Clomid – Is it really a cure for infertility?
Whether it is from browsing online or from talking to a friend about your infertility, the name ‘Clomid’ often seems to make an appearance. You may have read many success stories on fertility blogs, but what do experts and clinicians have to say about Clomid, and is it an infertility cure? Here’s what you need to know.
What is Clomid?
Clomiphene Citrate AKA Clomid is a drug often prescribed to promote or induce ovulation to occur more regularly. If you have been diagnosed with ovulatory dysfunction and/or PCOS and have been unable to conceive naturally, then you may have been offered to take Clomid by your GP or Gynaecologist. But, what does it actually do?
Ovulation- how does Clomid affect it?
Certain hormones regulate and control our menstrual cycles which in turn, regulates our ovulation (the release of an egg). Two of our key sex hormones, FSH (follicle-stimulating hormone) and LH (luteinising hormones) levels are increased by Clomiphene which is an oestrogen-like hormone, by acting on the ovaries, but also the hypothalamus and pituitary glands in the brain. Oestrogen, FSH and LH are partners in crime. Oestrogen not only repairs and grows the lining of the uterus wall after each menstrual cycle but later on, in our cycles, it also exerts positive feedback on LH and FSH production. Both FSH and LH manage the release of an egg by triggering ovulation. Clomid, therefore, can induce our bodies to produce more than one egg during each cycle by increasing the levels of these hormones and in turn increasing ovulation.
Our hormones have multiple roles, from triggering your periods to ensuring an egg is released at ovulation, where it has the opportunity to be fertilised by sperm. Before we understand what Clomid does, let’s get more familiar with some of the key sex hormones, and what they do throughout your cycle. The three main parts of the show, go to oestrogen, follicle-stimulating hormone (FSH) and luteinising hormone (LH), which all work in tandem with each other during your cycle. Whilst oestrogen not only repairs and encourages the regrowth of the uterus wall after each period, it also exerts positive feedback of LH and FSH production later on in your cycle. Together, both FSH and LH are responsible for triggering ovulation. You can understand more about what happens throughout your cycle here.
When taken, Clomid, which is an oestrogen-like hormone, increases the levels of FSH and LH, by acting on the ovaries, hypothalamus and pituitary glands. Clomid does this by mimicking the action and effects of oestrogen on these organs. By increasing oestrogen and other hormone levels, Clomid encourages our bodies to produce more than one egg during each cycle and therefore also increases the number of times you ovulate. More eggs released from the ovaries = more opportunities for a sperm to reach one.
Is Clomid for me?
There are many factors that can affect your ability to conceive, from hormone levels, lifestyle choices, structural infertility causes (such as tube blockages) and multiple health conditions. As Clomid acts on one small, yet incredibly significant area of our fertility, it is usually prescribed to people who cannot ovulate due to certain conditions, such as PCOS. It may also be prescribed to people that do ovulate, but are still experiencing infertility, or are struggling to conceive due to irregular cycles and are unable to determine their ovulation window.
When considering Clomid, it is crucial to be mindful of all if the factors that can affect your fertility, and Clomid may not be for you if you have other complications such as large ovarian cysts, blocked fallopian tubes or other uterine abnormalities, low ovarian reserves or if you have previously had a bad experience with Clomid treatment in the past.
Obviously, there will be side effects…?
Every drug can come with it’s side effects. Whilst they work as fascinating little chemicals doing wonders in our bodies and helping treat or possibly cure many of our health conditions, they can also cause complications and/or disruptions in other areas of our bodies.
Some common side effects of Clomid are:
- Vaginal Bleeding
- Blurred vision
- Enlarged ovaries
However, one side effect and/or complication that stands out a bit is the likelihood of twins, triplets and possibly more. According to Hughes E, Collins J, Vandekerckhove (2000), you have a 10% chance of having twins with Clomid treatment. Having triplets or quadruplets, however, has a less than 1% likelihood.
Although research on Clomid and it’s side effects is limited, a recent study (Celano et al., 2011) found that 45% of women on Clomid experienced a depressed mood, and 41% of them experienced mood swings. So much so, that the term “Clomid Crazies” was invented by meme-makers on social media for the mood swings caused by Clomid.
In addition, a recent study has suggested that children born from mothers receiving fertility treatment with Clomid may be slightly more likely to develop childhood epilepsy. Notably, this increase was shown to be minimal. Nonetheless, as with any drug, it is important to evaluate the potential risks, regardless of how small they are, before treatment.
Clomid success rates…
According to Dr Carla, a consultant from Zita West clinic and Budinetz et al. (2015), Clomid is extremely effective: “A few women might be Clomid-resistant, however, 80% of women with irregular ovulation or anovulation will ovulate with Clomid.” It is still important to note that we are complicated and unique individuals, and therefore a lot of factors need to be considered when taking Clomid for conception.
One crucial factor, is knowing when to have sex. This depends and varies on your cycle lengths; however, it is known that with Clomid it is best to have sex during your most fertile period which is 12-16 days before your period starts. It is also helpful and recommended to catch your ovulation period by having sex every other day between day 10 and day 21 of your cycle.
About 40-45% of women conceive within 6 cycles of Clomid use, however, if you become Clomid-resistant (unsuccessful in conceiving after Clomid use) then doctors may prescribe other medication to take alongside it, such as metformin. Metformin is an oral treatment for Type 2 Diabetes. Due to the insulin resistance in some women with PCOS, it is often used as a form of treatment in PCOS.The timeline, again depends on many factors (as you would have figured out by now, it is a very popular phrase with anything health-related) such as your age and medical history, therefore, how long it takes you to be labelled ‘Clomid-resistant’ really varies.
Is Clomid an infertility cure?
Considering the vast variety of factors, different health conditions and all the various aspects of our reproductive health that affects our ability to conceive, it is incorrect to say that Clomid is a cure for infertility. It covers and acts on a niche area of our reproductive health and therefore it is more accurate to say that ‘Clomid is a treatment for infertility, rather than a cure, for people who struggle with ovulation’.
You may be hesitant in using Clomid due to the bizarre stories that you may have heard or read such as how people have been getting pregnant with octuplets or that it may cause blindness, but all of these are either worst-case scenarios or simply myths and rumours. Therefore, if you are struggling to conceive and you feel like you may want to try Clomid, there is no harm in talking to your doctor about it. Alternatively, taking a hormone and fertility test with us would give you an insight into your hormone levels and ovulation which would enable our expert clinicians to consider Clomid as a treatment for you.
Budinetz TH, Benadiva CA, Griffin DW, Engmann LL, Nulsen JC, Diluigi AJ. Ovulation rate and cycle characteristics in a subsequent clomiphene citrate cycle after stair-step protocol. Fertil Steril. 2015;103(3):675-9. doi:10.1016/j.fertnstert.2014.12.088
Celano CM, Freudenreich O, Fernandez-robles C, Stern TA, Caro MA, Huffman JC. Depressogenic effects of medications: a review. Dialogues Clin Neurosci. 2011;13(1):109-25.
Federal Drug Administration. CLOMID (clomiphene citrate tablets USP). October, 2012
Hughes E, Collins J, Vandekerckhove P. Clomiphene citrate for unexplained subfertility in women. Cochrane Database Syst Rev. 2000;(3):CD000057. doi:10.1002/14651858.CD000057
Kettner L, Matthiesen N, Ramlau-Hansen C, Kesmodel U, Henriksen T, Fertility treatment with clomiphene citrate and childhood epilepsy: a nationwide cohort study, Human Reproduction, 2021