Since the 1960s, Clomid, or Clomiphene, has been most commonly used as a first-line treatment for ovulation introduction in women with ovulatory failure. As far as fertility treatments go, Clomid is relatively cheap, effective, widely available, and the body can tolerate it very well. Clomid works by blocking estrogen receptors on the hypothalamus, causing them to “believe” there is an estrogen deficiency in the female’s body. The hypothalamus then sends signals to the pituitary gland to release both a follicle stimulating hormone (FSH) and a luteinizing hormone (LH) which causes the growth of the follicles.

Clomid is typically a successful mode of treatment, with induced ovulation ranging from about 70-80% of selected patients, and a pregnancy rate of about 30-50% following up to six cycles of treatment. There is even a risk of twin pregnancy in about 10% of patients and a high risk of multiple pregnancy of about 1%. However, patient who are known to be resistant to Clomid, a second-line treatments may be considered depending on clinical circumstances. Some doctors may try laparoscopic ovarian drilling or combined treatment with clomifene citrate and metformin, if they have not already had tried this as first-line treatment or gonadotrophins.

How Should You Take Clomid?

A doctor will usually prescribe a 50 mg pill dosage of Clomid (Clomiphene) for 5 days e.g. from 2-6 days or 5-9 days of the menstrual cycle. The pregnancy may be excluded before taking Clomid if the patient’s period becomes infrequent or stops altogether. If you are not pregnant your doctor may prescribe progestogen tablets to be taken orally to induce a withdrawal bleed so you can take the tablet on day 2 of the withdrawal bleed. If ovulation does not occur, the dosage can be doubled or trebled if ovation does not occur.

The physician will measure blood progesterone levels around day 21 to 23 of the treatment cycle (i.e. ovulation) to determine whether the patient is responding to treatment. The starting dose of Clomid should only be increased if there is no response after the second cycle of treatment because of those women who will respond to 50 mg dose, only two thirds will do so in the first cycle. Ovulation tends to occur about a week after the last pill if the treatment is proven successful.  Doctors typically advise their female patients to have intercourse every other day for about a week, starting five days after the last pill.

Side effects from Clomid are usually uncommon but may include hot flushes, nausea, mood changes, and headaches, flashes of light, blurred vision, ovarian cysts, or abdominal discomfort. It is normally recommended that Clomid not be taken for more than 6 months to prevent these types of disorders, including reducing the risk of ovarian cancer. Clomid may also alter the quality of cervical mucus in high doses, making it thick, and possibly also effecting the endometrium making it less receptive. It is recommended that if ovulation has not been achieved after four treatment cycles, the patient is considered unresponsive and treatment using Clomid is discontinued.

References

Clomid Side Effects Center. (2014). Retrieved from www.rxlist.com: http://www.rxlist.com/clomid-side-effects-drug-center.htm

Clomid Treatment. (2014, April 3). Retrieved from www.about.com: http://infertility.about.com/od/infertilitytreatments/a/clomid101.htm

Fertility drug: Clomiphene. (1997-2004). Retrieved from www.babycenter.com: http://www.babycenter.com/0_fertility-drug-clomiphene_6186.bc

When Clomid Does Not Achieve Ovulation. (2014, May 18). Retrieved from www.about.com: http://infertility.about.com/od/clomid/a/clomidovulation.htm