Drinking while on clomid

Clomid

Clomid is a brand name of the prescription drug clomiphene.

Clomid improves fertility by stimulating egg release in women and increasing sperm production in men.

Clomid belongs to a group of drugs known as selective estrogen receptor modulators (SERMs).

SERMs bind to areas on the outside of cells where estrogen normally binds, either enhancing or decreasing the effects of estrogen.

The Food and Drug Administration (FDA) first approved clomiphene under the brand name Clomid in 1967. Sanofi Aventis manufactures the drug.

Clomiphene is also marketed under the brand name Serophene.

Clomid in Men

Although some doctors prescribe Clomid to encourage sperm production, no major studies supporting this effect or showing that it improves fertility in men exists.

Some men taking Clomid for fertility may develop tumors in their testicles or enlarged breasts.

According to anecdotal reports, some athletes take Clomid to enhance their physical performance in sports.

In fact, some professional sports associations, including the National Football League (NFL), have banned Clomid use by their athletes.

Clomid Warnings

Clomid is not safe for everyone. Tell your doctor before taking Clomid if you:

  • Are allergic to clomiphene or any other ingredients in the drug
  • Are pregnant
  • Have liver disease
  • Have abnormal bleeding from the uterus
  • Have cysts on your ovaries that are not caused by polycystic ovarian syndrome (PCOS)
  • Have thyroid disease
  • Have cancer of the lining of your uterus (endometrial cancer)
  • Have a pituitary gland tumor
  • Have an adrenal gland disorder
  • Have a head injury

Pregnancy and Clomid

Clomid can harm your unborn baby and can cause birth defects or miscarriage.

Since Clomid may pass into breast milk or slow milk production, doctors warn breastfeeding mothers to avoid taking drug.

Clomid should not be taken if you are pregnant, so tell your doctor if you are or may be pregnant.

Clomid Twins and Ovulation Calculator

There are a number of anecdotal reports online and elsewhere that Clomid, when used for fertility, can increase your likelihood of conceiving twins.

Some research also suggests that using Clomid results in twins about 10 percent of the time.

There are also a number of online tools that are purportedly designed to assist you in deciding when to take Clomid, based on your (or a woman’s) ovulation cycle.

However, you should only take Clomid as directed by your doctor. Ask your doctor to advise you on the best dosing schedule for you.

SIDE EFFECTS

Clinical Trial Adverse Events.

CLOMID, at recommended dosages, is generally well tolerated. Adverse reactions usually have been mild and transient and most have disappeared promptly after treatment has been discontinued. Adverse experiences reported in patients treated with clomiphene citrate during clinical studies are shown in Table 2.

Table 2. Incidence of Adverse Events in Clinical Studies (Events Greater than 1%) (n = 8029*)

Adverse Event %
Ovarian Enlargement 13.6
Vasomotor Flushes 10.4
Abdominal-Pelvic Discomfort/Distention/Bloating 5.5
Nausea and Vomiting 2.2
Breast Discomfort 2.1
Visual Symptoms
Blurred vision, lights, floaters, waves, unspecified visual complaints, photophobia, diplopia, scotomata, phosphenes 1.5
Headache 1.3
Abnormal Uterine Bleeding 1.3
Intermenstrual spotting, menorrhagia
*Includes 498 patients whose reports may have been duplicated in the event totals and could not be distinguished as such. Also, excludes 47 patients who did not report symptom data.

The following adverse events have been reported in fewer than 1% of patients in clinical trials: Acute abdomen, appetite increase, constipation, dermatitis or rash, depression, diarrhea, dizziness, fatigue, hair loss/dry hair, increased urinary frequency/volume, insomnia, light-headedness, nervous tension, vaginal dryness, vertigo, weight gain/loss.

Patients on prolonged CLOMID therapy may show elevated serum levels of desmosterol. This is most likely due to a direct interference with cholesterol synthesis. However, the serum sterols in patients receiving the recommended dose of CLOMID are not significantly altered. Ovarian cancer has been infrequently reported in patients who have received fertility drugs. Infertility is a primary risk factor for ovarian cancer; however, epidemiology data suggest that prolonged use of clomiphene may increase the risk of a borderline or invasive ovarian tumor.

