Clomid: How it Works and What to Expect

Is Clomid the Right Fertility Medication for Me? Clomid, Infertility and Ovulation Induction


Clomid (clomiphene, clomiphene citrate) is among the most well-know and frequently prescribed of all fertility drugs. Clomid is taken orally and is considered a "first line" prescription fertility drug for dealing with infertility issues. Clomid is so widely prescribed that you may even find a "Clomid Club" on many preconception forums and communities. Clomid is used predominately for inducing ovulation in women with ovulatory disorders like anovulation, PCOS, and other infertility symptoms.

Clomid works by impacting hormonal production, by influencing the "fertility hormones" (estrogen, FSH, and LH) that precipitate ovulation. Like many prescription medications, Clomid works by "tricking the brain" into believing that estrogen levels in the body are low. This in turn encourages the brain to send signals to release more Gonadotropin Releasing Hormone (GnRH), which causes the pituitary gland to produce more FSH (follicle stimulating hormone) and LH (luteinizing hormone). LH is the hormone that facilitates ovulation (the release of the egg), and it's also the hormone used as the marker in urine ovulation testing.

Sounds complicated? In effect, clomid precipitates, through these various hormonal mechanisms, increased production of LH and FSH, which in turn foster a mature ovarian follicle and the release of the ovum. This is called ovulation induction. In more clinical terms, Dr. G. Berger notes: "Structurally like estrogen, clomiphene binds to the sites in the brain where estrogen normally attaches, called estrogen receptors. Once these receptor sites are filled up with clomiphene, they can't bind with natural estrogen circulating in the blood and they are fooled into thinking that the amount of estrogen in the blood is too low. In response, the hypothalamus releases more GnRH, causing the pituitary to pump out more FSH, which then causes a follicle to grow to produce more estrogen and start maturing an egg to prepare for ovulation".

Clomid is taken orally for about five days near the beginning of the cycle. Dosage and "start dates" will be indicated by the prescribing doctor. Once ovulation commences, most pregnancies occur in the first 6 cycles of treatment. While clomid has a high rate of success in inducing ovulation, it cannot guarantee pregnancy. Note: if you test too early for ovulation in your cycle with a urine ovulation test (lh), you may receive a false positive on an ovulation test when using clomid.

Fertility Supplements and Clomid: Currently, there are a number of herbal-nutritional supplements on the market containing vitex (chasteberry, vitex agnus castus). These products may be viewed as an herbal infertility therapy, and products like FertilAid and FertilityBlend are based on impressive clinical studies indicating that fertility can be improved with fertility supplementation. However, both of these manufacturers indicate that clomid should not be used in conjunction with vitex (or herbal infertility products in general). Fertility supplements like Fertility Blend and FertilAid are non-prescription. While on clomid, women are still encouraged to take a prenatal supplement with folic acid.

Well-known side effects of clomid include - you guessed it - multiple births (aka twins, triplets...). For women using clomid, twins may occur in 5% of births. Triplets are much less frequent. Although there has been some discussion linking prescription infertility treatments like clomid to ovarian cancer, evidence seems to point now to other causes, even infertility itself as a cause of some cancers. There is no evidence that clomid causes an increase in congenital abnormalities or birth defects in children.

Clomiphene and Clomid Abuse. While clomid cannnot be "abused" in any traditional sense, it can be prescribed (or rather over-prescribed) for infertility issues before a fertility workup has been performed, or before there is even any sign of ovulatory disorder, anovulation, luteal phase defect (LPD), PCOS, etc. Proper screening is essential prior to prescription. Given that male fertility issues constitute nearly 30% of infertility cases, a thorough evaluation and/or fertility workup should be performed on the woman to verify that ovulation induction via clomid is indeed required. For women without ovulatory/ovulation issues or infertility symptoms, clomid use may actually interfere with conception. Before accepting a clomid prescription, ensure that your doctor has performed the requisite infertility workup and/or has correctly identified a fertility issue or ovulatory disorder.

