Treating Infertility With Clomid: What To Know

by Jun 16, 2020

If you have discussed fertility treatment with your doctor you might have heard of Clomid. This is the most prescribed drug in fertility treatment and often the first one tried. So what is it, how does it work, and what other options are there?

drug capsule and flowers

If you are having issues conceiving you should start the discussion with your family doctor and OB-GYN. Before sending you to an expensive fertility expert they will most likely ask you some basic lifestyle questions, run tests, and discuss your treatment options.

Why would Clomid be prescribed?

Clomid is specifically designed for women who have issues ovulating. If you suffer from irregular periods or menstruation without ovulation, clomid could be a good choice. Unlike stronger fertility drugs it can be prescribed by your OB and is taken in pill form instead of being injected.

If you are just starting your fertility treatment and you have unexplained fertility clomid might be given as a first step. It is often chosen by couples as an alternative to more expensive treatments as they begin. For women with polycystic ovary syndrome (PCOS), Clomid is a common first fertility treatment.

Clomid restarted ovulation in 80 percent of women. That doesn’t mean they successfully conceived, but they started releasing eggs on a regular cycle giving them the chance to conceive naturally.

How does Clomid work?

In order to coax the body into ovulation, Clomid makes your body think your estrogen levels are lower than they really are. This decreased estrogen causes the body to increase secretion of FSH (follicle stimulating hormone) and LH (luteinizing hormone). The increased FSH stimulates follicle development and the increased LH stimulates ovulation.

Treatment usually starts with taking the same dosage for five days in a row at the same time of day. After a cycle (five days), your doctor may have you come back to measure hormone levels. Using your hormone levels as a guide they can help you time intercourse or decide if intrauterine insemination is needed. They will also decide what the dosage should be for the next cycle.

While using Clomid you can use a Mira ovulation tracker to measure the increase in LH and find your fertile window. Even though Clomid is less expensive and less invasive than other treatments it isn’t a long term treatment. Side effects and possible decreased fertility with long term use mean it is important to time intercourse to increase your chance of conceiving and minimize the length of use of the drug.

It is recommended that Clomid not be used for more than three to six cycles as prolonged use can lead to issues that might make it harder to get pregnant. Extended use of the drug can actually lead to thickened cervical mucus making it harder for sperm to get through to the egg.

Alternatives to Clomid

Even though Clomid successfully jump-starts ovulation in 80 percent of women who take it, it definitely isn’t for everyone.

About one in four women are clomid resistant, meaning ovulation doesn’t start again on clomid alone. Depending on why your doctor believes the drug isn’t working they might start you on a second medication in conjunction with the Clomid or move on to a different fertility treatment.

If you suffer from primary ovarian insufficiency, early menopause, lack of ovulation related to low body weight, or hypothalamic amenorrhea, Clomid most likely won’t work for you and you might want to consider alternative fertility treatments.

Femera or Letrozole are oral alternatives to Clomid that have similar ovulation success rates. Letrozole saw slightly higher pregnancy rates than Clomid, but this drug isn’t sold as a fertility drug. It is actually used as a cancer treatment to lower estrogen production and comes with its own set of side effects.

Remember Clomid is often just a first step in your fertility treatment journey. If it doesn’t work there are many other options to try and steps to take. It doesn’t mean you will have to jump right to more invasive and expensive treatments. Take your time, discuss your options with a trusted specialist and get to know your own body during this journey.

✔️ Medically Reviewed by Dr Roohi Jeelani, MD, FACOG and Lauren Grimm, MA

roohi jeelaniDr Roohi Jeelani is Director of Research and Education at Vios Fertility Institute in Chicago, Illinois. Dr Jeelani earned her medical degree from Ross University School of Medicine in Portsmouth, Dominica. She then completed a residency in Obstetrics and Gynecology and a fellowship in Reproductive Endocrinology and Infertility at Wayne State University, Detroit Medical Center, where she was awarded a Women’s Reproductive Health NIH K12 Research Grant. She is board certified in Obstetrics and Gynecology. Dr Jeelani has authored numerous articles and abstracts in peer-reviewed journals, and presented her research at national and international scientific meetings. A Fellow of the American College of Obstetrics and Gynecology, Dr Jeelani is a member of the American Medical Association, the American Society of Reproductive Medicine, and the American Association of Gynecologic Laparoscopists.

Lauren Grimm is Research Coordinator at Vios Fertility Institute in Chicago, Illinois. Lauren earned her bachelor’s degree from Loyola University Chicago, where she also completed her masters in Medical Sciences. Lauren has worked alongside Dr. Jeelani for the last 3 years, authoring a number of abstracts and articles in peer-reviewed journals, and presented her research at national and international scientific conferences. Lauren will be continuing her education this fall at Rush University Medical College in Chicago, IL as an MD candidate.

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