Fertility Medications: Clomiphene (Clomid)
What is Clomid?
Clomid, also sometimes called Serophene or clomiphene citrate, is a medicine in tablet form used to improve both the quality and timing of ovulation and to enhance implantation. It is helpful in many women who have menstrual cycle irregularities, who either do not ovulate or ovulate in a suboptimal way.
How does it work?
Clomid works in the brain by blocking estrogen receptors and fooling the brain into thinking that your body does not produce estrogen. As a result, the brain increases the amount of follicle stimulating hormone (FSH) available to act on the ovaries, and the ovaries will then produce one (or in some cases several) follicles which will go on to release eggs.
Though there are many potential side effects of Clomid, most women experience none or only a few. Some women experience hot flashes, mood changes, irritability, insomnia or visual symptoms. In addition, ovulation can be associated with pelvic pressure or cramping, which can continue throughout the cycle.
Clomid also has an increased risk of twins (approximately 5 to 10%) since more than one egg may be released, however, the incidence of triplets is exceedingly rare (less than 1 %). Hyperstimulation can occur if you have an unusually sensitive reaction, but is extremely rare.
If you are on the drug and have concerns about side effects, call to discuss these concerns. The incidence of birth defects, stillbirths, or even miscarriage is not increased with Clomid. The risks to you are also felt to be negligible, and the overwhelming weight of evidence does not support any increased risk of cancer, early menopause, or pregnancy complication.
How do we know it is working?
To make sure you are developing follicles and releasing eggs optimally, and that you are on the ideal dosage for you, ultrasound and blood work are quite helpful. Progesterone blood levels one week after ovulation helps to assess the effectiveness of your Clomid dose. We usually combine the use of clomid with two ultrasounds- a baseline scan and a day 12 scan, to ascertain whether a dominant follicle has formed.