Postmarketing Adverse Events

The following adverse reactions have been identified during post approval use of Clomid. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Body as a Whole: Fever, tinnitus, weakness

Cardiovascular: Arrhythmia, chest pain, edema, hypertension, palpitation, phlebitis, pulmonary embolism, shortness of breath, tachycardia, thrombophlebitis

Central Nervous System: Migraine headache, paresthesia, seizure, stroke, syncope

Dermatologic: Acne, allergic reaction, erythema, erythema multiforme, erythema nodosum, hypertrichosis, pruritus, urticaria

Fetal/Neonatal Anomalies:

  • Abnormal bone development: skeletal malformations of the skull, face, nasal passages, jaw, hand, limb (ectromelia including amelia, hemimelia, and phocomelia), foot (clubfoot), spine, and joints
  • Cardiac abnormalities: septal heart defects, muscular ventricular septal defect, patent ductus arteriosus, tetralogy of Fallot, and coarctation of the aorta
  • Chromosomal disorders: Downs syndrome
  • Ear abnormalities and deafness
  • Gastrointestinal tract abnormalities: cleft lip and palate, imperforate anus, tracheoesophageal fistula, diaphragmatic hernia, omphalocele
  • Genitalia abnormalities: hypospadias, cloacal exstrophy
  • Lung tissue malformations
  • Malformations of the eye and lens (cataract)
  • Neoplasms: neuroectodermal tumor, thyroid tumor, hepatoblastoma, lymphocytic leukemia
  • Nervous system abnormalities: neural tube defects (anencephaly, meningomyelocele), microcephaly, and hydrocephalus
  • Renal abnormalities: renal agenesis and renal dysgenesis
  • Others: dwarfism, mental retardation

Gastrointestinal: Pancreatitis

Genitourinary: Endometriosis, ovarian cyst (ovarian enlargement or cysts could, as such, be complicated by adnexal torsion), ovarian hemorrhage, tubal pregnancy, uterine hemorrhage, reduced endometrial thickness

Hepatic: Transaminases increased, hepatitis

Metabolism Disorders: Hypertriglyceridemia, in some cases with pancreatitis

Musculoskeletal: Arthralgia, back pain, myalgia

Neoplasms: Liver (hepatic hemangiosarcoma, liver cell adenoma, hepatocellular carcinoma); breast (fibrocystic disease, breast carcinoma); endometrium (endometrial carcinoma); nervous system (astrocytoma, pituitary tumor, prolactinoma, neurofibromatosis, glioblastoma multiforme, brain abcess); ovary (luteoma of pregnancy, dermoid cyst of the ovary, ovarian carcinoma); trophoblastic (hydatiform mole, choriocarcinoma); miscellaneous (melanoma, myeloma, perianal cysts, renal cell carcinoma, Hodgkin’s lymphoma, tongue carcinoma, bladder carcinoma)

Psychiatric: Anxiety, irritability, mood changes, psychosis

Visual Disorders: Abnormal accommodation, cataract, eye pain, macular edema, optic neuritis, photopsia, posterior vitreous detachment, retinal hemorrhage, retinal thrombosis, retinal vascular spasm, temporary or prolonged loss of vision, possibly irreversible.

Other: Leukocytosis, thyroid disorder

Read the entire FDA prescribing information for Clomid (Clomiphene)

Ya’ll should be glad I’m writing this post now. Because right now I feel pretty good, hopeful and, well, sane. Talk to me in a few hours though and you might just get an entirely different Jenn. Why? Because I just took Clomid for the first time. And the side effects—for me at least—have been up, down and all around.

I thought it would be “fun” to keep a Clomid side effects journal of sorts. Turns out, the joke was on me. Here’s a play by play of my experience! (And note that I took Clomid from cycle days three to seven. While the worst side effects were felt during those first five days, I had plenty of the crazy after—especially when it was combined with more anxiety-producing doctor’s visits.)

Clomid Side Effects Day by Day

Day 1: After waiting to start my period so that I could start Clomid, I’m almost giddy today at the excitement of actually finally getting pregnant. I’m still on my period, so I have mild cramps now and again, but I’ve been nothing but happy today. Okay, maybe a little overly sentimental, as while walking around the neighborhood I thought about walking with my future kids, and I happily teared up at the idea. Then, a little later in the day, I was listening to a Smashing Pumpkins song that reminds me so much of meeting my husband in college that I happy-cried again. And despite really, really wanting to listen to The Bodyguard soundtrack this afternoon (guilty pleasure, what can I say?), I decided it best to not tempt the Clomid with the Whitney Houston.

Day 2: Woke up super excited again, and then my mood quickly shifted to big-time cranky pants. I have been super annoyed by little things. Like the sirens being tested today at noon? Rage producing. Afternoon into the evening, a commercial could make me cry, which isn’t uncommon but isn’t commonplace either. And my desire to work? None whatsoever. Although that may have more to do with working long hours and it being gloriously springy outside. Oh, also bloated and extra hungry today. Grr.

Day 3: After mood swings yesterday, I spent most of the day feeling tentatively normal…but waiting for the crazy. I’m still bloated yet am happy to report that my hunger is back to normal. Feeling a little on edge and not quite myself, but the real mood swing came around 5 p.m. when I had a random crying outburst and a general poor-me feeling that “We’ll never have kids,” over and over. A bit over-dramatic. A bit.

Day 4: Despite having a hot flash (my first on Clomid!) in the middle of the night and waking up in sweat, I slept great and woke up feeling great. Fast forward to lunch where I made the mistake of watching Parenthood. Gets. Me. Every Time. Triggered bawling. Thankfully, it was short lived. I had some slight stress/rage-out in the afternoon, but then I was pretty normal for the rest of the night. I’ll take it!

Day 5: Happy it’s my last day taking Clomid, and feeling good thus far. Warm and tingly down there. A good sign of growing eggs? Hmmm. Keep telling myself to “not over-think it…”

Days 6-9: Normal. Thank the Lord.

Day 10: Um, not normal. Back to crying. Nervous for my appointment tomorrow that will tell us how my body is responding. Headache. Oh, ouchy headache.

Day 11: I’m not sure how much I can blame Clomid side effects for this one, but cue complete breakdown No. 1. I’m frustrated, angry, depressed and just everything all at the same time. Lots of crying. Appointment shows some progress, but not ready to ovulate yet. More headache. Another couple of hot flashes that night.

Day 12: Normal. Hallelujah!

Day 13: Complete breakdown No. 1 doesn’t have anything on today. The doc says Clomid is still making my hormones run amok making me nutters, and I have a full-out angry-at-the-world/I-might-as-well-plan-my-child-free-life-now outburst. It involves, yelling, crying and staring into space with the reality that I am unable to have a child without drugs and medical help. Sigh. Thankfully, after all of this, my appointment shows progress and that we might have a chance to “try” this month. Finally. I’m flooded with a sense of relief.

Day 14: Normal. Hopeful.

The rest? Well, that remains to be seen. Throughout all of the Clomid side effects, I really felt like I was on an emotional roller coaster and most definitely an emotional detox. It was like I was a teenager again—minus the insecurities and the constant desire to sneak out of the house to make out with my boyfriend. I had feelingscome out of me that have probably been waiting there for months, if not years. They all just bubbled up and out through crying spurts that rocked me to my core. Almost as if layer after layer, walls I’d built up over time started to erode. So much so that I had no choice but to be vulnerable, raw and almost beaten down.
But after every emotional event passed (almost as soon as it came—until those last few), I did feel better and more real. And in the process, I’ve learned a great deal about myself. I do want children. I will go through what it takes to do this. And it’s okay to let other people support you. It’s okay to be real and yourself, even when that self is hurting like an overemotional mo-fo.

And I think my husband summed it all up best when he said: “If you’re this emotional from the Clomid, then obviously it’s working, right?” Heck, yes. Fingers crossed that this crazy ride is coming to a close—so that our new ride can begin.

For those who have been in this situation, what type of Clomid side effects did you have? Did you become highly emotional, too? And were you—in a twisted sort of way—kind of glad you went through it? —Jenn

Clomiphene Side Effects

Medically reviewed by Drugs.com. Last updated on Nov 23, 2018.

  • Overview
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For the Consumer

Applies to clomiphene: oral tablet

Along with its needed effects, clomiphene may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking clomiphene:

More common

  • Bloating
  • stomach or pelvic pain

Check with your doctor as soon as possible if any of the following side effects occur while taking clomiphene:

Less common or rare

  • Blurred vision
  • decreased or double vision or other vision problems
  • seeing flashes of light
  • sensitivity of eyes to light
  • yellow eyes or skin

Some side effects of clomiphene may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Hot flashes

Less common or rare

  • Breast discomfort
  • dizziness or lightheadedness
  • headache
  • heavy menstrual periods or bleeding between periods
  • mental depression
  • nausea or vomiting
  • nervousness
  • restlessness
  • tiredness
  • trouble in sleeping

For Healthcare Professionals

Applies to clomiphene: compounding powder, oral tablet

General

At recommended doses, this drug is well tolerated. Most side effects have been mild and transient and disappear promptly after treatment has stopped.

