IVF Babble
How Does Clomid Work for Fertility?
Clomid explained

Clomid and fertility

Have you been prescribed Clomid for fertility? Clomid is one of the world’s most prescribed fertility drugs because it doesn’t need to be prescribed by a fertility specialist. It’s also an oral medication, so it doesn’t require injections or complex instructions. Best of all, it’s effective in triggering ovulation in up to 80% of patients. Of those, around 40% will get pregnant with Clomid, although this number decreases the closer you get to aged 40 and above. Are you planning to start taking Clomid? We’ve compiled a guide to everything you need to know about Clomid.

What is Clomid?

Clomid, also known as Serophene and clomiphene citrate, is a medication taken orally to help with female infertility. It’s commonly prescribed by GPs and gynaecologists to help women with ovulation. In the United States, it is also prescribed ‘off-label’ for male infertility.

Clomid comes in a 50 mg pill and is taken for five days at the beginning of your menstrual cycle. It’s typical to begin Clomid on day three, four, or five of your cycle. Your doctor will prescribe up to 200 mg of Clomid to be taken per day. It’s normal to start at a low dose and increase the dosage with each month. They’ll likely monitor your bloods and follicle count (via an internal scan) throughout your cycle. This information will help you determine when to have sex or schedule your intrauterine insemination (IUI).

In most cases, your doctor won’t want you to use Clomid for longer than six cycles, but this can depend on your dosage and results. Speak to your doctor and/or fertility clinic to learn more about your specific dosage needs.

How does Clomid work?

Simply put, Clomid makes your body think its oestrogen levels are lower than they actually are. These perceived lower levels send a signal to your pituitary gland to start working even harder and increase production of luteinising hormone (LH) and follicle-stimulating hormone (FSH). When you have higher FSH levels, your ovaries will produce multiple egg follicles, and LH levels stimulate and trigger ovulation.

When you ovulate, your ovary releases an egg around the midpoint of your menstrual cycle. This egg then travels down your fallopian tube. If it meets sperm, it may become fertilised. If not, it is absorbed back into the uterine wall and is shed during your next period. If you don’t ovulate regularly, it’s harder to get pregnant. You can’t easily predict your fertile window, and the entire process becomes even more stressful. That’s why Clomid can help.

How does Clomid work for men?

It’s important to note that Clomid is not approved for use in men in the UK. In fact, even though it is often prescribed off-label as a treatment for male infertility in the US, it hasn’t been FDA-approved for this purpose. Therefore, doctors in the UK will not prescribe Clomid for men, but fertility clinics in other countries will.

Clomid is prescribed to me to boost low testosterone levels and increase sperm count. Peer-reviewed studies have found conflicting results on its efficacy. While some men experienced a moderate increase in their sperm count when compared to placebo or untreated control groups, others saw no improvement. There was no consistent improvement. However, another recent study showed that Clomid might improve motility and sperm shape.

The UK is very cautious when it comes to approving fertility treatments and new medications. Based on the current studies, Clomid is unlikely to be approved for male use in the UK.

Clomid and Alcohol

Lots of our readers want to know – “can I drink alcohol while taking Clomid?” While Clomid doesn’t interact negatively with alcohol, do remember that alcohol can decrease your chances of pregnancy and reduces IVF success. Some women do report dizziness from Clomid, and alcohol can increase this effect. It’s also a good idea to speak with your GP or chemist to ensure that none of your other medications interact negatively with alcohol.

 

Success rates of Clomid

Success Rates of Clomid
By now, you might be wondering, “what are the success rates of Clomid?” Women who are taking the drug to promote ovulation have an approximately 80% chance of ovulating within three months of taking the drug. 40% of these women will conceive.

In a study of more than 4000 women on Clomid undergoing a round of IUI, different age groups experienced the following success rates:

  • 5% for women aged 35-37 years
  • 3% in women aged 38-40 years
  • 3% for women aged 41-42 years
  • 0% for women over age 42

Clomid and PCOS

Clomid is a common prescription for women with polycystic ovary syndrome (PCOS). PCOS is a chronic condition that causes ovarian problems, including irregular menstruation and ovulation. It can also cause an increase in male hormones, such as androgen, which can lead to thinning hair and excess facial and body hair growth. It also caused polycystic ovaries, in which your ovaries produce too many follicles (fluid-filled sacs).

Women with PCOS can and do get pregnant naturally, but the condition can make ovulation sporadic. That’s where Clomid comes into play. Clomid increases oestrogen levels and promotes regular ovulation. While it doesn’t work for everyone, it is a cost-effective and relatively simple fertility treatment that most people with PCOS try before moving onto other treatments.

When do you ovulate on Clomid?

Everyone is different, and it’s impossible to predict exactly when you’ll ovulate after taking Clomid. You’ll find plenty of Clomid ovulation calculators online, but these are really just taking a best guess based on your cycle, age, and dosage. You can track your ovulation by monitoring your basal temperature, peeing on ovulation test strips, or assessing your cervical mucus for an ‘egg white texture.’

Most women ovulate around 7 to 10 days after they take their last Clomid tablet. So the best time to have sex after Clomid is two days after you take your last tablet (likely day 10 of your cycle), and then regularly for 10 days.

While some people prefer to have sex every day while trying to conceive, others do it every other day. It can be easy to get fatigued and bored when having procreative sex every day, so try to spice things up and keep things interesting. Remember, there’s nothing wrong with a quickie!

Clomid Side Effects

As a fertility drug, Clomid is typically well tolerated by patients, but it does have some side effects that you should look out for. These side effects include:

  • Headaches
  • Bloating
  • Nausea
  • Mood swings
  • Hot flushes
  • Tender breasts
  • Blurred vision and double vision

Multiple Pregnancies

You should also note that taking Clomid does slightly increase your chances of multiple pregnancies. The risk increased by around 7% for twins, and .5% for triplets and quads. You should discuss your concerns with your doctor, and they may implement regular monitoring if you are worried about conceiving twins. While some people do search “how to take Clomid for twins,” twin pregnancies are always riskier, and most doctors recommend against specifically trying to conceive twins. 

Thinned Uterine Lining

Clomid affects your oestrogen lining, which can thin your uterine lining. A thick and healthy uterine lining is vital for embryo implantation, so this is something your doctor will want to monitor.

Cancer

While there is no conclusive data that Clomid increases the risk of cancer, any increase in oestrogen can heighten the risk of endometrial cancer.

Problems with Cervical Mucus

Your cervical mucus helps transport the sperm from your vagina up through the cervix into your fallopian tubes. Healthy cervical mucus should be thin and watery, but higher oestrogen levels can make it thicker. That makes it harder for the sperm to travel up into the uterus. If you are undergoing IUI or IVF, this won’t be an issue, as the insemination catheter does not rely on cervical mucus for success.

Taking Clomid Could Help You Conceive

So, does Clomid work? If you’re not ovulating regularly, Clomid could be a helpful treatment. It helps many women get pregnant by helping them to predict their ovulation and have sex at the right time.

It’s inexpensive and non-invasive, and most women find the side effects quite minor. Best of all, your GP or gynaecologist can prescribe it without the need for a referral to a fertility clinic. It’s worth trying Clomid before you move on to more invasive treatments. Good luck!

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Reference

With thanks to the fantastic experts at Manchester Fertility