Clomiphene citrate (CC, Clomid, Serophene) is often the first fertility drug that couples come in contact with. It is (relatively) inexpensive as fertility drugs go, it is easily taken (orally rather than by injection) and it is the first line drug used for ovulation induction in patients with PCOS and other ovulatory disorders. It has been used for patients with luteal phase defect. It can also be used to assess ovarian reserve or, in other words, the likelihood that a woman's ovaries can still produce viable eggs. Clomid is not useful for women whose ovaries have reached the end of their working life.
How does it work?
Clomid is actually quite a potent and somewhat complicated medication. It is capable of reacting with all of the tissues in the body that have estrogen receptors.
These tissues include hypothalamus, pituitary, ovary, endometrium, vagina, and cervix. Clomid influences the way that the four hormones required for ovulation, GnRH, FSH, LH and estradiol, relate and interrelate. While we do not completely understand the mechanisms by which this drug works, in essence it appears that Clomid fools the body into believing that the estrogen level is low. This altered feedback information causes the hypothalamus (an area of the brain) to make and release more gonadotropin releasing hormone (GnRH) which in turn causes the pituitary to make and release more FSH and LH. More follicle stimulating hormone and more luteinizing hormone should result in the release of one or more mature eggs - ovulation.
Twin pregnancies may occur in as many as 10% of the women who use Clomid. Triplet pregnancies are far more rare 3%. Clomid has been used to induce ovulation for more that thirty years. There is not any evidence that it causes an increase in congenital abnormalities or birth defects in children. It is not associated with an increase in premature labor or in other complications of pregnancy.