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Clomid - your questions answered

By Kate Davies, RN, BSc(Hons), FP Cert - Fertility Nurse

When you are trying to conceive, words like ‘Clomid’ start to become commonplace in your vocabulary. However, despite being on first names terms with this medication, do you really understand Clomid?
 
In our online PCOS Support Group we’re hearing that many women still have lots of questions about this medication, and to many Clomid is shrouded in mystery. We have put together some of your most burning clomid questions and give you the no-nonsense answers below:
 
 

 
What is Clomid?
 
Clomid (otherwise known as clomifene citrate) is a drug that is used to stimulate your ovaries to release eggs. Clomid is the most common ovulation stimulation drug used for fertility.
 
How does it work?
 
For ovulation to occur, a woman’s body needs an accurate balance of hormones. Particularly the hormones made by the pituitary gland the follicle-stimulating hormone (FSH) and another crucial ovulation hormone called luteinising hormone (LH). Clomid works by blocking the feedback mechanism to the pituitary gland, fooling the pituitary gland in to making and releasing more FSH and LH than normal. These extra hormones work harder on the ovaries, stimulating them to ovulate.
 
How likely am I to ovulate when taking clomid? Approximately 7 out of 10 patients treated with clomid will ovulate and 4 out of 10 will conceive. Most women who ovulate will do so in the first three months of treatment.
 
Is Clomid right for me? Your doctor will discuss with you whether or not you are suitable for clomid treatment. Clomid is recommended for the treatment of ovulation disorders in women who have PCOS and may be used in conjunction with metformin.
 
You may be prescribed clomid to boost egg production, before undergoing certain fertility treatments such as IUI. In some cases it may be used for the treatment of unexplained infertility, although this is no longer recommended as there is a lack of evidence that clomid helps in this situation.
 
Will Clomid work if I have PCOS? Clomid is generally used for women who are not ovulating properly, and this includes women with PCOS. Some women with PCOS may be resistant to Clomid and this is more likely if you have a BMI greater than 25. In this situation, your Doctor may advise that you try and lose weight before starting on Clomid.
 
This can be very frustrating for women with PCOS, as losing weight is very hard to do. Talk to your Doctor about the other options available to you to help you lose weight before starting Clomid.
 
How do I take Clomid? Clomid is taken as a daily does, in a treatment of 5 days each month. It is generally started at the beginning of each cycle, on day 2 of your cycle. However you must follow your Doctors advice on when to start.
 
The recommended starting dose is 50 mg tablet per day, taken at the same time each day. If you forget a dose, speak with your Doctor for advice on what to do in this circumstance.
 
What are the side effects? All medications have potential side effects and often the list that comes with the medication can look a little scary. However, not everyone experiences them, and many women notice little or no unwanted side effects. If you do notice any side effects, be reassured that this is likely to improve as your body adjusts to the new medicine.
 
Below is a list of the common side effects:
 
Common Clomid side-effects (less than 1:10 women) What you should do
Feeling flushed Wear light clothes and keep cool
Nausea Eat small amounts at regular intervals
Abdominal pain and/or feeling bloated Discuss this with your doctor straight away
Headache and/or painful breasts If troublesome or continues inform your doctor
Painful periods and/or bleeding between periods Speak to your Doctor as soon as you can
Blurred vision and other eyesight problems Speak with your doctor straight away and avoid driving or using machinery

Do not hesitate to discuss any side effects, should they occur, with your doctor.

 
What about sex and Clomid? Many women wonder when they should have sex when taking Clomid. It is much the same as trying to get pregnant without taking Clomid. Ovulation is likely to occur 5-12 days after taking the last Clomid tablet.
 
The general recommendations are that you should have sex every 2-3 days throughout the cycle but you can also concentrate your efforts in the 5 days leading up to ovulation and the day of ovulation. If you are using OvuSense, you’ll be able to see exactly when this is and make the most of these days.
 
How should I be cared for by my doctor when taking Clomid? It is really important, that you are carefully monitored by your Doctor, when taking Clomid. This may include regularly appointments and scans to make sure everything is going well. If you are not responding to the initial 50mg dose, your Doctor may decide to increase the dose and monitor you closely to see how you respond.
 
Careful monitoring is important when taking Clomid, as in rare circumstances over-stimulation of the ovaries (OHSS) can occur. OHSS can develop into a serious condition, however most cases of OHSS are mild and resolve after a few days.
 
The current recommendations are that Clomid should only be taken for 6 months in total. Drugs that stimulate the ovaries can result in more than egg being released at ovulation and therefore giving you a 1:10 chance of a multiple pregnancy.
 
This is why it is important to attend for any scans so how your ovaries respond to the drugs can be assessed.
 

Book your FREE consultation with the OvuSense Fertility Nurse, Kate -  to assess your fertility potential, answer your burning fertility questions, get recommendations on how to optimize your fertility and have your charts analysed.

If you are an OvuSense customer you are entitled to a FREE 1 hour consult, if you are not currently using OvuSense you book a FREE 15 minute consultation. Consultations are held by Skype or Telephone. Don't see a time that suits you? Email Kate on kate.davies@fertility-focus.com