Clomiphene can help you conceive if you ovulate irregularly or not at all, particularly if you have polycystic ovarian syndrome (PCOS). (If you have PCOS and this treatment doesn't seem to work for you, your doctor may also prescribe metformin, an insulin-sensitizing drug that can help you respond to clomiphene.) You might also take clomiphene (and other fertility drugs) before you undergo an assisted reproductive technology (ART) treatment such as in vitro fertilization (IVF), to encourage you to produce several eggs for the procedure.
Clomiphene can also help men with a hormonal imbalance (that originates in the pituitary gland or hypothalamus) linked to a low sperm count, or poor sperm quality or motility (its ability to move). (See more information about fertility drugs for men.)
Clomiphene is usually taken in pill form for one five-day cycle a month. It helps you produce more of the hormones that trigger ovulation (follicle-stimulating hormones (FSH)), prompting your ovaries to produce one or more mature eggs, depending on how often you normally ovulate.
After you finish a cycle of clomiphene, your hypothalamus (the part of your brain that regulates basic functions such as temperature) releases luteinizing hormone (LH), which tells your ovaries to release your mature egg or eggs into your fallopian tubes. If an egg meets up with a healthy sperm on its way to your uterus, you'll have a chance to conceive.
If your period is regular, you'll start taking clomiphene three to five days into your monthly menstrual cycle and continue taking it for about five days. (To figure out when your next menstrual cycle will begin, use our ovulation calculator.)
If your period is irregular or absent, your doctor will make sure you're not pregnant and induce menstruation by prescribing a medication called Provera (medroxyprogesterone acetate), so you can begin taking clomiphene.
You'll most likely ovulate five to 12 days after you take the last pill. Your doctor will monitor you closely and often to see whether your ovaries are getting ready to release an egg. Most women go through three to six cycles of treatment at the most (it can take a month or two of drug therapy for you to start ovulating regularly). Your chance of getting pregnant doesn't improve if you take the drug longer, so if you don't succeed after three cycles, your doctor may increase the dosage or suggest another treatment.
Fertility drugs can cause a wide range of minor side effects, including mild swelling of the ovaries, stomach pain, breast tenderness, insomnia, nausea and vomiting, blurred vision, headaches, fatigue, irritability, depression, weight gain, and, in rarer cases, ovarian cysts. (See tips on handling the effects of fertility drugs.)
You'll also have a 10 percent chance of conceiving twins with these fertility drugs. (Women sometimes conceive triplets or more, but much less frequently.) Though many couples consider this a blessing, multiple fetuses increase your risk of miscarriage and other complications.
This treatment can also be a very hands-on, emotionally intense process, since you'll have to go the doctor's office for frequent monitoring. Find a willing friend, support group, or professional to talk to before, during, and after your treatment. (See therapists' top ten tips for coping with a fertility problem. Visit the BabyCenter Community to discuss Clomid and similar fertility drugs with others.
Women who take clomiphene with other fertility drugs sometimes develop ovarian hyperstimulation syndrome (OHSS), a condition signaled by weight gain and a full, bloated feeling. Some patients also have shortness of breath, dizziness, pelvic pain, nausea, and vomiting. OHSS occurs when you respond too well to the drugs and produce too many eggs; your ovaries rapidly swell to several times their size and leak fluid into your abdominal cavity. Normally this resolves itself with careful monitoring by your physician. But in rare cases it can be life threatening, and you have to be hospitalized for more intense monitoring.
On the bright side, researchers who recently examined the results of eight different studies conducted between 1989 and 1999 found that fertility drugs don't increase a woman's risk of developing ovarian cancer, even if she takes them for more than a year. Previously this issue was a major source of controversy and concern.
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Fertility drugs are quite successful at stimulating ovulation: About 80 percent of women ovulate, usually within the first three months of treatment. Of those who ovulate, 40 percent get pregnant (the wide range is due to all the other factors affecting pregnancy, from your age to the speed and agility of your partner's sperm). Very little information is available on the live birth rate for these fertility drugs, but a few studies put the number at 30 to 60 percent.
In the United States, you should expect to spend at least $50 on one cycle of Clomid. But this doesn't include the cost of doctors' visits, ultrasounds of your ovaries, or follow-up procedures such as artificial insemination. If your insurance policy doesn't cover this treatment, you'll have to pay the cost up front.
Learn more about handling the cost of fertility treatment.
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