Fertility in a pill: Understanding Clomid and if it's right for you

Clomid (Serophene)

Clomid - it's a common name brand drug that some women consider when getting pregnant turns out to not be as easy as they thought it would. While no woman expects to have trouble conceiving, it happens to more women than you would think. If you have been trying to get pregnant for at least a year with no success you may consider seeing a specialist, and they might suggest a treatment like chlomiphene citrate (Clomid). Also called Serophene, Clomid is a brand name and if your doctor prescribes the generic chlomiphene, or one of the other titles, it's all the same drug and will produce the same effects. Clomid works by causing your body to ovulate, or release a mature egg from the ovaries for fertilization by a sperm.

Because about 25% of all fertility struggles are related to ovulation issues, the drug is a good choice. Relatively inexpensive, it's easy to take (as a pill only) and has about an 80% success rate in triggering ovulation. It is because of all of these reasons that Clomid is the most prescribed fertility drug on the market today; and probably why you are more familiar with it than other treatments. Chances are you know someone who has taken it and gotten pregnant which is why you may be considering it for yourself.

Who should take Clomid?

Whether or not Clomid is right for you will really be a decision that you and your doctor should make as a team, but there are a few guidelines to consider. Because Clomid causes ovulation, women with blocked fallopian tubes or other structural issues won't benefit from Clomid because the egg will not be able to travel through the tubes for fertilization and implantation in the uterus. Some medical conditions may not make Clomid a good option for you. Ask your doctor before taking Clomid if you have:

  • Are already pregnant (obviously)
  • Liver disease
  • Undiagnosed abnormal uterine bleeding
  • Uncontrolled thyroid or adrenal dysfunction
  • Endometrial cancer
  • Ovarian cysts not due to PCOS

Clomid may also be considered for women who have Polycystic Ovarian Syndrome (PCOS). Because these women often have trouble ovulating or don't ovulate at all, fertility drugs can help improve the chances of getting pregnant. It is also a cost effective first choice for couples who don't have the money for more invasive fertility treatments like IVF - which can cost up to $10,000 or more per treatment and may or may not produce a pregnancy. For women who have trouble with their periods - either they aren't having them at all, the timing is all wrong, or are having a period without ever ovulating, Clomid can help and may be tried before other types of treatment.




What kind of side effects does Clomid produce?

For the most part, Clomid produces only mild side effects, but since it does alter your hormones some women may have more ups and downs than others. Of course the most well-known side effect is the potential for more than one baby. You have about a 10% chance of twins if using the drug and only a 1% chance of having more than two. The most common side effects include:

  • Potential for multiple births (especially if taking higher doses of the drug)
  • Ovarian enlargement
  • Flushing
  • Abdominal discomfort
  • Blurred vision and visual disturbances
  • Nausea/vomiting
  • Breast pain
  • Mood swings

Some less frequently reported symptoms are:

  • Insomnia
  • Nervousness
  • Headache
  • Dizziness

If you are taking Clomid and your symptoms are severe enough to keep you from enjoying everyday activities, you should talk to your doctor.

There are no documented dangerous drug interactions with Clomid, but make sure to tell your doctor about any over the counter, herbal supplements, or prescription medications you are taking before Clomid is prescribed.

The dosing schedule: Keep a calendar handy

A woman's hormonal cycle is delicate and precisely timed, and for that reason Clomid must be taken on a set schedule for maximum benefit. Every doctor may adjust the dosing schedule a bit, so follow your doctor's recommendations, but you can usually expect something like this:

  • 50 mg to start, taken for five days on days 3-7 of your cycle or days 5-9 of your cycle. We are assuming that day one is the first day of bleeding (not spotting) of your period. Research has shown that regardless of whether you start your Clomid on day 2 or day 5, conception rates appear to be the same so don't disagree with your doctor if he or she suggests a schedule that's different than this.
  • If no results from your first round, your doctor may increase your dose to 100 mg at his or her discretion, or may keep the dose at 50 and try another cycle. Doses over 150 mg may actually make conception more difficult and your chances of having more than one baby increase as you increase the dosage.


What if Clomid doesn't work?

Most women are allowed to try six cycles or so of Clomid - if nothing happens, it will be time to look at other options for treatment and a bit more testing. It is estimated that the drug will cause 75% of women to ovulate leaving another 25% looking for answers. Your doctor may try increasing your dose and could go very high - as much as 250 mg in an attempt to get a response from your body. If still there is no result you may be labeled as "Clomid resistant" meaning that your body just doesn't respond to the drug as planned. No big deal. Your doctor may suggest treatments to help your body respond to Clomid, but if not, you move on.

Your doctor may also evaluate other issues - such as insulin resistance if you have been diagnosed with PCOS, and even your body mass index or BMI. BMI is a fancy way of saying your weight to height ratio; women who have a high BMI may be classified as overweight or obese - an issue that has been shown to affect fertility. Weight management, hormonal evaluations and a closer assessment of your pelvic structures will also help your doctor determine what treatments could help you get pregnant and then he or she will make recommendations for you. Just because Clomid doesn't work won't mean you should be planning a trip to the bank for a second mortgage for IVF... there are still other options.

Staying positive in the face of struggle

When getting pregnant doesn't turn out like you had hoped, it's easy to get discouraged. Perhaps Clomid will work for you on the first cycle, but if not don't lose heart. Be patient and do your best to reduce your stress and keep your body healthy as you undergo treatments. Expect many emotional ups and downs and rely on your support system to get through these days - hopefully at the end you will reap the reward of becoming a parent.