Clomid (clomifene citrate-clomiphene citrate)
Clomid (clomifene citrate-clomiphene citrate) is commonly prescribed for stimulating ovulation in women to help them fall pregnant. Clomid is taken at the start of the menstrual cycle from around day 2 at a dose of clomid 50 mg daily for 5 days. If a second course is prescribed the dose can be increased to 100mg. 3 treatment cycles is considered a course of fertility treatment.
Clomid is licensed for 6 months use for ovulation induction and is not recommended for more than that as it can increase the risk of developing ovarian cancer. However some consultants will prescribe it up to 12 months (doctors should advise their patients of the increased risk).
Clomid is often the first drug given to women by their doctors for infertility treatments. It's cheap and easy to administer. Clomid works by blocking the feedback actions of oestrogen thereby tricking the pituitary gland to produce more follicle stimulating hormone (FSH), which makes the ovaries produce eggs.
A blood test can be taken 7 days before the end of your clomid cycle (menstrual cycle) to measure levels of progesterone to see if clomid has worked and ovulation occurred.
Clomid treatment is sometimes combined with metformin to try and help regulate the menstrual cycle for woman with PCOS. It should not be taken if a woman has an ovarian cyst or liver disease.
Once a pregnancy test has been taken and it's positive, the woman should stop taking clomid as they are now pregnant.
Acupuncture and clomid
In traditional Chinese medicine (TCM), clomid is hot in nature and gets the blood moving to the uterus and ovaries.
According to Five Element theory, clomid is suitable for women who feel cold (a deficiency of yang) but who don't sweat at night (a deficiency of yin). However, if the woman feels warm or hardly ever feels the cold and can sometimes sweat at night, then clomid is too warm and will damage yin, like being on a slow cook, it will burn and damage the body's fluids, such as cervical mucous, a known side effect of clomid. This can actually worsen a woman's fertility as the man's sperm cannot get into the uterus without cervical mucous.
Clomid has been shown to reduce uterus wall development, thereby reducing the chances of the fertilised embryo implanting. To partially offset this side effect, progesterone can be given from ovulation or acupuncture treatment used, which has been shown in research to stimulate the thickening of the uterus wall (uterine glandular development) thereby improving implantation and pregnancy.
A research study conducted in 2008 compared acupuncture (plus moxibustion) to clomid in 120 women with infertility due to ovulatory problems. After treatment for 3 menstrual cycles women in both groups showed similar increases in ovulation rates. However, the pregnancy rate in the acupuncture group was significantly higher than that in the clomid group, due to lower levels of miscarriage.
Recent research has shown that combining clomid with Chinese herbs significantly improves polycystic ovary syndrome (PCOS).
Clomid can cause several serious side effects, including:
- Raise LH levels
- Reduce cervical mucous (egg white)
- Reduce the thickness of the uterus lining
- Mood swings
- Ovarian hyper-stimulation syndrome (OHSS)
- Multiple pregnancy
- Hot flashes (flushes)
- Birth defects (see below)
Tamoxifen is often used as a substitute if the woman experiences too many side effects from clomid. Letrozole, also known as Femara, it is sometimes used instead of clomid in women with a history of breast cancer. It doesn't reduce cervical mucus or thin the endometrial lining as much as clomid. Dexamethasome is sometimes used in conjunction with clomid to enhance ovulation.
There is evidence that using fertility drugs such as clomid when trying naturally or using FSH/LH drugs during an IVF cycle increases the mother's hormones levels to a point at which girls are more likely to be conceived than boys. It has also been linked to Autism.
Evidence suggests that even after taking clomid has successfully assisted ovulation, it can remain in the mother's system well into the initial weeks of pregnancy, which can put the foetus at risk of exposure to this dangerous drug. Clomid is classified as a category x drug by the FDA, meaning it is known to cause birth defects. Always read the label.
Animals or humans have developed foetal abnormalities after being given clomid in clinical research and there is evidence to suggest human foetuses may be at risk. As a category X drug, clomid may outweigh the potential benefits. A 2010 study at the Harvard school of public health found that ovulation-inducing drugs like clomid nearly doubled the risk of autism spectrum disorder in children, whilst a study by the Centers for Disease Control and Prevention (CDCP) in the USA identified the following as serious birth defects caused by clomid:
- Open cranium with the absence of a brain
- Heart defects
- Closed or underdeveloped oesophagus
- The baby's intestine or other abdominal organs protrude from the bellybutton
- Premature fusion of the skull bones
- Dandy Walker malformation syndrome (a brain malformation involving the cerebellum and the fluid filled space around it
- Multiple abnormalities of the gastrointestinal and genitourinary tracts
- Opening of the urethra is on the underside rather than the end)
- All or some of the limbs of a foetus do not completely form while in the uterus
A lot of my infertility patients try to get pregnant using clomid after failing to get pregnant naturally for over one year. For most women clomid can help them conceive, however there are instances when it doesn't help a woman fall pregnant naturally. In those cases, the woman's fertility is more problematic and other stronger forms of assisted reproductive therapy are often needed.
Please note that I do not offer or sell clomid. This page is for information purposes only.