Clomiphene Side Effects
There is a slightly increased chance of multiple pregnancy and ovarian hyperstimulation syndrome (OHSS). Other side effects of clomiphene therapy include hot flushes and headaches but these are not usually severe enough to discontinue treatment and may be less troublesome with time.
The majority of pregnancies occur in the first few treatment cycles. Some find that simple monitoring with basal temperature alone is as good as urinary LH monitoring and ultrasound for the first few clomiphene cycles but we prefer checking progesterone levels on the twenty-first day of the cycle. If there is no success with 50mg, the dose can slowly be increased in 50mg increments up to 200mg daily for five days.
Although attention has been drawn to the anti-oestrogenic activity of clomiphene , there is probably no substance in the suggestion that the cervical mucus is adversely affected. There would appear to be no increased risk of congenital abnormality (Q3.3) in pregnancy after clomiphene ovulation induction. Early pregnancy loss and ectopic pregnancy rates are not significantly increased in association with clomiphene induced ovulation.
There continues to be debate on the question of a relationship between the use of clomiphene and later development of ovarian cancer. The debate arose in 1994 when an analysis of 3,837 women previously investigated for infertility in Seattle between 1974 and 1985 was reported. Invasive or borderline malignant tumours of the ovaries had subsequently developed in 11 women whereas statistically four or five would have been expected. Nine of the women developing ovarian malignancy had taken clomiphene and five of these nine had taken the drug for twelve months or more. Treatment with clomiphene for less than a year was not associated with increased risk. The consensus is that the risk has probably been overstated. If it is clinically felt to be in your interests for you to continue with clomiphene this is medically acceptable provided that you have been given the current information.
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- 1 What are the objectives of infertility treatment?
- 2 Why have I been advised to take folic acid as part of my infertility treatment?
- 3 Although my ovaries have eggs in them, my tests show that I am not releasing them (anovulation) and this is causing infertility. How can this be treated?
- 4 If I take drugs to induce ovulation (ovulation induction) for my infertility, are there any risks?
- 5 How is ovulation induction treatment for infertility monitored?
- 6 How does clomifene citrate work for infertility?
- 7 How effective is clomiphene in the treatment of infertility?
- 8 Could I experience any problems whilst taking clomiphene?
- 9 Is there any advantage in having an injection of HCG to ensure ovulation?
- 10 How does tamoxifen work?
- 11 How can hyperprolactinaemia be treated?
- 12 How does metformin work?
- 12A How does letrozole work for infertility?
- 13 How do gonadotrophins work?
- 14 What are the risks for me if I receive gonadotrophin therapy?
- 15 What are recombinant gonadotrophins?
- 16 What is ovarian hyperstimulation syndrome (OHSS)
- 17 How is ovarian hyperstimulation syndrome treated?
- 18 How does electrocautery (ovarian drilling) work for infertility associated with polycystic ovary syndrome (PCOS)
- 19 I have been found to have endometriosis. How should this be treated to improve my chance of conceiving?
- 20 Tests have shown that I have problems with my Fallopian tubes. What can be done about this?
- 21 I have fibroids. How should these be treated to improve my fertility?
- 22 My post-coital test has shown that my mucus is stopping the sperm from swimming (mucus hostility). What can be done?
- 22a How can male infertility be treated?
- 23 When can intrauterine insemination (IUI) improve our chance of achieving a pregnancy?
- 24 What is in vitro fertilisation (IVF) and embryo transfer (ET)
- 24A IVF single or double embryo transfer?
- 25 What is intracytoplasmic sperm injection (ICSI)
- 26 How do tubal surgery and IVF compare?
- 27 What are egg donation and egg sharing?
- 28 What is selective embryo transfer?
- 29 Investigations have shown no obvious cause for our difficulty achieving a pregnancy. Are there any treatments for our unexplained infertility?
- 30 We have tried a variety of treatments but we still have not achieved a pregnancy. Why should this be?
- 31 We are finding the investigation and treatment of our fertility problems to be ever more stressful. Can stress be a cause of infertility?
- 32 How can we determine which fertility unit is likely to be the best for us?
- 33 Where can I obtain more information?
- 34 Infertility Support Groups.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
