The Real Story on Clomid from Dr. Fertility

Dear Dr. Fertility,

My husband and I are struggling getting pregnant with number two. We tried for about eight months, and then after that, I bought the Clearblue digital fertility monitor and have been using that for the past three months without success. I have been having a lot of breakthrough bleeding and cervical issues. At this point, I don’t think that my cycle and hormones can achieve a pregnancy without assistance.

My OB has recommended Clomid. What’s the pregnancy success rate using Clomid? How often is the outcome was twins or multiples? How many tries does it usually take for Clomid to be successful? What are the side effects?
–A Modern Mom reader

Dear Modern Mom reader,

The story on clomid is easy to understand. The drug essentially increases the release of FSH (follicle stimulating hormone) from the brain. This leads to the stimulation of the follicles and ovaries and, thus, may lead to one to multiple eggs being ovulated. Technically, it is an estrogen receptor modulator and tricks the brain into thinking that it needs to produce more FSH. This can lead to menopausal-like symptoms (i.e. hot flashes, headaches and irritability). I think that clomid a great drug for women who do not ovulate or do not have regular menstrual cycles.

My biggest problem with clomid is that many primary care doctors and gynecologists simply give it out without appropriately evaluating their patients (i.e. checking the health of the women’s eggs and the husbands sperm). This can be dangerous in that it delays appropriate treatment and wastes couple’s time and money. For young healthy women who are anovulatory, i.e. do not ovulate, may increase fertility rates to those of ovulatory women.

What’s more, you should know that taking clomid may increase the risk of multiples from about 1% to 2% that occurs naturally, to about 10%.

Before taking clomid, I would recommend that you see a fertility specialist and get worked up appropriately before starting to simply take medications.

Judging from the information you provide in your question, I have concerns that you are either experiencing problems secondary to a hormonal imbalance or uterine fibroids (which would cause the problem with breakthrough bleeding). In addition, you need some hormonal tests to check the health of your eggs, an evaluation of the uterus, and a semen analysis. Only once this is down should a treatment plan be made.

Best wishes,

Bradford Kolb, MD

Dr. Bradford Kolb, aka Dr. Fertility, is an infertility specialist and a managing partner of the Huntington Reproductive Center, in Pasadena, CA. Dr. Kolb is internationally known for his expertise in egg donation, oocyte cyroperservation and the treatment of couples who have failed traditional therapy in other centers. He appears on national television and radio shows regularly, addressing women’s reproductive issues. For more on Dr. Kolb, please go to his website: www.havingbabies.com

Have a question for Dr. Fertility? Email him at askdrfertility@modernmom.com