Genitourinary

Very common (10% or more): Ovarian enlargement (up to 13.6%), vasomotor flushes (10.4%)

Common (1% to 10%): Abdominal/pelvic discomfort/distention/bloating, breast discomfort, uterine bleeding abnormal, intermenstrual spotting, menorrhagia

Frequency not reported: Urinary frequency increased, urinary volume increased, vaginal dryness

Postmarketing reports: Endometriosis, ovarian hemorrhage, tubal pregnancy, uterine hemorrhage, reduced endometrial thickness, ovarian hemorrhage, tubal pregnancy, uterine hemorrhage, endometrial thickness reduced

Fetal/Neonatal Patients:

-Postmarketing reports: Hypospadias, cloacal exstrophy

Ocular

Postmarketing reports: Abnormal accommodation, cataract, eye pain, macular edema, optic neuritis, photopsia, posterior vitreous detachment, retinal hemorrhage, retinal thrombosis, retinal vascular spasm, temporary or prolonged loss of vision

Fetal/Neonatal Patients:

-Postmarketing reports: Eye malformed, lens malformed/cataract

Cardiovascular

Postmarketing reports: Arrhythmia, chest pain, hypertension, palpitation, phlebitis, tachycardia, thrombophlebitis

Fetal/Neonatal Patients:

-Postmarketing reports: Septal heart defect, muscular ventricular septal defect, patent ductus arteriosus, tetralogy of Fallot, coarctation of aorta

Endocrine

Postmarketing reports: Thyroid disorder

Fetal/Neonatal Patients:

-Postmarketing reports: Dwarfism

Oncologic

Frequency not reported: Ovarian cancer, ovarian tumor

Postmarketing reports: Ovarian cyst, hepatic hemangiosarcoma, liver cell adenoma, hepatocellular carcinoma, fibrocystic disease, breast carcinoma, endometrial carcinoma, astrocytoma, pituitary tumor, prolactinoma, neurofibromatosis, glioblastoma multiforme, brain abscess, ovary (luteoma of pregnancy, dermoid cyst of the ovary, ovarian carcinoma, hydatiform mole, choriocarcinoma, melanoma, myeloma, perianal cysts, renal cell carcinoma, Hodgkin’s lymphoma, tongue carcinoma, bladder carcinoma

Fetal/Neonatal Patients:

-Postmarketing reports: Neuroectodermal tumor, thyroid tumor, hepatoblastoma, lymphocytic leukemia

Nervous system

Common (1% to 10%): Headache

Frequency not reported: Dizziness, lightheadedness

Postmarketing reports: Migraine headache, paresthesia, seizure, stroke, syncope

Fetal/Neonatal Patients:

-Postmarketing reports: Neural tube defect, anencephaly, meningomyelocele), microcephaly, hydrocephalus

Dermatologic

Frequency not reported: Dermatitis, rash, hair loss/dry hair

Postmarketing reports: Acne, allergic reaction, erythema, erythema multiforme, erythema nodosum, hypertrichosis, pruritus, urticaria

Gastrointestinal

Common (1% to 10%): Nausea, vomiting

Frequency not reported: Acute abdomen, constipation, diarrhea

Postmarketing reports: Pancreatitis

Fetal/Neonatal Patients:

-Postmarketing reports: Cleft lip/palate, imperforate anus, tracheoesophageal fistula, diaphragmatic hernia, omphalocele

Hematologic

Postmarketing reports: Leukocytosis

Hepatic

Postmarketing reports: Increased transaminases, hepatitis

Metabolic

Frequency not reported: Appetite increased, serum desmosterol levels increase

Postmarketing reports: Hypertriglyceridemia

Musculoskeletal

Postmarketing reports: Arthralgia, back pain, myalgia

Fetal/Neonatal Patients:

Other

Frequency not reported: Fatigue, vertigo, weight gain, weight loss

Postmarketing reports: Fever, tinnitus, weakness, edema

Fetal/Neonatal Patients:

-Postmarketing reports: Down’s syndrome, ear abnormal, deafness

Psychiatric

Frequency not reported: Depression, insomnia, nervous tension

Postmarketing reports: Anxiety, irritability, mood changed, psychosis

Fetal/Neonatal Patients:

Postmarketing reports: Intellectual disability

Respiratory

Postmarketing reports: Pulmonary embolism, shortness of breath

Fetal/Neonatal Patients:

-Postmarketing reports: Lung tissue malformation

Renal

Fetal/Neonatal Patients:

-Postmarketing reports: Renal agenesis, renal dysgenesis

1. “Product Information. ClomiPHENE Citrate (clomiPHENE (clomiphene)).” Teva Pharmaceuticals USA, North Wales, PA.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Related questions

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What is Clomid and how does it work?

Clomid is an oral medication that can be used to stimulate ovulation. It works by blocking estrogen receptors at the hypothalamus, which is an important “hormonal control center” for the body. When this happens, the hypothalamus is stimulated to release follicle stimulating hormone (FSH), and luteinizing hormone (LH). These are the naturally occurring ovarian stimulants, which prompt ovulation in a normal cycle.

Why has my doctor recommended Clomid?

Clomid can be helpful for those trying to get pregnant who have any of the following problems:

Irregular Ovulation: It is difficult to conceive when a woman’s cycles are so irregular that she can’t be sure when she is ovulating. When effective, the use of Clomid should produce a predictable ovulatory response to allow for timed intercourse or intrauterine insemination.

“Male Factor” fertility problems: When there is a problem with the semen quality, sometimes your physician may recommend intrauterine insemination to maximize the chance of pregnancy. Clomid can be used to help improve the timing of the inseminations with the woman’s cycle.

Unexplained Infertility: Clomid has also been shown to be effective in increasing pregnancy rates in young healthy couples that have had an entirely normal fertility evaluation, but still are having trouble getting pregnant.

How is Clomid prescribed? What can I expect to feel?

When you first begin your period, call the office so that we may schedule an examination in the next 2-3 days. At your appointment, your doctor will perform a pelvic exam, and finalize the timing of your Clomid cycle. Typically you will take one to three tablets a day for five days early in your cycle (cycle days 3-7, or 4-8). During this time, some women will notice hot flashes, moodiness, or sleep pattern changes. Most patients notice no symptoms at all. Ovulation will typically occur 7-8 days following completion of the Clomid treatment. Because the ovaries are stimulated, you may notice some bloating, or discomfort with intercourse. Verifying ovulation may be done in several ways. Your doctor will recommend which method is most appropriate: These include basal body temperature testing, LH kit testing, office ultrasound, and blood tests. At your visit, your physician will instruct you as to when to expect ovulation in that cycle, when to time intercourse, and if/when you need to return for a follicle scan/ultrasound to confirm ovulation.

How will I know if I’m pregnant?

Check a pregnancy test at home, if you do not have your menses within two to three weeks of the expected time of ovulation. If your period starts, call on the first day, so that we may schedule you for another cycle.

How many cycles of Clomid should be taken?

This depends on a number of different factors that are specific to each patient. Your physician can outline an overall fertility plan so that you know the long-term goals, and when additional medications or treatments may be indicated.

What are the risks of Clomid?

1. Rarely women will have hyperstimulation of the ovaries as a result of clomid use. In this case the ovaries become enlarged with multiple follicles. Severe pain or marked swelling of the abdomen should prompt you to call your doctor.

2. The chance of multiple ovulations is slightly higher with clomid than with a normal menstrual cycle: The chance of twins resulting from clomid is 6-8%. There is no increased risk of higher order multiples (triplets, etc) over the baseline rate in the population.

3. Rare side effects include visual changes, reversible hair thinning, dizziness, or hives.

4. Patients with currently existent large ovarian cysts or liver disease should not use clomid.

5. There has been discussion as to whether multiple cycles of ovarian stimulatory drugs increase the risk of ovarian cancer. Overall, studies have shown no increase in a woman’s risk of ovarian cancer taking Clomiphene with other infertile women.

Clomiphene

Ovulation and Ovulation-Inducing Fertility Medications for Treating Infertility in Women

Ovulation is the monthly process whereby the female reproductive system produces a mature egg. During ovulation, the brain’s pituitary gland releases two hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH). Together, these hormones are known as gonadotropins. FSH acts as a ‘messenger’ sent by the pituitary gland to stimulate the development of follicles in the ovaries, each of which will contain one egg. LH is responsible for triggering the release of the egg (ovulation).

During the first half of the menstrual cycle, the ovarian follicles produce the hormone estradiol, which stimulates the growth of the uterine lining (endometrium) and the production of the watery ‘raw egg white’ cervical mucus that functions to help the sperm as it swims up through the uterus to the fallopian tubes. After approximately two weeks, the pituitary releases a surge of LH hormone, triggering ovulation. At this stage, the follicle, now known as the corpus luteum, begins to produce the hormone progesterone, which serves to thicken the uterine lining to prepare for possible pregnancy. Two weeks after ovulation, if a pregnancy has not occurred, the corpus luteum stops progesterone production, the endometrium sloughs off and menstrual bleeding occurs.

Ovulation-Inducing Fertility Drugs

Any number of conditions can hamper the body’s ability to ovulate effectively. One of the primary ways to address this challenge is with medications that stimulate the ovarian follicles to produce multiple eggs in one cycle. The two most common fertility medications used to promote ovulation include Clomiphene Citrate (Clomid or Serophene) and Gonadotropins (Follistim, Menopur, Bravelle and Gonal-F).

Clomiphene is a synthetic chemical, taken orally, that binds to estrogen receptors in the brain and causes pituitary FSH levels to rise (see below). Gonadotropins are identical to human protein hormones FSH and LH and, given by injection, bypass the pituitary gland and directly stimulate the ovaries.

