects if taken during pregnancy. Many argue that the medication is safe and say that the drug should be out of your system by the time pregnancy occurs, though more research needs to be done.
Other options for treating Clomid resistance include low-dose gonadotropin therapy, with or without IUI treatment. This includes drugs like Gonal-F, Follistim, and Ovidrel, in other words recumbent FSH and LH fertility drugs. These drugs are more expensive and come with more side effects than Clomid, but they may induce ovulation when Clomid fails.
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