For nearly 30 years, clomiphene citrate – sold under the brand name Clomid® or Serophene® – has often been the first treatment against infertility. Patients who do not ovulate or ovulate unpredictably use clomiphene orally for five days. This stimulates the ovaries to produce eggs (ovulation) in 60 percent to 80 percent of women, half of whom will become pregnant with no further assistance. Use of Clomiphene in women who do not ovulate is called ovulation induction. Clomiphene is also used in women who do ovulate to increase the number of eggs produced in hopes of increasing pregnancy rates. This approach is called superovulation induction.
Ultrasounds are often used to monitor stimulation from Clomiphene. Ovulation should begin about seven days after the drug has been administered. If this does not occur, the dosage may be increased until ovulation is achieved. Once ovulation does occur, the medication should be used until pregnancy occurs, with a reassessment performed after six ovulatory cycles.
Side effects are mild and can include:
Most of these side effects are mild and should resolve after discontinuing the medication. However, if the patient experiences any visual disturbances she should stop taking Clomiphene and inform her provider. Clomiphene can also increase the chances of multiple births.
Injectable hormones may be recommended to stimulate or control ovulation for a number of infertility problems. These medications are highly successful in stimulating ovulation in women, and are given in varying doses depending on how they are to be used.
The various injectable hormones used in fertility treatments include:
Injectable hormones may cause side effects, such as swelling, bruising, or infection at the injection site. If the ovaries become enlarged and tender, there is also a risk of ovarian hyperstimulation.
There is also an increased risk of multiple pregnancy when using ovulation-stimulating drugs, which can carry health risks for both the mother and child. Women who are pregnant with more than one baby have more problems during pregnancy and delivery than women carrying a single child. Multiple fetuses have a high risk of being born too early (prematurely), which can cause health and development problems.
Studies have shown that low doses of aspirin – a blood thinner – may prevent miscarriage in women who tend to form blood clots in the placenta, which cuts off the nutrients supply to the developing baby. This is controversial and there are studies on both sides of this debate.
Women with pituitary tumors, which decrease ovulation, benefit from taking bromocriptine or cabergoline to reduce the level of prolactin hormone in the pituitary.
Women who have blood-clotting disorders linked to recurrent pregnancy loss are prescribed heparin, which is an injectable blood thinner.
It is best to seek advice from the prescribing physician or pharmacist regarding side effects and other conditions of any fertility drug.