Clomid and Infertility

Trying to conceive and your doctor has recommended using Clomid. What will this drug do for you? And are there side effects you should know about?


 
So, you want to get pregnant but so far haven’t had much luck. Your doctor has run some tests and reviewed your menstrual cycle records and recommended using Clomid (clomiphene citrate) to help you. What will this drug do for you? And are there side effects you should know about?
 
Here’s what happens during a “normal” menstrual cycle. Shortly after your period starts, your estrogen levels drop. That’s a signal to your body that you are not pregnant this month, so it starts producing a hormone called gonadotrophin releasing hormone, which in turn stimulates the pituitary gland to produce follicle stimulating hormone. Just like the name says, that hormone (known as FSH) causes follicles in your ovaries to grow. Each follicle contains an egg. 
 
As the follicles grow, they start to produce more estrogen. When the estrogen level is high enough, another hormone is produced and signals the follicle to release the egg. Now conception can occur.
 
For some women who are trying to get pregnant, something in this system isn’t working correctly, and the hope is that the Clomid will get ovulation to happen. When Clomid is prescribed, it is taken early in your menstrual cycle (usually days three to seven or days five to nine). It works by blocking the estrogen receptors in your body, making the body think that your estrogen is very low. In response, your body produces more of the FSH, which will cause follicles to grow in your ovaries (and the growing follicles then produce more estrogen). 
 
With Clomid, about 80% of women who are not ovulating will ovulate, and about 40% of them will conceive. It is usually recommended that Clomid not be used for more than four to six months. This medication can be used in conjunction with some type of artificial insemination to ensure that the sperm has the maximum opportunity to reach the egg. 
 
Clomid does have side effects. One of them is an increased risk of having twins, triplets or higher multiples. One study found that about 7% of the pregnancies that occurred when the mother was taking Clomid were twin pregnancies (compared to a rate of less than 2% without fertility treatments). Starting with a low dose can reduce this risk. Other side effects include hot flashes, bloating, weight gain, mood swings, nausea, headaches, spotting, breast tenderness, vaginal dryness and blurred vision. Clomid should not be used if you are breastfeeding. 
 
What if Clomid doesn’t work? If you are still not conceiving after three cycles, your doctor may suggest using intra-uterine insemination in conjunction with the Clomid. Or he may suggest using a different medication which directly increases the amount of FSH in your system to see if that will do more to encourage ovulation. 
 

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