Clomiphene is an ovulation-inducing fertility supplement. This drug is often the first step for a couple requiring fertility treatment and is prescribed under several different names. Other brand names for clomiphene include clomid and serophene.
Women suffer fertility problems for a variety of different reasons. Clomiphene supplements fertility in women who are struggling to get pregnant because their ovulation cycle is irregular or because their periods have stopped altogether. The action of the clomiphene supplement is to kick-start and regulate the ovulation process.
How Clomiphene Is Taken
Clomiphene is taken in pill form. You would usually begin taking the supplement between the 3rd and the 5th day of your menstrual period. You take the pill for five consecutive days. The usual starting dosage is 50 mg per day, but this may be increased after an unsuccessful cycle. Treatment with clomiphene will usually be prescribed for a period of three and six months only, to avoid risks to the health of the patient.
How Clomiphene Works
Clomiphene triggers the production of certain hormones which stimulate the ovaries to produce and release mature eggs which can be fertilized by sperm. The clomiphene blocks the brain’s estrogen receptors. The estrogen hormone regulates a woman’s menstrual cycle. When the brain’s estrogen receptors are blocked, the brain is “tricked” into thinking that the body’s estrogen levels are too low. As a consequence, the brain sends out signals to other parts of the body, telling them that they need to produce more hormones. The hypothalamus (a part of the brain) delivers a message to the pituitary gland (also in the brain) that the body needs more Gandatropin Releasing Hormone (GnRH). The increased levels of GnRH encourage the body to produce Follicle Stimulating Hormone (FSH). This encourages the follicles in the ovaries to grow and produce eggs. Approximately one week after the last clomiphene tablet is taken, the body’s increased levels of FSH trigger a surge in Luteinizing Hormone (LH) which in turn tells the ovaries to release the mature egg(s) they have been nurturing. The egg or eggs travel down the fallopian tubes where they can be fertilized by sperm.
Clomiphene And Timed Intercourse
Now that clomiphene has stimulated ovulation, the next task is to fertilize the egg that has been produced. If you take clomiphene, your fertility specialist will monitor your cycle and advise you when is the best time to have sex in order to boost your chances of conceiving.
Clomiphene And ART
Clomiphene may be taken to supplement Assisted Reproductive Technology (ART). Intrauterine Insemination (IUI) in particular, is one ART treatment which is often used in combination with clomiphene. Clomiphene is prescribed to trigger ovulation and, when ovulation occurs, IUI is used to introduce sperm directly into the uterus so that there is a higher chance of the egg(s) being fertilized.
Clomiphene supplements directly stimulate the ovaries which increases the possibility that the ovaries will produce more than one egg at a time. That is why clomiphene patients are more likely than women who conceive naturally to get pregnant with twins or triplets. Another risk of clomiphene is:
Ovarian Hyper Stimulation Syndrome (OHSS)
OHSS is usually mild and can be treated by drinking more water, however, in severe cases, the condition can be life threatening.
Symptoms of mild OHSS include: mild abdominal bloating and pain, mild nausea, and weight gain (perhaps five to 10 pounds in three to five days).
Symptoms of severe OHSS include: severe abdominal bloating and pain, nausea and vomiting, a decrease in urination, passing dark-colored urine, breathlessness and weight gain (perhaps ten pounds or more in three to five days).
In a worst case scenario, OHSS can cause blood clots, kidney damage and twisting of the ovaries.
Medical experts disagree on whether or not taking clomiphene increases a woman’s risk of developing ovarian cancer. A study published in 2009 found that there was no evidence to suggest that clomiphene supplements put women at a higher risk of developing the condition. The study looked at 50,000 women who took fertility drugs between 1963 and 1998, but was criticized for its relatively short follow-up on patients. Most women who develop ovarian cancer do so at around the age of 60. Critics said the study would need to continue monitoring these women until this age to gain more reliable results. In any case, for this and other reasons, clomiphene treatment is generally limited to between three and six months, to avoid any potential risks.