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Common Fertility Medications Explained – Clomiphene

Dr. Ricardo Yazigiby Dr. Ricardo Yazigi, MD

Clomiphene (Clomid, Serophene) is a medication commonly used for the treatment of infertility. Although its use is widespread, its effectiveness is often limited when it is not properly utilized.

Indications

Clomiphene is a pill, taken orally, for 5 to 7 days to induce ovulation. Therefore, the best indication for the use of clomiphene is for women who do not ovulate on their own. Typically those women do not have menstrual periods or do have them but very seldom or irregularly.

Clomiphene is also appropriately used in conjunction with artificial insemination (AI), also called intrauterine insemination (IUI). Most of the time, this combined treatment is offered to women who have unexplained infertility or endometriosis. In these instances, clomiphene may be capable of facilitating the maturation of more than one egg, most of the time two. Therefore, there is roughly a 5% chance of a multiple pregnancy with the use of this medication. When multiple pregnancies occur, it will most often be twins – triplets are extremely rare.

Side Effects

Clomiphene may have short-term as well as long-term side effects. Hot flashes and mood swings are the most common side effects. Long-term side effects are multiple pregnancy, and more rarely ovarian hyperstimulation syndrome (OHHS) and ovarian cancer. OHHS can occur in the rare situation in which the ovary may have a large number of mature follicles, which can produce some swelling and inflammation of the ovary with resulting abdominal discomfort as well as other laboratory abnormalities. The occurrence of ovarian cancer is quite debatable. The standard practice at present is to restrict the use of fertility drugs to less than twelve cycles as the chances of ovarian cancer are thought to increase after that. When a pregnancy is achieved and a baby is delivered, however, the chances of ovarian cancer drop to the levels observed in the general population, suggesting that a term delivery has a protective effect on ovarian cancer. Because of the aforementioned risks of cancer, fertility specialists restrict the number of treatment cycle with clomiphene to the minimum necessary, in order to leave room for more advanced treatments if necessary.

Success Rates

Many women conceive with clomiphene. However, if you haven’t gotten pregnant after taking this medication within 3-6 months, it may be time to move on to more aggressive treatment. Generally, three rounds will be enough to determine whether more aggressive treatments are in order.

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