Clomiphene Citrate treatment

Clomiphene is a long trusted oral medication relied upon for its safety, effectiveness and relatively low cost. Clomiphene is used to treat absent or irregular menstrual cycles (ovulation induction), to address a condition called luteal phase defect by increasing progesterone secretion during the second half of the cycle and to make menstrual cycle lengths more predictable, thus improving the timing of intercourse or artificial insemination. Clomiphene may also be used to enhance ovulation in women who are already ovulating (ovulation augmentation).

Clomiphene Citrate for ovulation induction

Clomiphene used in conjunction with a medication called Provera may be effective in initiating menstruation and ovulation in women who have no menstrual cycle:

  • Treatment begins with a 5-7 day course of Provera, taken orally.
  • Two to three days after Provera is completed, a menstrual period should begin.
  • On the 3rd, 4th or 5th day of menstrual flow, a course of clomiphene is started.
  • A clomiphene citrate 50 mg tablet is taken orally for 5 days.
  • On day 11 or 12 of the menstrual cycle, ultrasound monitoring is conducted to determine if an ovarian follicle or follicles have developed. Also at this time, patients are asked to use an ovulation predictor kit to test their urine for a surge in LH (luteinizing hormone) indicating that eggs have matured and ovulation is imminent. If no LH surge is detected, ovulation itself may be triggered with an injection of the medication hCG (Ovidrel), which will cause the release of the mature egg(s) from the follicle(s).
  • Natural intercourse or insemination is timed to ovulation.
  • If ovulation has been assisted by an hCG injection, a form of the hormone progesterone is given via vaginal tablets or gel. The progesterone hormone serves to support the endometrial (uterine) lining and prepare it for the fertilized egg.
  • Two weeks after ovulation, patients are asked to take a home pregnancy (urine) test. If the test is positive, a blood test will be performed to confirm results.

If ovulation doesn’t occur during this initial clomiphene dosage, another course of provera will be prescribed and the dose of clomiphene increased until ovulation occurs. It may be possible to begin another clomiphene cycle immediately or, if residual cysts are present on the ovarian follicles, a ‘rest’ cycle may be advised before resuming treatment.

If ovulation cannot be induced even with a higher dose of clomiphene, this form of treatment will be discontinued, and ovulation induction may be attempted again using a different form of fertility drug (letrozole or gonadotropins).

Clomiphene Citrate for Ovulation Augmentation

In women that menstruate regularly on their own, clomiphene may be used to help the ovaries to produce more than one mature egg. This is sometimes referred to as “superovulation.” The process is as follows:

  • On Day 3 of the menstrual period, a course of clomiphene is begun. Starting clomiphene early in the cycle helps with the recruitment of more than one mature egg.
  • Typically, two clomiphene citrate 50-mg tablets are taken orally for 5 days, from cycle day 3 to cycle day 7.
  • On day 11 or 12 of the menstrual cycle, ultrasound monitoring is conducted to determine if an ovarian follicle or follicles have developed. The ultrasound helps to determine how many mature eggs are forming within their follicles. In order for ovulation induction to be successful, 2-3 follicles should be visible at this point (with just one follicle, we would not be significantly enhancing a woman’s chances to become pregnant). When an ovarian follicle matures, it produces the hormone estrogen, which causes the lining to thicken in preparation for an implanting embryo. Ultrasound monitoring at this stage also serves to measure the endometrial (uterine) lining and to make sure the clomiphene itself is not having any adverse effects on the endometrium (see Clomiphene side effects, below),
  • At this stage, patients are also asked to use an ovulation predictor kit to test for a surge in LH hormone, indicating imminent ovulation. In most cases, patients are given an injection of hCG (human chorionic gonadotropin) also known as Ovidrel. This hormone initiates the release of the egg (ovulation) and the development of the corpus luteum, which will help the body to produce progesterone. Ovulation usually occurs approximately 38-44 hours after the hCG injection.
  • After ovulation, a form of the hormone progesterone is given via vaginal tablets or gel in order to support the endometrial (uterine) lining and prepare it for the fertilized egg.
  • Patients are asked to take a home pregnancy test (urine test) two weeks after ovulation. If the home test is positive, a blood test will be performed to confirm the results.

If the clomiphene cycle did not produce sufficient egg follicles, it may be possible to begin another cycle immediately; or, if residual cysts are present on the ovarian follicles, a rest cycle may be advised before resuming treatment.

Clomiphene Citrate side effects

Ovulation predictor kits detecting the LH surge may demonstrate false positive results if testing begins near the time of clomiphene citrate administration. If patients start ovulation predictor kit testing on cycle day 9 or earlier, there is a high probability of obtaining a false positive result. For that reason, we recommend caution in testing too soon.

