• Follistim®, Gonal-F®
• Repronex®
• Ganirelix®, Cetrotide®
• hCG
• Metformin
• Progesterone
• Parlodel

Clomid (clomiphene citrate)

You may have received Clomid treatment prescribed by your OB/GYN. Clomid is routinely prescribed by many generalists to induce regular ovulation. Clomid works at the level of the hypothalamus, which is a zone of nerve cells located at the base of the brain. The hypothalamus is the body’s “reproductive hormone regulator” working much like a thermostat. The hypothalamus releases gonadotropin releasing hormone (GnRH), which causes the pituitary gland to produce reproductive hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

During the first few days of your menstrual cycle, the hypothalamus stimulates the pituitary to produce FSH. This hormone causes the recruitment and development of ovarian follicles, each of which contains an egg.

Estrogen levels rise as healthy follicles develop, while the hypothalamus regulates the pituitary’s output of FSH. Estrogen is also necessary for the development of the endometrium (lining of the uterus). Once the follicles are mature, the hypothalamus signals the pituitary to release a surge of LH, that causes ovulation 36 hours later.

Clomid travels through the bloodstream to the hypothalamus where it competes with estrogen for “binding sites”. This competition causes the hypothalamus to “read” lower estrogen levels and continue to cause FSH production thus recruiting and supporting follicles.

Numerous Clomid studies document that the drug is most likely to be effective within the first 3-6 months of treatment. Treatment beyond 3-6 cycles is rarely warranted or effective. Furthermore, treatment with Clomid “empirically” without other infertility evaluations has also been found to be ineffective. Women aged in their thirties, who have tried unsuccessfully to become pregnant for six months or more, should see an infertility specialist for a complete infertility evaluation.

Infertility specialists will usually continue Clomid therapy for three to six months once it is documented that the patient is ovulating.  If ovulation does not occur on Clomid at the lower doses, infertility specialists often increase the dose. If 3-6 months of Clomid therapy fails treatments such as IUI or IVF may be attempted, dependent upon many patient specific factors.