Women with liver disease should not use clomid. Clomid should not be given to patients with ovarian cysts, since they may grow larger. It should not be taken by a patient who may be pregnant, although there is no proof of fetal problems or complications.

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Comments

My ins does not cover clomid; however I got the generic brand at CVS for $20 for 5 pills prescribed by my gynocologyst. No work up was done. They did a blood test and it was determined I did not ovulated the month before. This is my second month. Fist month I too days 5-9 and used ovulation tests starting day 10-30 and never got a positive however when I went for the 21 day progesterone test it had said I ovulated so I missed it somehow. I am on month 2 and have decided to take day 3-7 to see if it makes a difference.

I have not been prescribed clomid but have gotten my hands on some. I have pcos and the doctor told me that i need to go in for fertility testing so I can get on clomid, My problem is my ins does not pay for fertility testing and they want the money upfront for testing and we are talking thousands of dollars. So I got some form the internet knowing I have pcos and that I am not ovulating I am going to take my chance with it. I am looking for advice on the best days to take it my CD's go from 38 to 46 and sometimes years apart. I dont want someone to tell me if you cant afford testing dont have kids I do have ins but fertility testing is out of pocket and even knowing i am the problem will only help me if i test me and my husband so thousands up front for both of us is out of the question when I have already been diagnosed it is kind of crazy. So again just looking for best days to take it and what to watch for so i know if i need to contact my doctor.

if my fsh level is already high, why increase it further? i don understand the consept. my fsh level is high, and its an uncomfortable feeling, the flashes, night sweat ect is unbearable. so is increasing fsh not increasing these thing.
thank hope u respond.

I have never heard of clomid before until yesterday, am thinking of trying it out without My Dr's prescription. Let God have his way. He promised in his word that he will do whatever we ask in His name accordind to his will. Praise God ,because he has done it already.

I was diagnose with PCOS about a little over a year now. I was prescribed Metiformin(sp?) for the first year of TTC to raise or lower some of my hormones. Since that ended up not doing much for me, my doctor then prescribed Clomid. I have always been one to have irregular cycles since I was 13, skipping 2 1/2 yrs once, and knowing you have to take Clomid during the middle or end of your bleeding period, I asked my Dr. what would I have to do if I end up skipping yet another month? He told me an alternate route of taking it two weeks later from the missed cycle. So that is what I did. However, on the last day of taking Clomid, a few hours I started my cycle, which was technically a week earlier than it was suppose to be. Anyway, my question is, is that normal or has anyone ever had that happen to them before? Not sure when i ovulate or time intercourse since now that I'm all screwed up. We are just afraid to miss the time to conceive!

for me i have a bitter story i was pregnant but lost the baby at 38 weeks.

i still put my faith in GOD by reminding of his promise to his children.
the bibble says for none shall be barren in thy land because we are fruitfull vines, what does fruitfull vine does? they replenish and by the grace of GOD we are fruitfull vines and we must replensh.

Mr Dr,
I am 24 year,every month 20th my pireid started, so after howmany days start clomid 50mg.& dosege,olso sendme ovulation calculation date. thanks

i got pregnant with my 3 year old boy with out taking n e medications after waiting 2 years to conceive but now dat he is bout to be 4 years old i want another kid but i cant get pregant cause i am very irregular with my menses so dr started me with provera is been 6 months now n finally gave me clomid i will start taking it this week on da 5th day of my menses i dont know if u guys can help but my quest is would it be easier for me to get pregnant with clomid since i dont have fertility problems its only dat i dont ovulate cause of irregularity Please help!!!

I'm 34, no birth control for over 8+yrs...regular periods every 27 days. Same partner 2yrs, semen analysis normal, HSG showed small fibroids but not large enough to prevent pregnancy. Starting my first round of clomid next week days 5-9. 50mg twice a day. I'm very nervous and anxious. I've heard both good and bad success stories about Clomid. Any advice is appreciated! My questions are:
What time of day should I take them?
Do I ovulate with regular periods?

let all those want babies not loose heart but be strong in faith.GOD is the greater life giver He give seed to the sower

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