What side-effects may be experienced with clomiphene? with clomiphene

There is a slightly increased chance of multiple pregnancy and ovarian hyperstimulation syndrome (OHSS). Other side effects of clomiphene therapy include hot flushes and headaches but these are not usually severe enough to discontinue treatment and may be less troublesome with time.

The majority of pregnancies occur in the first few treatment cycles. Some find that simple monitoring with basal temperature alone is as good as urinary LH monitoring and ultrasound for the first few clomiphene cycles but we prefer checking progesterone levels on the twenty-first day of the cycle. If there is no success with 50mg, the dose can slowly be increased in 50mg increments up to 200mg daily for five days.

Although attention has been drawn to the anti-oestrogenic activity of clomiphene , there is probably no substance in the suggestion that the cervical mucus is adversely affected. There would appear to be no increased risk of congenital abnormality (Q3.3) in pregnancy after clomiphene ovulation induction. Early pregnancy loss and ectopic pregnancy rates are not significantly increased in association with clomiphene induced ovulation.

There continues to be debate on the question of a relationship between the use of clomiphene and later development of ovarian cancer. The debate arose in 1994 when an analysis of 3,837 women previously investigated for infertility in Seattle between 1974 and 1985 was reported. Invasive or borderline malignant tumours of the ovaries had subsequently developed in 11 women whereas statistically four or five would have been expected. Nine of the women developing ovarian malignancy had taken clomiphene and five of these nine had taken the drug for twelve months or more. Treatment with clomiphene for less than a year was not associated with increased risk. The consensus is that the risk has probably been overstated. If it is clinically felt to be in your interests for you to continue with clomiphene this is medically acceptable provided that you have been given the current information.

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