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How Does Clomid Work? A Fertility Expert Explains

It took my husband and me 2.5 years to finally conceive — and it was the worst process: the ups and downs, the anticipation, and the feeling of failure. In fact, it was the very last attempt where we said if it didn’t work we would talk to a fertility specialist about getting on Clomid or some other help. Thankfully, we got pregnant in the summer of 2018, but for those still on the TTC journey, you may have heard about Clomid as a fertility treatment. But how does Clomid work? I have PCOS and it seemed like a good option for me, but what conditions are there to take a fertility drug, and most importantly, do they work?

Dr. David Diaz, a reproductive endocrinologist and fertility expert at MemorialCare Orange Coast Medical Center in Fountain Valley, California, explains that Clomid helps you ovulate on a regular basis and it regulates when you release your egg “in a predictable manner to improve the timing of intercourse.” That way, you’ll increase your chances of conception, he tells Romper. “Clomid is considered the ‘gold standard’ oral medication used as the first line treatment to help women with infrequent or absent ovulation,” he says. “An example of some conditions treated with Clomid include chronic anovulation [not ovulating] and polycystic ovaries, both commonly encountered in fertility clinics. It is also the only oral drug sanctioned by the FDA for inducing ovulation in anovulatory women with or without other pre-existing conditions."

So how does it regulate when you ovulate? Here’s where it gets a little tricky. Diaz explains that Clomid is like a “false messenger. “It blocks estrogen receptors in the body, thereby tricking the pituitary gland to release Follicle Growth Hormone (FSH). This stimulates egg sac growth and ultimately ovulation."

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Thinking this may be a good fit for you? There are some things to consider. Diaz says, "The occurrence of ovulation is combined with timed intercourse at home or IUI insemination in the doctor's office. Clomid blood levels remain longer in the body, which can result in buildup and eventually side effects. To minimize side effects, you should start with the lowest effective dose of Clomid." Diaz says it's also important to remember that "since most pregnancies occur sooner rather than later, it should not be used for more than three-to-four cycles without a reassessment by the physician."

Before you take Clomid, you'll have to go through "level one testing" first, according to Diaz. "Human pregnancy requires that numerous factors function with exact precision in order for a healthy pregnancy to develop. To begin, the fertility specialist must document the presence of a normal uterus, healthy sperm, adequate ovarian function, and open fallopian tubes. We complete this level one testing efficiently within a couple of weeks. Testing specific hormone blood levels provides information about ovarian health and the odds of success."

If you passed the level one testing and begin to take Clomid, you'll be monitored by having an ultrasound on your ovaries "to document a mature egg sac, called a follicle, indicating Clomid has achieved the desired effect," Diaz says. "Our patient can then attempt to conceive naturally, or if a low sperm count is present, insemination can be performed. Without proper monitoring, it is not possible to know how each patient is responding."

So basically, Clomid helps you to ovulate. If you have trouble ovulating on a consistent basis or at all, talk to your health care provider about whether they think Clomid may be a good fit for you, and you can go over the proper dosing.