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clomiphene citrate
Clomiphene citrate is an oral ovulation induction drug. If your infertility problem stems from infrequent or absent ovulation, clomiphene citrate may be the first infertility treatment your healthcare provider recommends. Clomiphene citrate is relatively inexpensive, so some physicians will go ahead and prescribe treatment after the initial battery of fertility tests. If you don’t ovulate after three treatment cycles or don’t become pregnant after three ovulatory cycles, healthcare providers will often move on to more involved fertility tests.
Before you start on drug therapy, your healthcare provider will probably order some standard tests. These might include an endometrial biopsy to check for hyperplasia or cancer of the uterine lining if you’ve been anovulatory for a long time, as well as tests that rule out pituitary (prolactin), thyroid or adrenal disorders. Your partner should have a semen analysis done to check for sperm abnormalities.
Prior to taking the clomiphene, you should have an ovarian ultrasound to rule out the presence of ovarian cysts. If the cycle is unsuccessful and you are ready to begin another cycle, another ultrasound is warranted.
how it works
Clomiphene stimulates the body to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH), the necessary hormones for ovulation. Clomiphene does not directly stimulate ovulation, but instead returns the sequence of events surrounding ovulation to a more normal state. For women who don’t produce mature follicles, clomiphene can help develop mature eggs before ovulation.
how to take it
Clomiphene is usually taken orally for five days. You can monitor your progress at home by charting basal body temperatures (BBT) or using an over-the-counter ovulation predictor kit. However, your healthcare provider should determine the best strategy for monitoring the drug’s effect. Some might prefer that you come into the office, because multiple follicles may develop in response to clomiphene. You may have a transvaginal ultrasound to monitor your follicular development.
Your healthcare provider will advise you regarding dosing of clomiphene and the best times to have intercourse. However, if you don't ovulate or become pregnant after the first cycle, your healthcare provider may increase your dosage on subsequent cycles. If you don't become pregnant after three cycles of treatment, your healthcare provider may consider new options.
side effects
There are risks and side effects associated with clomiphene. Your healthcare provider will discuss important safety information with you when this product is prescribed. Read the clomiphene citrate Prescribing Information.
results
In clinical trials, successful therapy characterized by pregnancy occurred in approximately 30% of these patients. Of the reported pregnancies, almost 8% were multiple pregnancies (mostly twins).
Couples shouldn’t be discouraged if clomiphene cycles don’t result in a pregnancy, since this is the most conservative of several approaches. If you don’t become pregnant after treatment, your healthcare provider might combine clomiphene with other fertility drugs, or try a different approach altogether, such as gonadotropins.
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