Terminology Tuesdays: Doc, what are the side effects?

I get asked this question frequently. Today, I discuss the most common side effects that you may experience when taking Clomid for infertility!

Clomiphene citrate (Trade name: Clomid) is a pill that “is indicated for the treatment of ovulatory failure in carefully selected infertile women who wish to become pregnant.” Many patients ask what sort of side effects they may experience when taking Clomid. Fortunately, many women who take Clomid do not experience any side effects. Additionally, the side effects are temporary and go away once the medication is stopped.

Clomid’s side effects are dose-related. The higher and more frequent the dose, the more severe the side effects experienced. The most common side effects and their risk of occurring are listed in the package insert provided by the company that makes the medication (Sanofi-Aventis):

Ovarian enlargement (13.6%)

Vasomotor flushing (Hot flushes) (10.4%)

Abdominal-pelvic discomfort (distension, bloating, pain or soreness) (5.5%)

Nausea and vomiting (2.2%)

Breast discomfort (2.1%)

Visual symptoms (1.5%)

Headache (1.3%)

Intermenstrual spotting or heavy periods (1.3%)

The hot flashes are “not usually severe and disappear soon after treatment is discontinued.” The visual symptoms that may occur are blurring of vision or spots or flashes and can be accentuated when the patient is exposed to a more brightly lit environment. These visual symptoms “may occasionally occur during or shortly after clomiphene citrate therapy.” The visual symptoms usually go away after discontinuation of the Clomid, “however, cases of prolonged visual disturbances have been reported.”

Patients have been known to have developed Ovarian Hyperstimulation syndrome (OHSS) with Clomid use. However, the occurrence of OHSS with Clomid usage is rare. “Caution should be exercised when using clomiphene citrate in patients with uterine fibroids due to the potential for further enlargement of the fibroids.” The incidence for multiple pregnancy is increased when taking Clomid for infertility. According to the package insert, the chance of twins is 6.9%, triplets = 0.5%, quadruplets = 0.3%, and quintuplets = 0.13%. Also, “there is an increased chance of ectopic pregnancy (tubal pregnancy) in women who conceive following clomiphene citrate therapy.”

If you are taking Clomid for infertility and experience side effects, alert your doctor immediately.

For more information, please read the package insert that accompanies your prescription of Clomid.

Source: Clomid package insert by Sanofi-Aventis

Dr. Lowell T. Ku, M.D. is an award winning and leading Reproductive Endocrinology and Infertility specialist at Dallas IVF, one the nation’s premiere infertility centers.  Dr. Ku clarifies the many confusing terms used in the world of Infertility using straightforward explanations.