Medications - Clomiphene Citrate
Clomiphene Citrate works on the pituitary and hypothalamus (the control center for the pituitary) and favorably influences the release of the two hormones that regulate the ovary, namely follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones from the pituitary gland stimulate a follicle in the ovary to grow. Once the follicle(s) have reached a certain size and maturity, they will release the egg(s).
How the Medication is Taken
Clomiphene citrate is given as one or more tablets a day for 5 days, starting on the 3rd, 4th or 5th day of the menstrual cycle. "Day 1 " is considered the first day of full menstrual flow. For example, your physician may prescribe clomiphene citrate daily from cycle days 5-9. If ovulation does not occur with this dosage, this dosage may be increased by one tablet daily each month until a dosage is found which will result in ovulation. If more than one tablet is taken per day you may take all the tablets at once each day. The time of day you take the medication is not important; also you may vary the time you take it from day to day.
There are three possibilities after clomiphene citrate is given:
- Ovulation occurs, and pregnancy results. If you think you might be pregnant, call your doctor's office for instructions on how to obtain a blood pregnancy test.
- Ovulation occurs but no pregnancy results. Do not take the clomiphene citrate until you have a normal menstrual period.
- Ovulation does not occur. If you have not had a menstrual cycle approximately 24 days after you have taken the last clomiphene citrate tablet and the ovulation predictor kit did not show ovulation before d#20 of your cycle or BBT is not above 98.0° F, you probably did not ovulate. Call the office and speak to a nurse.
The side effects of clomiphene citrate include nausea, hot flushes, bloating, blurred vision, and uncommonly, persistent enlargement of the ovaries. In general, side effects are uncommon with clomiphene citrate and they are all reversible. The chance of multiple gestation (almost exclusively twins) is approximately 5-8% with clomiphene citrate compared to the usual rate of 1%.
There are two pharmaceutical companies that make the clomiphene citrate (generic name):
- Merrell Dow - Clomid®, and
- Serono - Serophene® (trade names).
They both work equally well. Shop around as prices vary considerably among pharmacies.
You may have read about an increased risk of ovarian tumors in women who have taken clomiphene citrate for more than a year. More recent studies have suggested that clomiphene citrate is not associated with an increased risk of ovarian cancer.