Clomid, every infertile’s first foray into IF treatment. I saw it described in a book (If at First You Don’t Conceive by Dr. William Schoolcraft) as “the aspirin of the infertility world”. Clomid is an interesting drug in that it can do great things, enough to get you knocked up, if used properly. Unfortunately it is also often misused.
Clomid (clomiphene) is a very common treatment to induce ovulation in women. Basically how it works is it ups the level of FSH (follicle stimulating hormone) so that follicles will grow, grow faster, grow bigger and grow more abundantly. For women who have ovulatory problems, such as PCOS patients, this helps to remedy the problem of not producing mature enough eggs for release and fertilization. In my case, Clomid is followed up by Ovidrel, a “trigger” shot that ensures ovulation occurs.
Clomid is taken for 5 days in any given cycle and is given in increments of 50mgs per dose. I am currently on the lowest dose of 50mgs daily. This can be from cycle day (CD) 3-7 or CD5-9. I typically take it from CD3-7. Following the final dose, there is time for the follicles to grow and then monitoring begins on CD12 and takes place every other day until one or more of the follicles reaches 20mm and is ready to ovulate (naturally or by trigger). Monitoring includes both blood work and ultrasound. Once the follicles are mature, I use the Ovidrel injection to force ovulation and provide a more concrete window for timed intercourse.
Clomid has some lovely side effects that get worse with an increase in dosage. Some of the side effects include: upset stomach, vomiting, hot flashes, breast tenderness, headache, blurred vision, abdominal bloating and pain. Oh, and don’t forget the mood swings!! Those are killer. So far, on my low dose I have only experiences some of these but it is still not fun at all. Another important side effect to watch out for with your Dr. is thinning of your endometrial lining. After prolonged use of Clomid, your uterine lining may become too thin to sustain a pregnancy which really defeats the purpose of taking Clomid in the first place!
It is very important to be monitored while on Clomid. Unfortunately, many women who are just starting out on the IF path are prescribed Clomid by an OBGYN who does not provide monitoring. Since there are no checks to ensure that it is working properly, naturally the success rate of Clomid when given by an OBGYN is much lower. The danger extends beyond inconvenience however. Clomid can cause Ovarian Hyper Stimulation Syndrome or OHSS in the worst case scenario which is a life threatening situation. This is when there are way too many follicles growing and causing the ovary to grow too large. These follicles can burst and can cause internal bleeding into the abdominal cavity.
One final side effect and important reason to be monitored on Clomid- MULTIPLES! “Clomid Twins” has become a common phrase tossed around the offices of REs and OBGYNs these days. It makes sense that there is an increased risk of having twins (8-10%) with Clomid since it increases follicle production. When you are properly monitored however you can be sure that you haven’t overdone it and aren’t releasing 4,5,6,7 etc follicles into your tubes for a shot a life. Most people will still go forward with 2 or 3 because it also increases chances of success but everyone on this treatment must be prepared for the possibility of multiple blessings!
Next Medication Monday- More on Ovidrel,the TRIGGER!
