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Fertility Pills to Start Ovulation

Clomiphene citrate, commonly referred to by its brand name Clomid, is a relatively effective method of inducing ovulation. For women who do not ovulate on their own or ovulate late in their cycles, this five-day regimen can give them hope in conceiving a child.

  1. Function

    • Clomiphene works by tricking your body into thinking there's not enough estrogen. The body then tries to make more estrogen by increasing levels of gonodotropin-releasing hormone (GnRH). The increase of GnRH triggers production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones stimulate the release of an egg.

    Dosage

    • Clomid is generally given in 50 mg increments. To start, the woman takes 50 mg starting on day 3 or day 5 of her cycle; she will take it for five days. Ovulation generally happens about a week after the last dose, so the couple is advised to have intercourse every day or every other day until ovulation is confirmed. If ovulation does not occur, the doctor may induce menstruation so the couple can try again, this time at a higher dose.

    Side Effects

    • Due to the alteration of hormones, clomiphene can cause several side effects that are annoying, yet not serious. These include headaches, mood swings and hot flashes. One side effect that may impede fertility is the drying up of cervical mucous. Since estrogen helps create cervical mucous that is conducive to protecting the sperm, the effect of clomiphene on the brain (making it think there isn't enough estrogen) can cause vaginal dryness. This may be prevented by taking guaifenesin, an over-the-counter cough medicine used to thin mucous in the chest, as this also thins out cervical mucous. Lastly, the lining of the uterus may become thinner when using clomiphene, making implantation less likely.

    Time Frame

    • Clomiphene may be used for six cycles before moving on to another method to induce ovulation, such as injectables like Gonal-F (follitropin alfa) or Follistim (follitropin beta). Many women will respond in some way on the first cycle, and this is usually indicative of the efficacy of future cycles.

    Risks

    • There are two major risks when using clomiphene citrate. The first is hyperstimulation of the ovaries, in which too many egg follicles are produced. The other is the chance of multiple pregnancies, which is a result of the hyperstimulation, as more than one egg may get fertilized when this happens.

    Other Options

    • Some doctors are comfortable prescribing drugs for off-label use or treating another issue with a drug that may happen to help with ovulation as well. These include Metformin (glucophage), which is used to help keep blood sugar levels down and Femara (letrozole), which is used for treatment of breast cancer. These work in a fashion similar to clomiphene and have comparable side effects but are not generally prescribed specifically to induce ovulation.

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