By: Stephen R. Lincoln, MD, FACOG Reproductive Endocrinologist
How does it work? Clomiphene Citrate is an oral medication that stimulates the release of FSH (Follicle Stimulating Hormone) from the pituitary gland. In turn, FSH stimulates the production and release of follicles from the ovaries. Clomiphene may be given to patients who do not ovulate regularly, who have an ovulation dysfunction, patients with unexplained infertility, or patients undergoing intrauterine insemination.
How is Clomiphene Taken? Clomiphene is administered orally with starting doses of 50-100 mg/day for five days (cycle days 3-7, 4-8 or 5-9). The dose of Clomiphene may be increased by 50 mg increments in order to achieve desired clinical results. Ovulation is expected to occur 4-8 days after the last tablet of Clomiphene is taken. The time and dose may be different depending on your medical history.
How do we determine that Clomiphene is working? If you have not been ovulating regularly, the presence of menstrual flow at the end of the treatment cycle is the most obvious sign of appropriate response to Clomiphene. Other methods of monitoring ovulation include basal body temperature charts, serial ultrasounds, urinary ovulation predictor kits and blood measurements of progesterone. Pregnancy is the ultimate confirmation that Clomiphene is working.
What side effects can be expected? Temporary hot flashes are the most common side effects of Clomiphene citrate. Temporary ovarian enlargement may cause abdominal discomfort. Less frequent symptoms include breast tenderness, headache, nervousness, moodiness, dizziness, nausea and vomiting, fatigue and visual disturbances. About 10% of women experience side effects, usually mild, from Clomiphene citrate. Approximately 90% of pregnancies resulting from Clomid are singleton births. Twins occur in approximately 9-10% of pregnancies and
<1% result in triplet pregnancies. The incidence of congenital malformations (birth defects) in children conceived while using Clomiphene is the same as in the general population. Additional information on Clomiphene is available on the pharmaceutical manufacturer's package insert, or directly from the manufacturer.
Does Clomiphene Citrate cause cancer? Clomiphene Citrate has been on the market for over 30 years. Some studies have suggested a small increase in the lifetime risk of ovarian cancer for patients who have taken the medicine for over 12 cycles. There is no evidence of any increased risks for patients who take Clomiphene for less than 12 cycles. We generally recommend a 3 - 6 month course of treatment and then moving on if no pregnancy has occurred.