Clomid: How Can It Help You Get Pregnant?

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Sep 18

What is Clomid?

Clomid is the brand name for Clomiphene citrate, which is a SERM (Selective Estrogen Receptor Modulator). The easiest way to think about it is that Clomid binds to estrogen receptors, making your body think it has no estrogen.

How Does That Help With Ovulation?

Normally, every month, you have a group of eggs available in your ovarian “vault.” Each egg grows inside a follicle and produces a small amount of estrogen. This small amount signals the brain: “Hey, we need to ovulate!” In response, your brain sends out FSH (follicle-stimulating hormone) to help the eggs grow.

As an egg grows, it makes more estrogen, which eventually triggers an LH surge, allowing ovulation to happen.

But in some people, like those with PCOS, the brain may misinterpret estrogen signals. High baseline estrogen (from having a lot of eggs, being overweight, or other factors) can prevent the brain from sending enough FSH, leaving you stuck in an anovulatory (non-ovulating) pattern.

This is where Clomid comes in. By blocking estrogen receptors in the brain, the brain thinks estrogen is low and sends out a strong FSH signal to start follicle growth.

How is Clomid Used?

Clomid is usually taken for five days at the beginning of your cycle. The goal is a natural rise in FSH—you don’t need it longer because your brain and ovary need to communicate naturally to prevent multiple eggs from growing at once.

Typical Dosing

Starting dose: 50 mg (1 pill)
Common increase: 100 mg/day (2 pills)
Higher doses: Up to 150–200 mg/day in select cases

Some patients respond in an “all or none” fashion—especially those with higher AMH levels. Others may need IVF if ovulation induction doesn’t work, since IVF bypasses the brain’s FSH signaling entirely.

Who Should Take Clomid?

Clomid was originally used for PCOS, but studies now show that Letrozole (Femara) is usually more effective. Still, Clomid has several important uses:

Unexplained infertility – often combined with IUI to increase the number of eggs
Luteal phase issues – can help normalize cycles in those who ovulate but have a short luteal phase
Low ovarian reserve – can help stimulate ovulation when AMH is low
IVF cycles – sometimes used at the start to encourage FSH production in low- or high-reserve patients
Men with low testosterone or sperm concentration – daily dosing can improve sperm production

Clomid won’t work for hypothalamic amenorrhea, since the brain is not sending FSH signals at all.

Side Effects of Clomid

Since Clomid tricks the brain into thinking estrogen is low, it can cause symptoms similar to menopause:

Hot flashes
Mood changes, irritability
Insomnia
Fatigue

Other potential effects include:

Thin uterine lining – may affect implantation; ultrasound monitoring can help
Ovarian cysts – usually harmless but may delay the next cycle
Ovarian torsion – rare, but a serious surgical emergency
Very rare stroke risk – watch for vision changes

Biggest risks:

Multiple pregnancy: 5–8% chance of twins or more
Not responding: Some patients may not respond due to underlying conditions

Sometimes, Clomid is combined with Metformin, steroids, or lifestyle adjustments to improve response.

Clomid vs Letrozole

PCOS: Letrozole is typically first-line
Other indications: Clomid is often preferred for unexplained infertility, luteal phase issues, and low ovarian reserve

Key Takeaways

Clomid has been around a long time, is generally safe, and not associated with birth defects or cancer. The main risks are multiples, not responding, or side effects. Some people experience severe symptoms, while others have none at all.

If your doctor recommends Clomid, make sure you: