Clomiphene Citrate (Fertility Drug)

For some couples, conception happens easily, while for others, it requires a lot of patience and effort and sometimes even fertility treatment. Clomiphene citrate, commonly known as Clomid, is the most widely used drug to trigger ovulation and the foremost medicine in fertility treatment.

What is Clomiphene Citrate?

Also known as Clomid, Clomiphene citrate is a nonsteroidal ovulatory stimulant in the Selective Oestrogen Receptor Modulator (SERM) class of drugs. It is generally the first medicine prescribed to a woman who does not ovulate regularly. The drug is specifically recommended for treating ovulatory dysfunction in patients having PCOS and different forms of amenorrhea. The doctor may prescribe different doses of clomid medication depending on whether you are unable to ovulate or you have irregular periods because of polycystic ovaries. You may be prescribed clomid alone or in combination with Metformin.

Why Should You Take Clomiphene Citrate?

Clomiphene citrate is prescribed by the doctor, to induce ovulation and is the first step in treating infertility in women. You require clomiphene when your body is not capable of developing a mature egg in the follicle, on its own. You may have a clomiphene citrate pregnancy in the following cases:

• You have irregular cycles or anovulatory cycles
• You have polycystic ovary syndrome (PCOS)
• You have unexplained infertility
• You do not want to opt for expensive and invasive treatments
• You are undergoing an intrauterine insemination (IUI) procedure

How Does Clomifene Citrate Work?

Clomiphene citrate (Clomid) acts as an agonist as well as an antagonist for oestrogen. It plays an important role in the development of mature follicles and boosts egg-production in the ovary. It works in the following ways:

• Clomiphene blocks the effects of oestrogen hormone in the body. This happens when it gets attached to the oestrogen receptors preventing the hormone from further binding those receptors
• This blockage effect tricks the brain into assuming that the oestrogen levels in the body are low
• Low levels of oestrogen trigger the release of two other hormones namely FSH and LH, which are essential for ovulation
• Follicle Stimulating Hormone(FSH) stimulates the follicles and helps in the ripening of eggs inside the follicles in the ovary
• Luteinising Hormone(LH) triggers the release of the mature eggs from the follicles to the fallopian tube

Clomid Success Rate

Using clomiphene for ovulation induction is an established and effective treatment. It is used to normalise the process of ovulation in women. 50 mg of clomiphene citrate’s success rate is quite high, and it is preferred in spite of mild side effects. About 70% to 80% women taking clomid ovulate in response to the drug while 40% may become pregnant and about 10- 12% may give birth. The odds of conceiving within the first six months or treatment with clomid are 50%.

Clomid success rates on first cycle depend on individual cases. A woman who is over 35, but has an ample number of eggs, may be benefited, but it may not prove very effective for those who are underweight or overweight.

Clomifene Treatment

The dosage of clomiphene citrate plays an important role in the success of the treatment. It is usually started with the lowest dose of 50mg and taken from day 3 through day 7 of your menstrual cycle. Some doctors may suggest that it be taken from day 5 to day 9 of your cycle. It is administered orally, and at the same time, every day for 5 days.

If you do not ovulate with the initial low dose of clomid, the doctor may increase your dosage by 50mg. This is repeated for subsequent cycles until the maximum dose of 250mg is reached. If you do not ovulate for 6 cycles, you will be taken off this drug and be prescribed an alternative treatment.

How Will You Know If You Ovulate?

Checking on your ovulation cycle is important when you are taking clomid, as it helps you by indicating your most fertile period. You can keep a check on your ovulation status in a number of ways. These include:

• Using ovulation predictor kits
• Keeping record of your Basal Body Temperature (BBT) every morning. The BBT increases when you are ovulating
• Getting your ovaries monitored through an ultrasound

How Long Need You Take The Clomiphene Citrate Treatment

It is recommended to continue clomiphene medication for a maximum of 6 months. Continuing the medication above a period of 6 months can cause certain adverse effects. This is because clomid has the anti-oestrogen properties that affect the endometrium lining and cervical mucus negatively.

How Long Does It Take To Get Pregnant On Clomid?

It has been observed that women who are most likely to conceive with clomid do so in the first three months of starting the therapy, with very rare chances after 6 months.