If a patient is not pregnant and menses occurs, the same dose of clomiphene is given after a normal pelvic sonogram. We usually recommend up to 6 cycles for ovulation induction patients and up to 3 or 4 for ovulation augmentation patients.

Possible side effects of Clomiphene include:

  • Flushing (extremely common)
  • Ovulation pain and increased sensitivity –also called “mittelschmerz”
  • Blurry vision, double vision or ‘traces,’ (a complication which may cause treatment to be discontinued)
  • Moodiness (requiring discontinuation in severe cases)
  • Nausea
  • Breast tenderness
  • Headache
  • Vaginal dryness
  • Clomiphene can sometimes decrease cervical mucus production, which may make it impossible for the sperm to swim through the cervix into the uterus. To get around this potential problem, intrauterine insemination (IUI) may be advised so that cervical mucus may be bypassed altogether.
  • In approximately 20% of patients clomiphene may negatively impact estrogen production, which in turn prevents the uterine lining from thickening at the necessary time. If the lining is too thin, the embryo cannot implant successfully. This side effect tends to occur with repeated use or with higher doses of medication. Endometrial thinning will stop once clomiphene treatment concludes. An alternative therapy often recommended in these situations is a medication called Letrozole, which has a milder effect on the hormonal system. Letrozole temporarily lowers estrogen levels, prompting the pituitary gland to increase FSH and LH production and promote ovulation. (While letrozole is not yet FDA-approved for ovulation induction, widely conducted studies indicate that there is no detriment to this treatment option.)
  • Less than 5% of women may experience an exaggerated response to treatment, known as ovarian hyperstimulation syndrome. This condition is rare in clomiphene treatment, and more common with use of gonadotropin medications. Ovarian hyperstimulation syndrome is marked by abdominal bloating, nausea and diarrhea, and in more severe cases, symptoms including shortness of breath, difficulty with urination and chest pain. Adjustments can be made for those who hyperstimulate by decreasing medication and shortening the treatment cycle. In 1% of cases, severe hyperstimulation may require intervention with intravenous fluids or removal of abdominal fluid so that fertility treatment may continue. The symptoms of hyperstimulation begin about a week after ovulation. Mild cases last about a week and usually respond to hydration and careful monitoring. In general, ovarian hyperstimulation is highly unlikely, given careful monitoring of follicle development.
  • Multiple pregnancy may be a risk with clomiphene treatment. The incidence of twins is increased to 5%; multiple births higher than twins are rare (1-2%). If an ultrasound scan reveals 3 or more mature follicles (eggs) indicating that a high multiple pregnancy is possible, patients may be advised to consider whether or not they would undergo embryo reduction, should a triplet pregnancy occur. If this procedure is not desired, or if multiple pregnancies would pose a physical or emotional challenge, patients may be recommended to forego attempts to conceive during this cycle.

Clomiphene citrate treatment success rates

Of women who are anovulatory (unable to produce an egg each month), approximately 70% will ovulate when treated with clomiphene; and conception rates consistent with a patient’s age should be achieved. Women less than 35 can achieve pregnancy rates of 20-25% per month as long as there are no other significant factors present. Older patients may not achieve these rates as their declining egg quality will become a factor. We stress that success rates are highly individual and depend on a number of factors. The best thing to do is have a thorough discussion with one’s RE physician to gain a better understanding of the likelihood of success with this or any treatment plan.

There are alternate fertility treatments for those who do not become pregnant with clomiphene therapy. If 3-6 full clomiphene cycles do not result in a pregnancy, other methods of ovulation induction can be recommended. For older patients, gonadotropins and intrauterine insemination may be recommended. For younger patients, in whom the risk of multiple gestations may be too high with gonadotropins and IUI, In Vitro Fertilization may be the next best step that will be recommended.

Generic Name: clomiphene (KLOE mih feen)
Brand Names: Clomid, Serophene

Medically reviewed by Sanjai Sinha, MD Last updated on Jan 12, 2019.

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The Clomid brand name has been discontinued in the U.S. If generic versions of this product have been approved by the FDA, there may be generic equivalents available.

What is Clomid?

Clomid (clomiphene) is a non-steroidal fertility medicine. It causes the pituitary gland to release hormones needed to stimulate ovulation (the release of an egg from the ovary).

Clomid is used to cause ovulation in women with certain medical conditions (such as polycystic ovary syndrome) that prevent naturally occurring ovulation.

Clomid may also be used for purposes not listed in this medication guide.

Important information

Do not use Clomid if you are already pregnant.

