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Clomid for Infertility: Success Rate for Ovulation & Pregnancy

Clomid for Infertility: Success Rate for Ovulation and Pregnancy

Clomid (Clomiphene) is one of the first medications tried in treating infertility-related issues in women. The medicine works by stimulating ovulation from the ovaries. In this post, we will see how Clomid achieves this, who can benefit from it, and what alternatives exist if it doesn’t work for you.

Clomid for Infertility
Clomiphene is an ovulatory stimulating drug

Understanding Clomid

Clomiphene is quite a popular medication amongst fertility experts as it is both affordable, and its effectiveness has been well-documented. It is often the first medicine that your fertility expert will prescribe to treat infertility.

Clomid can be effective when used alone as a part of Assistive Reproductive Technology (ART) or in combination with other technologies such as IVF. When used in IVF, Clomid can improve the chances of conception by stimulating ovulation.

Who is Clomid for?

As Clomid stimulates ovulation, it is best suited for women who have issues in the ovulatory phase of their menstrual cycle. Women with anovulatory cycles (menstrual cycle without ovulation) or irregular periods can benefit greatly by using clomiphene. The medication is available in the form of a tablet which is much easy to administer than other stronger fertility medications that need to be injected.

Clomid is usually the first choice to treat unexplained infertility as the first step toward conception. Many couples prefer trying Clomid, especially at the beginning of their fertility treatment cycles, as it is less expensive than other fertility treatments. Clomid is also the first-line treatment for women trying to conceive with PCOS.

The success rate of Clomid to start ovulation in women having an anovulatory cycle is about 80%. That said, clomiphene is not suitable for all women facing fertility issues. Women having hypothalamic amenorrhea (no menstrual period due to being underweight) or primary ovarian insufficiency, for example, are not ideal candidates for Clomid therapy.

How does Clomid work?

Clomid works by fooling your body into thinking that the estrogen levels in your body are lower than they are. A decreased perceived level of estrogen makes the body release Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). An elevation of FSH, in turn, stimulates the maturation of the ovarian follicles, and the rising levels of LH cause ovulation.

You can determine your fertility window by using Fertility2Family’s ovulation predictor kit (OPK) while on clomiphene, using OPKs throughout your fertility journey has been proven to be the least invasive way to find your peak luteinizing hormone and your LH surge to help predict your most fertile window. 

The Clomid treatment cycle begins by administering the same dose of the drug at the same time for five days in a row. Once the first cycle (five-day treatment) is complete, your doctor might want to do bloodwork to determine the levels of hormones in your body. Based on the finding of the blood tests, your fertility expert might help you determine the best time for having intercourse to boost your chance of getting pregnant. If the Clomid treatment does not produce satisfactory levels of the hormones, your doctor might suggest alternative infertility treatment as well. Once the Luteinizing Hormone and FSH levels after the first cycle of clomiphene are known, the dose for the next cycle might need to be adjusted.

Despite being an inexpensive alternative to other fertility treatments, Clomid can’t be a long-term solution to infertility problems. The drug comes with its fair share of side effects and can even cause fertility issues of its own when used long-term. Hence, it is crucial that you plan your intercourse and ensures that you conceive in the first few cycles of the treatment.

Clomid is generally not recommended for more than six cycles of five days each. Fertility can reduce by extensive use of Clomid. It has been shown that extended use of clomiphene can make the uterine mucus thick, making it difficult for the sperm to reach the egg. There is evidence linking the long-term usage of Clomid to uterine cancer as well.

Are there any side effects with Clomid?

Clomid does come with its list of side effects. Although most of these adverse effects are mild to moderate and the medication is generally regarded as safe, here are a few that you should be aware of while on clomiphene –

  • Bloating
  • Headaches
  • Nausea
  • Tenderness of the breast
  • Vision changes
  • Hot flashes
  • Mood swings

The use of clomiphene has also been linked to multiple pregnancies in some women. As Clomid stimulates the growth, development, and release of the egg, there is a chance that more than one egg is released in one cycle, resulting in multiple pregnancies. The chance that you will have twins while on Clomid is roughly about 7%.

