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Fertility drug: Clomiphene

Clomiphene citrate can help you get pregnant if:

Depending on your fertility issues or overall health, a doctor might prescribe drugs other than clomiphene. Find out more about fertility drugs for women .

Does clomiphene work for men?

Clomiphene can help men who have a hormonal imbalance linked to low sperm count, or poor sperm quality or motility.

What’s clomiphene treatment like?

Clomiphene treatment can be an emotionally intense process for some women because they’re anxious about their body’s response to the medication. Women taking clomiphene also have to go to the doctor’s office frequently for monitoring.

Here’s how it works:

  • Taking the drug. You take a clomiphene pill for five days at the start of your period. This helps your body produce more follicle-stimulating hormone (FSH), which makes the follicles grow. Follicles are the fluid-filled sacs where eggs mature.
  • Looking for the surge. After five days of taking clomiphene, your brain releases a “surge” of luteinizing hormone (LH), which signals the ovaries to release one or more mature eggs from the follicles when you ovulate. The LH surge happens five to 12 days after you take the last clomiphene pill.
  • Waiting for the release. The doctor monitors you closely to see whether your ovaries are ready to release an egg. A blood test or ultrasounds are done to monitor how the follicles are developing. You may also be asked to use an ovulation predictor kit or a basal body temperature chart to detect when you ovulate.
  • Timing the conception. Monitoring when eggs are released helps your doctor figure out the ideal time for you and your partner to have sex, or the best time to schedule a procedure such as IUI. And when an egg meets a healthy sperm in the fallopian tube, there’s a chance you’ll conceive.

How long does clomiphene treatment take?

It depends on how regular a woman’s menstrual cycle is and how many times she has to try before she gets pregnant.

It can take a month or two of drug therapy – with a dosage increase, if necessary – before ovulation begins. Once ovulation occurs, it can take three to six cycles of treatment. Most doctors don’t recommend using clomiphene for more than six treatment cycles.

  • For a regular period: Clomiphene is taken for five days, two to five days into a period. To figure out when your next period begins, use our ovulation calculator .
  • For an irregular period or no period: A medication called medroxyprogesterone acetate is taken for 10 days to get a period started. Clomiphene is taken after the period begins.

If you don’t succeed after three cycles, the doctor might add another medication or suggest a different treatment.

What are the side effects of clomiphene?

Most women tolerate clomiphene well, but for some it causes minor side effects, including:

  • Mood swings
  • Hot flashes
  • Thick and dry cervical mucus
  • Pelvic pain
  • Breast tenderness
  • Ovarian cysts
  • Nausea
  • Headaches
  • Mild depression
  • Blurred or double vision (though this is less common)

What are the risks of clomiphene?

There’s a 5 to 12 percent chance of conceiving twins with clomiphene. (Less than 1 percent of women conceive triplets or more.) Though many couples consider it a blessing, carrying multiples increases your risk of miscarriage. preterm labor, and other complications.

In very rare cases, clomiphene causes a mild form of ovarian hyperstimulation syndrome (OHSS), which can lead to weight gain and a full, bloated feeling. OHSS happens when the ovaries respond too well to fertility drugs and produce too many eggs. The ovaries quickly swell to several times their normal size and produce fluid that leaks into the abdomen.

Mild OHSS usually goes away on its own with bedrest and careful monitoring by a doctor. But in very rare cases it’s life threatening – and hospitalization or more intensive monitoring may be necessary.

On the bright side: Contrary to what some researchers thought years ago, recent studies have found that taking fertility drugs such as clomiphene does not increase your risk of developing ovarian cancer. In the past, this was a major source of controversy and concern.

What’s the success rate of clomiphene?

About 80 percent of women ovulate in the first three months of treatment. Of those, 30 to 40 percent get pregnant by the third treatment cycle.

The chance of giving birth to a baby depends on several factors, including age and the quantity and quality of the sperm.

How much does clomiphene cost?

In the United States, expect to spend $10 to $100 on one cycle of clomiphene, depending on your insurance coverage, the dosage, and whether you choose a brand name or generic drug. But this doesn’t include the cost of doctors’ visits, ultrasounds, or follow-up procedures such as IUI. If an insurance policy doesn’t cover the treatment, you’ll probably have to pay the entire cost up front.

