Clomid (Clomiphene Citrate)
Clomid is a medication prescribed to regulate and stimulate ovulation. Researchers discovered Clomid’s effect on ovulation while studying it’s potential as a birth control pill.
Clomiphene is usually started on cycle day 3, 4, or 5 and continued for five days. The usual starting dose is 50 mg. and if ovulation does not occur the dose may be increased up to 150 mg. per day. Clomid is associated with an increased risk of multiple births (10% twins) and the risk increases when it is used with FSH. Side-effects of Clomid can include decreased cervical mucus, thinning of the endometrial lining and emotional irritability.
An infertility specialist should be consulted if pregnancy has not occurred within 3-6 cycles of Clomid treatment. Numerous studies show that treatment beyond this time is unlikely to be effective; yet, we sometimes see women who have taken Clomid for a year or longer. This increases the chance of side effects, is expensive and wastes valuable time. Egg quality can decline rapidly and there may be a short window where other more effective treatments can be tried.
Our specialists often use ultrasound during Clomid cycles to monitor follicle development. They also physically examine patients at regular intervals to check for side effects such as ovarian enlargement.
How Does Clomid Work?
FSH products (Gonal-F, Repronex, etc.) stimulate the ovaries directly whereas Clomid works at the hypothalamus, a small gland at the base of the brain. The hypothalamus monitors estrogen levels and when they are low it secretes gonadotropin releasing hormone (GnRH) to cause the pituitary to increase FSH production thus stimulating ovulation. Clomid occupies or binds estrogen receptors in the hypothalamus thus signaling the pituitary to increase FSH production.