The biggest risk with clomiphene is when it is used for a long duration. As we discussed before, Clomid can increase the thickness of cervical mucus. Extensive use of clomiphene is also associated with thinning the uterine lining in some patients after extended usage. It is also documented that using clomiphene for a longer duration might lead to the development of certain cancers, including Uterine cancer.

However, all these side effects of Clomid are apparent only if it is used for more than the recommended six cycles. If you are using the drug for the recommended period, the chance of such adverse drug reactions is minimal.

Your OBGYN will also try to minimize your exposure to the medicine by including other fertility methods such as Intra-Uterine Insemination (IUI) and IVF along with Clomid.

Getting pregnant with Clomid

Although Clomid is not for everyone, many women with fertility issues can get pregnant by using the medicine. Women with a history of anovulatory cycles and PCOS have seen a great benefit with Clomid therapy.

Clomiphene success rate

Let’s clarify that Clomid is not a miracle cure that will help every woman get pregnant. The success rate of the first cycle of Clomid therapy with or without IUI is only about 10-12%. Your chances might increase with subsequent cycles, but so do the chances of producing long-term side effects as well.

Clomid is best for women with anovulatory cycles and PCOS. If you are under 35, your chance of getting pregnant after each Clomid cycle is about 15%. The success rate is even higher in the case of women with an anovulatory cycle. Around 40% of women with anovulatory cycles can get pregnant after a single cycle of Clomid therapy.

Clomid is also a great adjunct to other fertility treatments, including IVF and IUI. The success rate of these treatments increases with the concurrent usage of clomiphene. In one study, the success rate of IVF after three cycles of Clomid was found to be at 70%, which is a remarkable improvement. clomid is also used with IVF as it is much cheaper than other injectable fertility treatments.

What does the treatment plan look like?

Many women find it a bit complicated to use Clomid during the initial cycles of ART. However, most of them will get used to it by the second cycle. You are required to take Clomid on specific days of the month during your menstrual cycle. You might need to take a few additional steps to ensure that it works properly as well.

The therapy begins by taking Clomid for five consecutive days starting from the third day of your cycle for women with regular cycles. If your menstrual cycle is irregular, you might need to take an additional drug called Provera around the 40th or 45th day of your cycle before you can start Clomid. Clomiphene does not bring about ovulation right away. The drug only stimulates the process that will lead to ovulation later in the cycle (around the 14th day).

Once on Clomid, your OBGYN will recommend you have sexual intercourse every other day from the 10th to the 16th day of your cycle. You will also be called to the doctor’s office to take a blood test on the 21st day of your cycle to ensure that you have ovulated.

Once it is confirmed that you have ovulated, you will have to undergo a two-week wait (TWW) before you can take a pregnancy test. If you are not pregnant in the current cycle, the doctor might recommend starting the next clomiphene cycle.

During the first cycle of Clomid therapy, you will be prescribed a lower dose (50mg). If the smaller dose is not successful, the doctor might double or even triple your dose for the next cycle. Ensure that you are diligently following the doctor’s orders while taking Clomid for the best possible outcome.

Clomid Alternatives: What if it doesn’t work?

As we discussed earlier as well, Clomid is not a medication that suits all infertility cases. You might be wary of the side effects of the drug; to might even want to see what other options you have.

Furthermore, about 25% of women are resistant to Clomid. What it means is that Clomid alone can’t start ovulation in such women. Your doctor might want to combine other medication with clomiphene if it is not working for you.

If you have primary ovarian insufficiency (less number of follicles in the ovaries), or hypothalamic amenorrhea, Clomid is certainly not a drug of choice for you.

Alternative fertility treatments such as Femara or Letrozole are quite similar to Clomid and have similar success rates. Although there are studies with Letrazole showing that it has a higher success rate of stimulating ovulation than Clomid, it has its side effects. Letrozole is not even marketed as a fertility drug; it is an anticancer drug that lowers estrogen levels in the body.

Your fertility journey can be long and arduous, and Clomid is just the first step. There are many options open to you if Clomid does not work. Talk to your fertility expert and discuss all your options. Keeping a positive outlook and knowing more about how your body works goes a long way.