See therapists’ top 10 tips for coping with a fertility problem. Visit the BabyCenter Community to discuss clomiphene and similar fertility drugs with others.

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Clomid (Clomiphene Citrate) Treatment and Side Effects

How Clomid Works, Why It’s Prescribed and Possible Side Effects

About 10% of pregnancies conceived with Clomid will result in twins. Donnie Ray Jones / Flickr

Updated October 03, 2016

Clomid is an ovulatory stimulating drug used to help women who have problems with ovulation. It is the most commonly used and best well-known fertility drug. Because Clomid can be prescribed by a gynecologist, and doesn't require a fertility specialist. it's also the very first fertility treatment tried for most couples.

Clomid is taken as a pill. This is unlike the stronger fertility drugs, which require injection.

Clomid may also be marketed under the name Serophene, or you may see it sold under its generic name, clomiphene citrate.

When Is Clomid Used?

If a woman has irregular cycles. or anovulatory cycles (menstruation without ovulation), Clomid may be tried first.

Clomid is used when there are problems with ovulation but no problems with male infertility or blocked fallopian tubes .

(If fallopian tubes are blocked, stimulating ovulation would be pointless. The egg and sperm can't meet if the tubes are blocked.)

Clomid is often used in treating polycystic ovarian syndrome (PCOS) related infertility.

It may also be used in cases of unexplained infertility or when a couple prefers not to use the more expensive and invasive fertility treatments.

(However, it's important to remember that the more expensive treatment is sometimes the most appropriate.)

Clomid may also be used during an IUI (intrauterine insemination ) procedure.

It is rarely used during IVF treatment. With IVF, injectable ovulation meds are more frequently chosen.

How Is Clomid Taken?

You should follow the directions your doctor gives you.

Every doctor has a slightly different protocol.

With that said, the most common dosage of Clomid is 50 mg taken for five days, on Days 3 through 7 of your cycle. Some doctors prefer you take the pills on Days 5 through 9 of your cycle.

Does it really matter if your doctor suggests the Day 3 to 7 protocol or the Day 5 to 9 one? Not really.

Ovulation and pregnancy rates have been shown to be similar whether the drug is started on day two, three, four, or five.

Don't feel concerned if your doctor tells you a different protocol to follow than your friend.

If 50 mg doesn't work, your doctor may increase the medication. Or, they may give it another try at 50 mg.

You might think that more is always better, but higher doses, especially at or above 150 mg, can actually make conception more difficult. (See below, under side effects.)

What are Clomid's Common Side Effects?

Clomid's side effects aren't so bad, as far as fertility drugs are concerned.

The most common side effects are hot flashes, breast tenderness, mood swings, and nausea.

Once the medication is stopped, the side effects will leave, too.

Possible side effects of Clomid include:

  • Enlarged and tender ovaries (14%)
  • Hot flashes (11%)
  • Abdominal tenderness, due to enlarged and tender ovaries (7.4%)
  • Bloating (5.5%)
  • Breast tenderness (2.1%)
  • Vaginal dryness or thicker cervical mucus (percentage of occurrence not available)
  • Nausea and vomiting (2.2%)
  • Anxiety and insomnia (1.9%)
  • Vision disturbances (1.6%)
  • Headache (1.3%)
  • Abnormal uterine bleeding (spotting) (0.5%)
  • Mood swings and fatigue (0.3%)

Read more about Clomid side effects and risks:

The side effect you're probably most familiar with is the risk of multiples.

You have a 10 percent chance of having twins when taking Clomid. Triplets or quadruplets are rare, happening less than 1 percent of the time.

One of the more annoying side effects to comprehend is that Clomid can decrease the quality of your cervical mucus. This can cause problems with sperm being able to move easily through the cervix, making conception more difficult.

Clomid can also make the lining of your uterus thinner and less ideal for implantation.

This is why "more" is not necessarily better when it comes to Clomid dosage and use.

How Successful Is Clomid?

Clomid will jump-start ovulation in 80 percent of patients. But ovulating doesn't guarantee pregnancy will occur.

About 40 to 45 percent of women using Clomid will get pregnant within six cycles of use.

Using Clomid for more than six cycles is not generally recommended.

