The Fertility Pill

The first treatment many fertility patients learn about is clomiphene citrate. Clomiphene citrate is the generic name for Clomid© and Serophene©. It is a non-steroidal, anti-estrogen drug administered in 50 milligram tablet form. Many patients may have heard it being casually referred to online as "the fertility pill," a moniker that can be a little deceptive.

Because clomiphene citrate is a pill and not an injectable drug like other fertility medications, patients are often more readily comfortable with its use. Also, the side effects of this drug can be less severe.

People who are anxiously seeking the answers to their personal fertility problems should know the facts about treatment options, including the seemingly harmless fertility pill.

Essentially safe

Clomiphene citrate is primarily used for women with certain ovulation disorders. It works by tricking the body into thinking its estrogen levels are low. When that happens, the body should then respond by producing more of the other hormones (GnRH, FSH, and LH) that promote the development and release of an egg from the ovary.

The dosage varies from patient to patient. A typical regimen is one or more tablets a day for five days, usually from day 2 through day 5 of the menstrual cycle. Side effects are mild, if any, and are similar in nature to pre-menstrual symptoms. The chances of twins resulting from clomiphene citrate use are around eight percent, and triplets or more are rare. Patients can use the drug either as part of treatment with artificial insemination or with unassisted timed intercourse, depending on several fertility factors.

Why doesn't everyone use it?

Because of the specific way in which clomiphene citrate works, not all cases of infertility will respond the same to its use. Statistics indicate that if a patient is going to successfully conceive with the help of clomiphene, it will be within the first few months of treatment. Experts recommend that if no pregnancy results after a third cycle of use, the patient and physician should discuss further treatment alternatives.

Because clomiphene citrate is "just a pill" and because of its relative low cost, some patients are too eager to try it. The inappropriate, unprescribed use of clomiphene can actually wind up costing patients precious time and money if theirs is a condition that won't typically respond to clomiphene. Also, some women who use the drug will experience a kind of hormonal backlash in which their body slows down its natural manufacturing of estrogen. The result is actually decreased fertility.

How is it used safely?

Clomiphene citrate should be used only by prescription after a thorough medical history and precursory fertility assessment, including pelvic examination, have been performed. The American Society for Reproductive Medicine (ASRM) suggests that serum FSH levels be measured. Specifically, women with thyroid or other glandular diseases, blood clotting disorders, abnormal uterine bleeding, cancer, or liver disease should inform their physician.

Women who are taking clomiphene citrate will usually be monitored by their physician through both blood draws and ultrasound during each treatment cycle.

If patients experience visual blurring or other eyesight problems while taking clomiphene, they should discontinue treatment and inform the physician. Patients should also let their medical team know of any pelvic discomfort, which might be an indication of enlarged ovaries.

The ASRM guidelines report that for couples with unexplained infertility, clomiphene citrate with intrauterine insemination (IUI) results in cycle fertility of approximately 8.5 percent to 9.5 percent -- "at least twofold higher than in those who receive no treatment."

Although its pill form and low cost may make clomiphene citrate seem like a quick and easy fix for infertility, wise patients recognize that all medications can have adverse reactions in some individuals. A fertility expert will be able to assess your level of risk and potential benefit from this and other treatment drugs.

For more information on clomiphene citrate and other fertility drugs, see this page.