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Clomid Overview
Clomid is a fertility drug that is given orally (by mouth)
for 5 days during each menstrual cycle. Clomid is usually taken
on cycle days 3-7 or 5-9 as determined by the physician. Cycle
day 1, by definition, is the first day of full flow of the menstrual
cycle. 
Clomid is a nonsteroidal agent with weak estrogenic
activity. This fertility drug works at the hypothalamus where it competes with
estrogen for binding sites. The hypothalamus then "reads"
lower estrogen levels and signals the pituitary to produce FSH,
which stimulates the ovaries.
Clomid induces ovulation, and once
ovulation is occurring, further increases in dosage are usually
not warranted. Success on this fertility drug is most likely to occur during
the first three to six ovulatory cycles of therapy and treatment
beyond six cycles is not usually recommended. Ovulation on Clomid can be documented using urinary test kits, measuring the level of progesterone and other methods. If pregnancy has not occurred after this time, in most cases, a fertility specialist should be consulted. Dr. Chantilis is a board certified fertility specialist located in Dallas, TX.
Clomid indications include the treatment
of patients with ovulatory dysfunction presenting with prolonged
cycles, irregular menses, and/or polycystic ovaries, to induce
ovulation. This fertility drug is sometimes utilized for unexplained infertility if a subtle ovulatory defect is suspected, or to enhance treatment
for male infertility.
The Clomid treatment cycle usually begins on day
3. A pelvic sonogram is ordered before starting clomiphene to
ensure that the ovaries are normal. Patients need to call the
office to schedule a baseline sonogram with the onset of menses.
Different women respond to Clomid in different
ways. Therefore, the initial starting dose may vary depending
upon patient age, weight, and other factors. The treatment plan
usually starts with clomiphene 50 mg (1 tablet) daily for 5 days.
If there is no evidence of ovulation, the dose of Clomid increases
by 50 mg daily for each subsequent cycle (as directed by the physician)
until ovulation occurs. If adequate ovulation has occurred, the
ovulatory dose is continued for 3 ovulatory cycles prior to further
evaluation. In some cases, physicians may combine Clomid with FSH.
- Multiple gestation- Clomid is associated with
a slightly increased risk (5-8%) of multiple gestation pregnancy
(more than one baby during pregnancy, i.e., twins, and rarely
triplets or more).
- Suspected Pregnancy- Clomiphene is contraindicated
during pregnancy. It is not to be used during pregnancy, or
suspected pregnancy. Please note, there is no evidence of an
increased risk of birth defects in women taking clomiphene before
pregnancy occurs.
- Liver Disease: Do not use this fertility drug in the presence of
active liver disease.
- Ovarian Enlargement: About 15% of patients will
notice ovarian cyst formation, possibly accompanied by abdominal
discomfort and/or bloating. These cysts usually regress without
treatment. There may be a mild mid cycle abdominal pain at the
time of ovulation, which is normal.
- Hot Flushes- Approximately 10% of patients will
have vasomotor symptoms known as hot flushes, a temporary feeling
of facial flushing, or tingling/numbness in extremities. These
are self- limiting.
- Decreased Cervical Mucus- Approximately
20-25% of patients will experience a decrease in the amount
of cervical mucus made, or a thin endometrial lining.
- Uncommon Clomid Side Effects:
- Nausea or Vomiting (2%)
- Breast Tenderness (2%)
- Visual Symptoms Approximately 1% of patients
will experience blurred or spotted vision. If this occurs,
discontinue Clomiphene use immediately and contact the office.
- Headaches (1%)
- Mood Changes
- Ovarian Cancer Risk: Some studies have suggested
that the use of fertility medications may increase the risk
of ovarian cancer. This finding has been refuted in other
studies, therefore, the true risk, if any, is unknown at
this time.
Learn move about the use of Clomid in stimulated IUI combined with FSH.
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