Clomiphene citrate (CC) therapy helps people ovulate. It was FDA approved in 1967 to be used by people who are infertile.
Common brand names are Clomid® and Serophene®.
CC is both a weak estrogen (female hormone) and an anti-estrogen. It “fools” the brain into sensing that female hormone levels are low. Then the parts of the brain that control reproduction make more hormones to stimulate the ovaries.
CC does not cause birth defects. It should not be taken if you are pregnant though.
People most often use CC for absent or infrequent ovulation. It is sometimes used for unexplained infertility too.
- 70 to 80 out of 100 people will ovulate on CC.
- 40 to 50 out of 100 people will become pregnant.
- Most people who become pregnant will do so within the first 3 cycles.
The multiple pregnancy rate (twins, triplets or higher order multiples) rate with CC is 5 to 10 out of 100. Most of these are twins.
Normal dosing
- 1 to 3 (50mg) tablets by mouth 1 time daily for 5 days. Start on cycle day 3.
- Cycle day 1 is the first day of your period.
The dose will increase if ovulation does not happen after lower doses.
Side effects
The most common are:
- Hot flashes (10%)
- Stomach bloating or discomfort (5%)
- Vision problems (1 to 2%)
Other rarer side effects are:
- Breast tenderness
- Nausea
- Nervousness
- Mood swings
- Enlarged ovaries
- Often gets better quickly. You may need to delay the next treatment cycle.
Call your care team if you have:
- Vision changes
- Very bad headaches
- Stomach or pelvic pain with intercourse
- If you have pain, you may need a pelvic exam and/or an ultrasound before your next cycle.
Call your care team if you ovulate 3 times with CC but do not get pregnant. Call your care team if you do not ovulate as expected.
Your care team will talk with you about ways to detect ovulation both with home ovulation kits and with a progesterone blood test. The blood test should be drawn 1 week after ovulation, or on day 21 or 22 if ovulation not clear.