Clomid (Clomiphene) Fertility Treatment Side Effects
Are you trying to get pregnant or preparing for fertility treatment and considering taking Clomid?
Clomid is one brand name for Clomiphene citrate. This oral medication was one of the most popular fertility drugs for the past 50 years to improve the odds of conceiving. While there are potential benefits to taking Clomid, the medication also comes with the risk of side effects.
Before making any decision about taking Clomiphene to improve fertility, it’s important to understand how it works, the potential side effects and impact on your body, and how to manage any symptoms.
Was Clomid Discontinued?
The brand name Clomid was discontinued in the U.S. in 2017 and Clomid competitor Serophene was discontinued in 2018 due to supply chain issues. However generic forms of Clomiphene are still available on the market.
What is Clomiphene Citrate?
When taken as an oral medication, Clomiphene Citrate acts as a selective estrogen receptor modulator (SERM). Clomiphene is used primarily as a fertility medication or fertility treatment.
Clomiphene is commonly taken by women who have irregular menstrual cycles or other conditions that make them less likely to ovulate (produce eggs) on their own. Women taking Clomid or Clomiphene for fertility issues typically take it around days 5-10 of the menstrual cycle to help the body produce an egg.
How Does Clomiphene Induce Ovulation?
As a powerful estrogen receptor, Clomiphene triggers the pituitary gland in the brain to release hormones that in turn stimulate ovulation. Clomiphene induces ovulation by blocking estrogen receptors which in turn triggers the pituitary gland to make an increased amount of two hormones, called follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH tell the ovaries to produce and release a mature egg, which can then be fertilized during intercourse.
Who Should Take Clomiphene?
Clomiphene is most often used to treat female fertility in women with irregular ovulation or anovulation. Clomiphene is often taken by those with:
- Polycystic ovary syndrome (PCOS)
- Post-oral-contraceptive amenorrhea
- Pituitary gland dysfunction
All of these conditions can result in women experiencing anovulatory cycles in their typical menstrual period where no egg is produced or released. Clomiphene requires a prescription from a healthcare provider, so you should always follow the advice of your medical provider if you’re considering taking clomiphene.
Can Men Take Clomiphene for Fertility?
Clomiphene can be used for both males and females who are experiencing infertility. In people experiencing male infertility, Clomiphene tells the body to make more testosterone, which can increase the number of sperm that are produced. Males typically need to take Clomiphene most days of the month for it to work as intended.
Common Clomiphene Side Effects
Clomiphene has several common side effects. The most common side effects reported by people taking Clomiphene citrate are
- Weight gain
- Vision problems
- Hot flashes
- Breast discomfort.
Other possible serious side effects of Clomiphene fertility drugs include skin flushing, enlargement of the ovaries, vision changes, pelvic pain or abnormal vaginal bleeding, and worsening of mental health disorders or an increase in mood swings.
Clomiphene treatment is occasionally linked to worsening health conditions like high cholesterol or liver disease. Therefore it is important to only take Clomiphene under the direction of an experienced healthcare professional. Your healthcare professional will monitor you closely while you use this medication, and work with you to minimize discomfort with potential side effects.
Does Clomiphene Cause Pregnancy Risks?
For people who conceive using Clomiphene treatment, some traces of the medication may remain in their bodies for around six weeks. However, this is not thought to cause any problems for the baby. In past studies of people using Clomid or Clomiphene alternatives, the risk of birth defects does not seem to be higher than those who did not take the medication.
Clomiphene and Multiple Pregnancies
Because Since taking Clomiphene causes an increased amount of FSH and LH and can stimulate the release of more than one mature follicle, it is more common to conceive multiple pregnancies (twins or triplets) while taking Clomiphene when compared to a pregnancy conceived without the help of medication.
How to Tell if Clomiphene is Working for Ovulation?
Women taking Clomiphene can use a urine ovulation-predictor test to see if they are ovulating. However, you should always wait to take an ovulation test until a few days after finishing your dose for the month to ensure an accurate test result.
Clomiphene can cause a false-positive result in some cases, therefore you can also use other tests for ovulation such as an ultrasound to ensure that your ovaries are producing a mature egg.
What To Avoid When Taking Clomiphene?
Alcohol or tobacco can cause adverse interactions with certain Clomiphene medications and are not recommended during fertility treatment or pregnancy. Clomiphene can also cause interactions with other medications such as abrocitinib, bexarotene, fluoroestradiol F 18, and ospemifene. Make sure your healthcare provider is up to date on your current medication list before starting Clomiphene treatment
Clomiphene vs Other Fertility Treatments
Newer medications like Letrozole have been compared to Clomid. Letrozole is a popular fertility medication for those with PCOS in particular. When you meet with your healthcare provider to discuss your individual health history and the best treatment plan, they will review the options that are considered safe and effective for you to try.
Some cases of infertility are related to the female partner (female-factor infertility), some are related to the male partner (male-factor infertility), and some are a mix of both. In cases where both the female and male partners have some fertility concerns, your healthcare provider may recommend a procedure called intrauterine insemination (IUI).
During IUI, the male sperm may be obtained ahead of time, then inserted directly into the uterus during an in-office procedure. Your healthcare provider may recommend that you use Clomiphene prior to this procedure to improve the chances that your body produces a healthy egg, which can then be fertilized.
In cases where other treatment options have failed or are not available, your healthcare provider may recommend a procedure called in-vitro fertilization (IVF). During IVF, eggs are retrieved from a female and then joined with sperm in a lab to create embryos. These embryos are then placed inside the uterus of the person who is trying to become pregnant.
To have the best chance of creating several healthy embryos, many people will be placed on Clomiphene during the period of time known as egg retrieval. During this process, the female partner takes medications such as progesterone, estrogen, and Clomiphene, and then the healthcare provider sees them for a procedure to remove the eggs from the ovaries and take them to a lab.
Final Thoughts if You’re Considering Clomiphene
The use of clomiphene can help some people achieve pregnancy without going through more invasive and expensive medical procedures. In females, it can stimulate the ovaries to make healthy eggs. In males, it can help with some common hormonal causes of infertility.
If you have been trying to get pregnant without success, talk to your healthcare provider about whether Clomiphene tablets or another type of medication could be a good option for you.
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Mbi Feh, M.K. & Wadhwa, R. (2022) Clomiphene. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK559292/
Seli, E. & Arici, A. (2023). Ovulation induction with clomiphene citrate. UpToDate. https://www.uptodate.com/contents/ovulation-induction-with-clomiphene-citrate
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