Clomiphene citrate – more commonly known as Clomid – has been on the front lines of fertility for over 50 years, but, unlike the more advanced fertility technologies, pregnancy rates for women using Clomid have varied very little in that time. For many women trying to conceive, especially those under the care of their OB/GYN, Clomid is the first step on their fertility journey. Before beginning Clomid treatment, check out this helpful Clomid FAQ addressing many of the questions that patients have when using Clomid.
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Clomiphene, also known as Clomid or Serophene, is an oral medication used to induce ovulation. This anti-estrogen medication works by blocking the estrogen receptors in the hypothalamus. As a result FSH production by the pituitary gland increases resulting in the development of one or more follicles inside the ovaries. About a week after the last dose of Clomid, ovulation will occur when a surge of luteinizing hormone from the pituitary gland causes the developing egg inside the follicle(s).
Though it is generally well tolerated, it can lead to cervical mucus changes and have endometrial effects that could negatively impact success rates. This may explain why 80% of women taking clomid will successfully ovulate but fewer than 50% of patients will conceive.
I Clomid is typically prescribed for five days at the beginning of the menstrual cycle. This is long enough for the medication to normalize and induce ovulation.
Yes, while ovulation is an important part of conception it is equally as important the quality of the male partners sperm and the ability for the sperm to access an ovulated egg in the fallopian tubes. For this reason, a full fertility evaluation looking at the sperm quality through a semen analysis and that the tubes are open with an HSG should be completed prior to starting any treatment, including Clomid. Why spend time a treatment that may not work due to other, unforeseen factors?
Yes, but remember, a woman’s age plays a major role in pregnancy rates so patients over age 35 may want to consider transitioning to more advanced therapies sooner. Even in the normal, non-infertility population the percentage of women who are able to conceive diminishes with age, with the most noticeable decreases occurring after the age 35. As a result, the success rates with a Clomid/intrauterine insemination (IUI) cycle are lower for patients in their mid-late 40s.
No, as long as a complete infertility evaluation is performed, many women will prescribe Clomid to assist conception by their OB/GYN, especially women who experience irregular or absent menstrual cycles. Many patients that come to Shady Grove Fertility without any prior fertility treatment, when medically indicated, will start with Clomid and timed intercourse or an IUI before moving to other treatment options.
Yes, whether or not you are under the care of your OB/GYN or a fertility specialist, patients taking Clomid should monitor the process of their developing follicles through bloodwork and ultrasound usually on day 11 or 12 of their cycle. Monitoring helps to reduce the risk of multiples as well as time the cycle to determine the most opportune time for insemination, through either timed intercourse or IUI.
Once the follicles reach a certain size, a trigger shot, or an injection of a medication that causes ovulation, is given and the patient can be told the best time to have intercourse to achieve pregnancy. Depending on many factors including the quality of the male partners sperm, if donor sperm is going to be used or previous timed intercourse cycles were unsuccessful, an IUI may be suggested to increase the success rates.
After the first cycle, should ovulation not occur adjusting the medication dosage may help to achieve ovulation. In most cases after three cycles if you have successfully ovulated moving to a more advanced form of treatment is suggested.
Clomiphene citrate is most successful as the first line of treatment for women who experience irregular or absent menstrual cycles resulting in a 15 to 20 percent pregnancy rate per attempt. Patients who do not ovulate due to low weight amenorrhea or hypothalamic amenorrhea rarely respond to clomiphene citrate. Clomid success rates vary based on the age and diagnosis for each patient. The chart below outlines the chances of success using Clomid based on diagnosis.
If you have questions regarding infertility treatment or would like to schedule a new patient appointment, please call our New Patient Center at 877-971-7755 or click to schedule an appointment.