You should not use Clomid if you have: liver disease, abnormal vaginal bleeding, an uncontrolled adrenal gland or thyroid disorder, an ovarian cyst (unrelated to polycystic ovary syndrome), or if you are pregnant.

Before taking this medicine

You should not use Clomid if you are allergic to clomiphene, or if you have:

  • abnormal vaginal bleeding;

  • an ovarian cyst that is not related to polycystic ovary syndrome;

  • past or present liver disease;

  • a tumor of your pituitary gland;

  • an untreated or uncontrolled problem with your thyroid or adrenal gland; or

  • if you are pregnant.

To make sure Clomid is safe for you, tell your doctor if you have:

  • endometriosis or uterine fibroids.

Do not use Clomid if you are already pregnant. Talk to your doctor if you have concerns about the possible effects of Clomid on a new pregnancy.

Clomiphene can pass into breast milk and may harm a nursing baby. This medication may slow breast milk production in some women. Tell your doctor if you are breast-feeding a baby.

Using Clomid for longer than 3 treatment cycles may increase your risk of developing an ovarian tumor. Ask your doctor about your specific risk.

Fertility treatment may increase your chance of having multiple births (twins, triplets). These are high-risk pregnancies both for the mother and the babies. Talk to your doctor if you have concerns about this risk.

How should I take Clomid?

Use Clomid exactly as directed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Your doctor will perform medical tests to make sure you do not have conditions that would prevent you from safely using Clomid.

Clomid is usually taken for 5 days, starting on the 5th day of your menstrual period. Follow your doctor’s instructions.

You will need to have a pelvic examination before each treatment cycle. You must remain under the care of a doctor while you are using Clomid.

You will most likely ovulate within 5 to 10 days after you take Clomid. To improve your chance of becoming pregnant, you should have sexual intercourse while you are ovulating.

Your doctor may have you take your temperature each morning and record your daily readings on a chart. This will help you determine when you can expect ovulation to occur.

In most cases, Clomid should not be used for more than 3 treatment cycles.

If ovulation occurs but you do not get pregnant after 3 treatment cycles, your doctor may stop treatment and evaluate your infertility further.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of Clomid.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

This medication may cause blurred vision. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Clomid side effects

Get emergency medical help if you have any signs of an allergic reaction to Clomid: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some women using this medicine develop a condition called ovarian hyperstimulation syndrome (OHSS), especially after the first treatment. OHSS can be a life threatening condition. Call your doctor right away if you have any of the following symptoms of OHSS:

  • stomach pain, bloating;

  • nausea, vomiting, diarrhea;

  • rapid weight gain, especially in your face and midsection;

  • little or no urinating; or

  • pain when you breathe, rapid heart rate, feeling short of breath (especially when lying down).

Stop using Clomid and call your doctor at once if you have:

  • pelvic pain or pressure, enlargement in your pelvic area;

  • vision problems;

  • seeing flashes of light or “floaters” in your vision;

  • increased sensitivity of your eyes to light; or

  • heavy vaginal bleeding.

Common Clomid side effects may include:

  • flushing (warmth, redness, or tingly feeling);

  • breast pain or tenderness;

  • headache; or

  • breakthrough bleeding or spotting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Clomid dosing information

Usual Adult Dose for Ovulation Induction:

50 mg orally once a day for 5 days. Therapy should be initiated on or near the 5th day of the menstrual cycle, but may be started at any time in patients without recent uterine bleeding.
If ovulation occurs and pregnancy is not achieved, up to 2 additional courses of Clomid 50 mg orally once a day for 5 days may be administered. Each subsequent course may be started as early as 30 days after the previous course and after pregnancy has been excluded.
Most patients ovulate following the first course of therapy. However, if the patient fails to ovulate, a second course of 100 mg/day for 5 days may be given as early as 30 days following the initial course. A third course of 100 mg/day for 5 days may be given after 30 days, if necessary.
Treatments beyond three cycles of Clomid, dosages greater than 100 mg once a day, and/or course durations beyond 5 days are not recommended by the manufacturer. However, successful pregnancies and term deliveries have been reported in women receiving up to 200 mg/day for 5 days, or extended 10-day course of therapy, or consecutive cycles of treatment beyond the 3 recommended by the manufacturer.

Usual Adult Dose for Lactation Suppression:

50 to 100 mg orally once a day for 5 days. Generally, one course of therapy is sufficient.

Usual Adult Dose for Oligospermia:

25 to 100 mg orally once a day. Therapy is generally given over a period of several months.

What other drugs will affect Clomid?

Other drugs may interact with clomiphene, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Clomid only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 3.01.

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Other brands: Serophene

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  • Oligospermia
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