What is Clomiphene Citrate? Can it help my fertility?

Clomiphene citrate is the generic form of the medication called Clomid. Clomiphene is part of a class of medications called SERMs (selective estrogen receptor modulators). These SERMs act to indirectly increase the body’s release of the hormone called FSH (follicle simulating hormone). FSH is made by the brain (specifically, the anterior pituitary gland), and this hormone is responsible for helping a woman ovulate an egg every month.

As the name suggest, FSH, stimulates a follicle to grow. A follicle is a fluid filled sac within the ovary which houses the egg. Every month, under the control of FSH, the ovary selects a dominant follicle, that will grow until it reaches a mature state. The egg then ruptures out of the follicle, and enters the fallopian tube where it waits for sperm to get fertilized.

Clomiphene helps increase FSH release from the brain. This is beneficial for women who don’t ovulate on their own and can also be beneficial for some women who do ovulate.

Women who do NOT ovulate:

In women that do not ovulate naturally, taking clomiphene can help increase their FSH level. Due to the brain’s endogenous increase in FSH levels, ovulation may take place. Think of FSH as fuel for the ovary. Some women with conditions such as PCOS (polycystic ovary syndrome) do not have enough fuel being directed to the ovary to allow ovulation to take place. Clomiphene helps increase FSH levels so that a follicle can become the dominant follicle that will mature until it releases the egg.

Women who do ovulate:

In women who regularly ovulate, clomiphene can still be taken, and this medication can again increase the amount of FSH hormone released by the brain. The higher levels of FSH act on the ovary, and may stimulate multiple follicles to grow and mature. This results in potentially ovulating more than one egg a month. When more than one egg is ovulated, there is a higher chance of fertilization by sperm, and subsequently a higher chance of conception.

A dominant follicle

A woman’s response to clomiphene can be monitored through the use of ultrasound to assess the growth of the follicles, how many eggs are expected to be ovulated and approximately when ovulation can be expected. Monitoring the response of clomiphene with ultrasonography is incredibly helpful and also provides useful information about planning a future treatment cycle if you do not get pregnant.

Women can also determine their response to clomiphene citrate by tracking their ovulation using urine ovulation predictor kits. These tests assess the urine for a hormone called Luteinizing hormone (LH) which peaks about 12-36 hours prior to ovulation.

Ovulation predictor kit

Side effects of Clomiphene citrate

As with all medications, side effects are possible after taking clomiphene. Some of these include:

  • Headaches
  • Hot flashes
  • Mood swings
  • Bloating
  • Weight gain
  • Visual changes
  • Breast tenderness
  • Multiple gestation (risk of conceiving twins, triplets, or more)

Before taking clomiphene, a full infertility evaluation is advised to ensure that this medication is safe for you and to ensure there are no other underlying cause of infertility.
Talk to your doctor about obtaining this testing, and if clomiphene is a medication that could help you.

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