Clomiphene Citrate (Clomid)
Clomid citrate is commonly the first medication that is prescribed for patients who are unable to ovulate on their own with unspecified infertility in combination with insemination. Women who have normal fallopian tubes, regular 28 day cycles, and partners with a normal sperm count, but are still experiencing infertility, are termed as having ‘unspecified’ infertility. The pituitary gland regulates the amount of FSH (follicle stimulating hormone) and LH (leutenizing hormone) in the system. These two hormones play a key role in ovulation. The levels of these hormones determine when and how many eggs are developed and released. LH is responsible for the further maturation and release of the egg(s).
Clomid citrate is an anti-estrogen medication. This means that it tricks the pituitary gland into thinking that the levels of estrogen in the body are low, causing the pituitary gland to secrete additional FSH and LH. This increase of FSH and LH stimulates the development of the follicles which contain the egg(s). Clomid citrate is taken as a pill, and is generally prescribed as one (50mg) pill each day for 5 days in the beginning of the menstrual cycle (days 3-7). A mature follicle is usually found around day 12 of the cycle. If ovulation does not occur, the medication can be changed to reflect the patient’s needs. Ultrasound is the best way to determine the number and maturity of the follicles. Ovulation predictor kits can be used to measure if there has been a surge of LH mid-cycle, indicating ovulation has occurred. Ovulation occurs about 24-28 hours after the detection of the LH surge in the urine. Once ovulation has occurred, natural or artificial insemination is performed in an attempt to fertilize the egg(s) that have been produced.