Clomifene citrate (Clomid) is a tablet given to treat ovulatory problems which cause subfertility. For women who are not ovulating or who ovulate irregularly, approximately 80% will ovulate, increasing the chances of becoming pregnant.
There is a slightly higher incidence of a twin pregnancy in women taking clomifene (5-6%) but higher multiple pregnancies (triplets or quads) are very rare.
How does Clomifene work?
Clomifene is taken for five days at the beginning of your menstrual cycle. The tablets work by making the brain think that the level of the hormone oestrogen in your body is low. In response, the brain releases more follicle‑stimulating hormone (FSH), which helps trigger ovulation. Ovulation usually happens around day 12 to 14 of your cycle.
- If you don’t have periods (or if they are very infrequent) you may also be prescribed a tablet called Medroxyprogesterone (Provera).
- You are advised to do a home pregnancy test before taking Provera tablets.
- Provera 10mgs should be taken for seven consecutive days. You should then have a ‘withdrawal bleed’. It can take up to 10 days for this bleed to start after the last Provera tablet is taken. If you do not have this bleed more than 10 days after taking the last tablet, please contact the Fertility Nurse Specialist for advice.
- If you start to bleed naturally while you are still taking the Provera tablets, simply stop taking these and start Clomifene instead.
How do I take Clomifene?
The first day of bleeding is called day 1 of your cycle. You should start taking Clomifene at the prescribed dose (usually 50mg) on day 2 and continue taking it until day 6 of your cycle (i.e. for five days).
Are there any side effects?
Most women have no side effects, but those that have been reported include hot flushes, breast or abdominal discomfort, mild nausea, and (rarely) blurred vision.
Medication should be discontinued if your eyesight is affected. There is also a higher risk of multiple pregnancy following Clomifene treatment.
Arranging an Ultrasound Scanning
On day 1 of your cycle that you are commencing Clomifene treatment, contact the Fertility Clinic at Forth Valley Royal Hospital on 01324 567166 to arrange an ovarian ultrasound scan (usually only done during the first cycle of treatment).
This helps to determine when ovulation is taking place and to exclude overstimulation. It also helps staff to advise you on the best time to have intercourse. Scanning is normally carried out between 08.00 and 09.00 and the first scan is usually carried out on the 10th or 12th day of the cycle.
A blood test will be taken on of the first cycle treatment cycle to make sure you have ovulated. You may need to continue taking Clomifene for up to six months during which time the dose may be altered by the doctor or nurse depending on your response.
If over stimulation is seen on scan (too many follicles) then the treatment cycle will be cancelled and you will be asked to avoid intercourse until the start of your next cycle (to minimise the risk of multiple pregnancy).
It is important to keep in touch with the Fertility Nurse Specialist so that your treatment can be monitored and appropriate follow-up arranged. If you have any questions or concerns about your treatment, please contact the Fertility Clinic at Forth Valley Royal Hospital on 01324 567166.