If six cycles go by, and pregnancy is not achieved, other alternatives may be considered.

More on fertility treatment:

General Infertility FAQ. InterNational Council on Infertility Information Dissemination, Inc. Accessed February 3, 2008. http://www.inciid.org/faq.php?cat=immunology&id=1

Cost of Clomid with and without Insurance

The cost of Clomid (Clomiphene Citrate) both with and without insurance is modest. However, the side effects may require future parents to spend far more.

The most obvious side effect is a successful pregnancy, which requires a far different discussion. You can dramatically reduce expenses by acting prior to conception!

You can find ways to reduce your expenses through insurance coverage, and with IRS discounts.

  • Discounts for out-of-pocket costs
  • Finding direct and indirect coverage

Cost of Clomid without Insurance

The cost of Clomid without insurance is easier to determine but more difficult to swallow. Spending can rise quickly without a third party plan picking up most of the tab. You can reduce your out of pocket costs by shopping around, and by taking advantage of hidden discounts.

Out of Pocket Costs

Clomiphene Citrate (Clomid) prices without insurance are modest. The average out of pocket cost of a cycle ranges from $35 to $70 depending upon dosage and quantity. Prices for non-generic versions run higher, which is one reason why fertility drugs are so expensive.

Prices show modest variation between Costco, CVS, Walgreens, and Walmart. They all seem to quote a very high initial price, and then something far more affordable and competitive with a coupon. Make sites make it very easy to print coupons providing significant discounting.

Paying for Clomid yourself may not break the bank, but you may graduate to protocols that are more expensive if the treatment does not help you conceive.

IRS Discounts

If you are having trouble conceiving, your doctor may start you on a Clomid cycle first, as it is relatively inexpensive, and taken orally. You will either conceive or graduate to treatments that are more expensive.

You may want to learn how to leverage discounts right away. The IRS provides Clomid discounts and interest-free infertility financing for couples willing to think ahead.

For most patients, the best tax strategy comes via your Flexible Spending Account (FSA). Schedule A allows you to deduct expenses, but only amounts above 10.0% of adjusted gross income. Clomid is inexpensive, so it is unlikely that total expenditures will reach this high. Your FSA provides first dollar savings.

Purchase your prescription Clomid using funds from your FSA. Your prices will be reduced by the percentage of federal, state, and FICA taxes you pay. Some pharmacies will even allow you to use your FSA debit card when you buy online.

Cost of Clomid with Insurance

The average cost of Clomid with insurance is almost impossible to determine. Very few couples are fortunate enough to have a plan that covers infertility. When they do, the plan designs differ widely.

You can find infertility health insurance coverage through creative approaches. Supplemental policies lower costs, but very few couples take advantage – even though they should. Perhaps you will be one who makes the smart choice.

Traditional Health Insurance

The cost of Clomid with traditional health insurance coverage depends on your plan design. Traditional healthcare coverage is very rare, as most plans do not directly cover any infertility treatment.

If you are lucky enough to find health insurance that covers infertility, there are still direct costs of Clomid to consider. Carriers like Kaiser and Blue Cross Blue Shield cover infertility only when required by state law.

Prescription Drug Plans

Since Clomid is a prescription drug, your plan formulary determines what you spend. A formulary is the list of prescription drugs covered by the plan.

Each formulary assigns a different copayment, which may be expressed in whole dollars or a percentage of the allowed charges. Most plans have three levels of copayment that may be required:

  • Generics – have the smallest copayment
  • Preferred brands – have larger copayments
  • Non-preferred brands – have largest copayments

Supplemental Health Insurance

The average cost of Clomid with supplemental health insurance is often much lower when you consider the resulting pregnancy. Supplemental plans are more widely available, and more easily obtained than traditional plans.

Short-term disability insurance for pays dividends when two intended Clomid side effects occur. Pregnancy is the primary side effect. Multiple pregnancies also frequently occur.

Lost income during maternity leave and hospital admission charges are two hidden downstream Clomid costs. Supplemental policies cover both of these losses. Additional benefits may be paid when twins or triplets spend time in neonatal intensive care.

You must purchase these policies prior to conception!

Posted February 27, 2013 by Kevin Haney

How Much Is Prescription Clomid

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