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The Muasher Center
for Fertility and IVF
8501 Arlington Boulevard, Suite 500
Fairfax, Virginia 22031
Ph. 703.542.3610
Fx. 703.876.6317
Clomid (clomiphene citrate)
Clomid (clomiphene citrate)
Clomid was one of the first fertility medications and is the most prescribed. Clomid is commonly used by obstetrician/gynecologists to induce ovulation in women who have irregular or no menses. Unfortunately, Clomid is also the most "overused" fertility medication often prescribed before an infertility workup is completed on the female or male. Dr. Muasher always seeks to establish a cause of ovulatory dysfunction and document male fertility prior to beginning any treatment.
Clomid induces ovulation by competing for estrogen binding sites at the hypothalamus, a small gland located at the base of the brain. The hypothalamus produces gonadotropin releasing hormone (GnRH) which stimulates the pituitary gland to manufacture follicle stimulating hormone (FSH). FSH is responsible for causing the recruitment and development of the ovarian follicles, each containing an egg.
Clomid indirectly causes an increase in FSH through its effect on GnRH so ovulation can often be established. However; once ovulation is occurring, increasing the dose has no clinical benefit. Injectable FSH stimulates the ovaries directly and increasing the dose causes the development of multiple follicles.
Numerous clinical studies indicate that the greatest chance for pregnancy on Clomid occurs during the first three cycles. Therapy beyond 3-6 cycles is rarely effective and can be counterproductive. Most fertility specialists prescribe three cycles of Clomid before moving to the next step. The next step after Clomid is often FSH stimulated IUI dependent upon each patient's specific diagnosis and situation