Side Effects Of Clomid (Clomifene Citrate)

Clomiphene citrate helps induce ovulation and assists conception in women who are unable to get pregnant naturally. Clomid may cause certain side effects because of its anti-oestrogenic properties. These effects generally disappear after discontinuing the medication. Some common effects include:

1. Nausea

caused by the increased production of progesterone

2. Breast Tenderness

due to the surge in progesterone

3. Abdominal Discomfort

There are chances of ovarian enlargement caused due to clomiphene citrate. This enlargement causes pain and distention in the abdomen

4. Mood Swings

Clomid can cause emotional or psychological side effects such as mood swings

5. Hot Flashes

Hot flashes, similar to those occurring during menopause, are often a side effect of clomid. These are not very severe but cause annoyance and discomfort

Other Risks Of Taking Clomiphene Citrate

Long term usage of clomiphene citrate is known to cause serious problems like ovarian cysts and can worsen infertility. Hence, it is advisable to take the medication as suggested by the doctor and only up to 4 to 6 cycles. The various adverse effects caused by clomid are as follows:

1. Thinning of the Endometrium

Clomid can result in a thin uterine lining, because of its anti-oestrogenic property. During a menstrual cycle, oestrogen causes the thickening of the endometrium. But in case of induced ovulation, clomid hinders the complete thickening process of the uterine lining

2. Less Cervical Mucus

Cervical mucus plays an important role in conception. It is the mucus, which helps the sperms survive and swim through to the uterus. Oestrogen assists in the production of clear, watery mucus by stimulating the cervical glands. Clomiphene, acts as anti-oestrogen decreases mucus production and thickens the mucus. This affects fertility

3. Ovarian Hyperstimulation Syndrome (OHSS)

OHSS is often reported by women using clomiphene citrate during the treatment of infertility. In some cases, it occurs when clomiphene is given in combination with the gonadotrophins. In this condition, the ovaries are enlarged with multiple follicles. This is accompanied by severe pain and swelling in the abdomen

4. Visual Disturbances

Many women taking clomiphene citrate have complained of blurred vision. In such cases, it is recommended to discontinue clomid

5. Risk of Multiple Pregnancies

The chances of multiple egg release are relatively higher with clomid usage. Clomid can cause twins in about 10% of pregnancies and less than 1% result in triplets or more

Things To Remember Before Taking Clomifene

Clomid is one of the most used conception aids in the market, as it helps you overcome your fertility issues and conceive. But, it has to be administered with certain precautions, so that it does not worsen your health or complicate matters. You should inform your doctor if you have any specific allergies or other medical ailments including:

• Hypersensitivity
• Kidney failure
• Liver failure
• Tumours
• Endometriosis

When To Not Use Clomifene?

Clomiphene is not recommended in cases where it can worsen the condition or may have no effect on the body at all. In such circumstances, it is better to avoid the drug and opt for alternate and treatment. Some of them are:

• Uterine abnormalities such as blocked fallopian tubes and fibroids
• Infertility issue in your partner
• Low ovarian reserves
• A history of cancers
• Poor response to clomid in the past

Frequently Asked Questions

Here are some of the FAQs that most women search for during their journey to conception with clomiphene citrate.

1. If I Took Clomiphene for 5 Days, What are the Chances I Can Get Pregnant?

Most women with ovulation problems get pregnant within 3 months of using clomiphene. After 5 days of taking clomiphene, you should wait for ovulation and have intercourse during the most fertile days. Your chance of getting pregnant are higher if you monitor your ovulation using a kit or ultrasound and have sexual intercourse just before ovulation.

2. Does Clomiphene Change Your Ovulation Day?

Yes, clomiphene can change your ovulation day. You usually ovulate 5 to 10 days after the last pill of clomid.

3. When to Have Sex When Taking Clomid?

Couples trying to conceive should have intercourse during the most fertile period of the cycle. Women ovulate 7 to 10 days after the last clomid pill taken, so, the fertile period can be considered between day 14 and day 19 of the cycle. It is recommended you have sex every other day from day 11 to day 21 of your cycle. If your clomid treatment is accompanied by an HCG injection, then you would be advised to have sex on the day of the shot and the following days. These steps will maximise the chances of fertilisation.

A useful drug for couples who are trying to conceive, clomid should always be taken in consultation with a doctor. Make sure you track your response to the medication being administered, and be prepared to opt for an alternative course of treatment if it does not work for you.

Disclaimer: This article is only indicative of the general use of Clomid, and should not be used as an absolute guideline. This fertility drug should be taken only on the doctor’s advise, and under close monitoring.