What is Clomiphene Citrate?
Clomiphene citrate is a medication commonly used in the field of
gynecology to treat
infertility in women who do not ovulate regularly. It is a selective estrogen receptor modulator (SERM) that stimulates ovulation by increasing the release of hormones necessary for the growth and release of a mature egg.
How Does Clomiphene Citrate Work?
Clomiphene citrate works by blocking estrogen receptors in the hypothalamus. This trick the body into thinking that estrogen levels are low, which leads to an increased release of gonadotropin-releasing hormone (
GnRH). The GnRH then stimulates the pituitary gland to release follicle-stimulating hormone (
FSH) and luteinizing hormone (
LH), which are crucial for
ovulation.
Who Can Benefit from Clomiphene Citrate?
Clomiphene citrate is typically prescribed to women who experience
anovulation or irregular ovulation, which are common causes of infertility. It is also used in women with polycystic ovary syndrome (
PCOS) and unexplained infertility. However, it is not effective in women with primary ovarian insufficiency or low ovarian reserve.
How is Clomiphene Citrate Administered?
The medication is usually taken orally, starting on the third to fifth day of the menstrual cycle, and continued for five days. The starting dose is typically 50 mg per day, but this can be adjusted based on the patient’s response. Monitoring through
ultrasound and hormonal assessments may be required to track the response to the medication.
What are the Common Side Effects?
While clomiphene citrate is generally well-tolerated, it can cause side effects such as hot flashes, bloating, breast tenderness, nausea, and mood swings. In rare cases, it can lead to ovarian hyperstimulation syndrome (
OHSS), which can be serious and requires medical attention. Multiple pregnancies (twins or more) are also a risk, occurring in about 5-10% of cases.
What are the Limitations of Clomiphene Citrate?
Clomiphene citrate is not suitable for all women. It is less effective in women over 35 years old, those with a high body mass index (
BMI), or those who have been trying to conceive for a long time. Additionally, it should not be used for more than 6 cycles due to the potential risk of ovarian cancer with prolonged use.
Alternatives to Clomiphene Citrate
For women who do not respond to clomiphene citrate, other options are available. These include medications such as letrozole, another ovulation induction drug, and injectable gonadotropins. In vitro fertilization (
IVF) is also an option for those who do not achieve pregnancy with simpler methods.
