Clomiphene Citrate or Clomid is a widely known and common infertility medications. It is considered first-line fertility medication. The first successful clinical trial of Clomid was in 1967, and the FDA approved it back then. The success rate for treating irregular ovulation related problem using Clomid is remarkable. Till now, Clomid is highly popular for infertility treatment, primarily due to ovulation problems.
What is Clomid?
Clomiphene Citrate, commonly known as Clomid, is a non-steroidal fertility medicine. It is an oral medicine that stimulates ovulation. It makes the pituitary gland release hormones by blocking the hypothalamus’s estrogen receptors that control the body’s hormonal control center.
The hypothalamus is stimulated to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH naturally prompt ovulation.
In simple words, Clomid stimulates a woman’s ovary to release egg if she has irregular ovulation.
What Is Ovulation?
The process of releasing an unfertilized egg once every month is ovulation. It usually occurs on the 14th day of a women’s menstrual cycle.
Who Should Take Clomid?
Doctors prescribe Clomid to women who have polycystic Ovary Syndrome(PCOS). PCOS causes irregular or absent ovulation. It might not work for everyone.
Women with ovarian insufficiency or early menopause might not ovulate while taking Clomid. The medicine might not work on women who face absent ovulation due to being underweight. However, women with hypothalamic amenorrhea may not get any result from taking this fertility medicine.
How Does Clomid Work for Infertility?
Clomid makes your body think that your estrogen level is lower than they actually are. As a result, the pituitary gland starts discharging follicle-stimulating hormones, or FSH or LH. A high level of FSH or LH stimulates egg follicle or multiple follicle production and development in the ovary. All these will result in a mature egg during ovulation, which gives your higher chance for fertility.
Your doctor should prescribe this drug, and you should not take this drug without a doctor’s supervision. It is a long term process and takes several check-ups within. So you need to consult a doctor as the doctor will give instructions through the whole cycle.
After careful diagnosing, your doctor or gynecologist will give you the dosage instruction of Clomid. It usually starts with one tablet of 50mg for 5 days and maybe increased if needed. The doctor might increase the dose if someone does not ovulate having a smaller quantity.
The Clomid Cycle
Taking Clomid is not as easy as taking medicine. You have plan almost a month to take Clomid, along with your doctor. The cycle can vary from person to person, depending on their health. You have to keep track of everything. You have to do specific things on specific days. Here is a general idea of the cycle of this infertility medicine.
Day 1: Period Begins
The cycle will start when your period begins. It doesn’t have to be the first day; it has to be the day your full flow starts. That will be officially day 1 of your cycle. You should write down the date, as the later processes will depend on the starting date. If you have an irregular period, then the doctor might take other steps for it.
Day 2-3: Ultrasound
For the next step, your doctor will ask you to do a transvaginal ultrasound check. The doctor will look if there are any cysts in your ovaries. Usually, there isn’t any. In that case, you can continue with your cycle.
If the doctor finds cysts, don’t get scared. Your doctor might cancel the cycle, but the cysts disappear on their own and do no harm. The only problem is you have to wait another month for your next process.
Day 3 -5: Start Clomid
Now that you got the green light, your doctor will tell you to take Clomid. You have to take one dose of medicine for 5 days, preferably at the same time every day. You never start taking Clomid on the first day of the cycle. Usually, you take it on the 3rd or 5th day, as instructed by your doctor.
Day 3-9: Clomid Starts Effecting
Even though you will not realize at this point, but the Clomid starts working. It starts a chain reaction that will lead to ovulation. Firstly it will trick your brain as if you have unusually low estrogen that will cause to release more FSH and LH. The increase in FSH and LH will trigger ovulation.
Days 10-21: Follicular Growth Monitoring
Few days after your last intake of Clomid, your doctor will monitor your improvement. You have to get an ultrasound test every few days. The doctor will see if your follicles are growing. Based on that, your doctor will decide if you need a trigger shot, IUI, or intercourse.
If two follicles are matured size, you have a higher possibility of having twins; if three or more follicles are developed, your doctor might ask you to cancel your cycle.
Day 15-25: Trigger Shot
To boost your ovaries at the time of intercourse, your doctor might prescribe an injection. The injection is used in addition to Clomid and commonly known as the trigger shot. It triggers ovulation in 24 to 36 hours. Depending on your growth after monitoring, your doctor will fix a date for the trigger shot. Usually, the shot is given after 7 to 9 days after the last intake of Clomid.
Day 10-17: Intercourse
You will probably ovulate between 10 – 17 days of the cycle. If you are given a trigger shot, then you will get ovulation within the next 24-36 hours. Unless the doctor says, otherwise, you should start having sex. Three days after your last Comid pill intake, you should have sex every day or every other day until you are confirmed that ovulation occurred.
Day 19-21: Progesterone Blood Test
Typically, your doctor will order a progesterone blood test sometime between 19 – 21 days. Progesterone is a hormone that rises after ovulation. The test ensures that you had ovulation due to Clomid. It also indicates if the progesterone level is too low. If that is the case, the doctor may order a progesterone vaginal suppository.
Day 21-35: Wait 2 Weeks
This is probably the most challenging part of the cycle. As there is nothing much you can do. All you have to do is wait for 2 weeks. You have to wait to know if the cycle worked.
Day 28-35: Pregnancy Test
Finally, after almost a month, you can know if the cycle worked. The doctor may order a beta pregnancy test in the middle of your 2 weeks wait. Your doctor might ask you to take an at-home pregnancy test within 28-35 days of the cycle.
If you get positive, Congratulations! You are pregnant. Your cycle worked.
If It Doesn’t Work
If your result is negative, the probable reason could be your pregnancy hormone levels were not that high. Even if you got a period within the cycle, then Clomid might not have worked.
Don’t be upset or defeated if your cycle didn’t work. Your doctor can change the cycle planning or dose of Clomid for better results. You can try it again the next month as you can try three to six Clomid cycles. If Clomid does not work for you, that does not mean you cannot get pregnant. It means you need a different type of treatment.
Benefits of Clomid
Clomid is popular for infertility as it has several benefits. Women are more comfortable with this medication as it is an oral medication. Such as,
- Compared to other treatments, it is cost-effective.
- It is an oral medicine which is way more preferable
- Have fewer side-effects compared to other methods
- Generally well tolerated by women
Negative Sides of Clomid
Clomid is very safe in general, yet it can have some side effects. Though women hardly get most of the side effects. Here are some of the side effects that you should be aware of:
- Hot fleshes (most common)
- Breast Discomfort
- Nausea or vomiting
- Mood swings
- Blurry or double vision
Clomid is mostly a safe choice for infertility. But in some cases, it can be harmful. If you have any problem, you should tell your doctor before being prescribed Clomid. Do not take Clomid without consulting a doctor if you have the following conditions.
- Tell your doctor if you get abnormal vaginal bleeding.
- Do not use Clomid if you are already pregnant.
- Do not use it if you have uncontrolled adrenal gland, ovarian cysts, or thyroid disorder
- If you have a post or present liver disease
- If you have a tumor in your pituitary gland
We have briefly discussed every aspect of Clomid. Though it has been the choice of infertility women for being safe, don’t try it on your own. Always consult a doctor before taking this drug, as the timing and dosage may vary from person to person. For any confusion or discomfort while taking Clomid, feel free to ask your doctor or healthcare provider.