Clomiphene citrate
What is clomiphene?
Clomiphene is a fertility drug that can increase the chance of ovulation occuring. It is marketed under the names Clomid and Serophene in Canada.
Clomiphene may be prescribed to:
- Stimulate ovulation in a woman who does not ovulate or who ovulates irregularly.
- Regulate and potentially induce multiple ovulations typically in a woman who and/or is going to have intrauterine insemination of sperm.
- Perform a clomiphene challenge test, which is sometimes used to evaluate a woman’s ovulation and egg quality (ovarian reserve). When given early in a woman’s menstrual cycle for 5 days, clomiphene elevates a woman’s follicle-stimulating hormone (FSH) level. On the next day, an FSH blood level that has dropped back to normal is a sign of a normal ovarian reserve and ovulation. An elevated FSH is a sign of low ovarian reserve. Women with a diminished ovarian reserve can use donor eggs, which greatly improves their chances of giving birth to a healthy child.
When do I take clomiphene?
Clomiphene is taken for 5 days early in the menstrual cycle – typically from day 3 to 7 of the cycle.
How to take clomiphene?
Orally at approximately the same time every day
How do I know when I am going to ovulate?
First, remember day 1 of the cycle is the first day of full menstrual flow. There are several ways to determine that you ovulated in the past (e.g. body temperature, progesterone blood testing), but only the detection of the hormone, LH in the blood or urine can tell you that you are going to ovulate, in the future.
When the hormone LH rises or “surges” ovulation will occur 24 to 36 hours later. The easiest and best way to determine when your LH surge is happening is to use ovulation predictor kits (e.g. LH kits).
Beginning a few days before you expect to ovulate, for example cycle day 12 for a 28 days menstrual cycle, you will begin urinating on the ovulation predictor strip. Use your first or second morning urination to test. When the test is positive you will, typically, ovulate 24-36 hours later.
If you are having an intrauterine sperm insemination (IUI) during this cycle please phone a Genesis nurse (604-879-3032 ext 234) on the first day of your menstrual period and on the day of the LH surge before 2pm. They will give you an appointment for an IUI the next day. The cost is listed here
If you are NOT having an IUI have intercourse on the day after the LH surge (the day after the ovulation predictor kit was positive) and 2 days later (e.g. day 13 and day 15)
Ovulation predictor kits can be purchased at most major drug stores and on-line. If the ovulation predictor kit does not turn positive by day 16 of the cycle, it may not have worked. If this occurs please call a Genesis nurses to receive instructions on how to proceed.
If you were not advised to use an ovulation predictor kit, simply have intercourse every second day from day 10 of the cycle to day 16.
What are the potential side effects of clomiphene?
Bloating, pelvic pain, nausea, vomiting, insomnia, light-headedness, constipation, breast discomfort, fatigue and a change in menstrual flow can all occur while taking clomiphene. If you develop blurred or altered vision please discontinue clomiphene and contact Genesis. Store clomiphene at room temperature.
When should I test for pregnancy?
Most menstrual cycles are approximately 28 days long and ovulation occurs 14 days prior to the onset of menstrual flow. If you are pregnant the menstrual flow will not come. Test for pregnancy using a home pregnancy test ~14 days after your ovulation predictor kit turned positive or 28 days after your last menstrual period.
If your period does not come, continue to test for pregnancy every second day. Contact a Genesis nurse if your menstrual period does not come 35 days after your last period and the pregnancy test remains negative. Please also contact us if you become pregnant! Please remember you may not conceive during the first cycle. Indeed, most patients require a few months of clomiphene treatment and sometimes dosage adjustments are required.
This information sheet does not replace any information given to you by your Genesis health care provider.