The Usage of Clomiphene (CC)

Clomiphene (CC) is a very popular ovulation inducing drug nowadays. Treatment with CC is generally effective. It has been in use for over 35 years. Although it is cheap and effective, it is associated with risks of multiple pregnancies and ovarian hyperstimulation and side effects such as visual disturbances.

It has a structure similar to oestrogen. This would fool the pituitary gland and hence the output of FSH, LH will be increased to stimulate ovaries, so that one or more follicles will be produced, thus increasing the chance of pregnancy.

Side effects are uncommon and some are listed below: hot flushes; nausea; vomiting; breast engorgement; weight gain; visual disturbance and OHSS. If visual disturbance occurs, it should be stopped. There are some criteria that should be met before clomiphene is given, such as normal semen analysis, at least one patent fallopian tube. And if BMI is over 30kg/m2, it is advisable to have some weight loss first. The usual dosage is 50mg per day, starting from Day 2 of menstruation for a total of 5 days. If it is over 35 days, a pregnancy test can be done. If no ovulation occurs, the daily dose would be stepped up. However, dose exceeding 3 tablets per day does not have any benefit as the cervical mucus may become very thick rendering penetrance of sperm difficult. On the other hand, if there are too many mature eggs, one might consider cutting back the dose to half tablet per day. If pregnancy does not occur, other ART treatment methods might have to be sought. Once there is ovulation, the success rate of pregnancy is similar to that of woman of same age group and a 11% higher chance of getting multiple pregnancy.

Hence we can conclude that clomiphene is very effective for most of anovulatory cases, especially polycystic ovarian syndrome.

The content in this article is for reference only, it does not provide any professional diagnosis or treatment advice.