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Therapy With Clomiphene (Serophene or Clomid)
Clomiphene is a medication to induce or improve ovulation (release of an egg from the female ovary). The medication is designed to help the body make more of its own FSH (Follicle Stimulating Hormone), which is a critical hormone for the ovulation process.
Clomiphene is simple to administer (an oral tablet) and relatively safe. Side effects of clomiphene include mild headache, mood swings, vaginal dryness, and ovarian cysts. Patients who achieve pregnancy with clomiphene have a 10% risk of having twins.
Response to clomiphene is often monitored by pelvic ultrasound, and treatment is often combined with closely timed intrauterine insemination to increase the chance of pregnancy.
Most pregnancies with clomiphene take place within the first few ovulatory months. Even the manufacturers recommend that a therapeutic trial is 3-6 ovulatory cycles. If a patient is ovulatory on one dose, increasing the dose by giving more clomiphene will not make a person more fertile and is not recommended. One or two tablets per day are typically recommended. Very few pregnancies occur with higher doses.
Some patients fail to respond, fail to ovulate, or fail to achieve pregnancy with clomiphene therapy. In these cases, other medications may be added such as insulin sensitizing agents, low dose steroids or injectable fertility medications (injectable FSH/LH called gonadotropins). At this point, most OB/GYNs consider referring the patient to a Reproductive Endocrinologist for evaluation and treatment, if this has not been done already.
Reproductive Resource Center of Greater Kansas City, P.A. (RRC) has two Board Certified Reproductive Endocrinologists, Dr. Rodney Lyles and Dr. Celeste Brabec, who specialize in infertility and endocrinology, providing the full spectrum of infertility treatment ranging from the more simple clomiphene therapy, through injectable gonadotropin medications, and on to the more advanced techniques of In Vitro Fertilization/Assisted Reproductive Technology including Blastocyst Transfer and Embryo Cryopreservation.
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