Clomid (aka Clomifene Citrate) is one of the most common ‘fertility’ drugs in the world and often the first choice of doctors looking to help their patients ovulate ‘better’.
It’s often used in a sort of “shur try it and see” approach.
Ask anyone on the street how it works and anyone who even knows about it will say something like “doesn’t it make you ovulate?”.
Yes…indeed. But how?
It’s a class of drug called a SERM, or a Selective Estrogen Receptor Modifier, in that it ‘modifies’ certain (or select) estrogen receptors, those being the ones in your hypothalamus!
It’s your brain that dictates how much estrogen your body should produce at any given moment. It does this by first tasting the blood to see how much estrogen is already in it. (Like a good chef tastes for salt!). Specifically, it’s the hypothalamus part of your brain that does the tasting. There are estrogen ‘taste buds’ on your hypothalamus, otherwise called estrogen receptors.
Clomid blocks these taste buds so that your brain can no longer accurately tell how much estrogen is in your blood.
The result of this is that the signal to stop producing estrogen doesn’t fire, or in technical terms the Pituitary gland does not get the signal to cut back on the amount of Follicle Stimulating Hormone (FSH) it is pumping out…so it continues to pump it out…and pump it out…and pump it out until the levels of FSH rise much higher than normal in the body.
FSH rises because Clomid has blocked it’s ‘off-switch’!
Soon after taking a few high doses of Clomid, the ovaries become bathe in FSH which hyper stimulates the follicles in the ovary to grow and attempt to ripen.
You could say it forces the ovaries to ripen some eggs!
For some people this is ‘job done’ ovulation happens, pregnancy follows, but for others it doesn’t work at all. Often Clomid is used in advance of IVF to help produce a cluster of eggs that can be harvested, tested and fertilised with a sperm in a petri dish. Again, for some it works fine, for many it doesn’t.
Why does it not work sometimes?
There is no easy answer to this, but the general answer is that women who are availing of this treatment are already dealing with underlying dysfunctions in their bodies, however the dysfunctions are different for different women. They may all have issues ovulating, but the causes for this are very varied.
To give just one example – let’s say a woman was having trouble ovulating because, out of a multitude of possible reasons, she was chronically tired - and so her cortisol production was compromised. Cortisol is necessary for many functions in the body but if your levels are lower or higher than you need them to be, then certain functions will be affected. One of these functions is egg maturation because you need a certain degree of cortisol to produce a viable egg.
But if you are low on that hormone then forcing your follicles to mature eggs is not going to fix that. Clomid cannot fix that problem!
Another issue with force-ripening eggs is that you may not have the nutritional raw materials to produce a healthy egg, this may be the reason for failed ovulation in the first place. In this case Clomid may well succeed in making your ovary produce a clutch of eggs, but that doesn’t mean they will be healthy or capable of sustaining fertilisation or pregnancy.
The bottom line is Clomid works for some, but in my world the best solution is to address the underlying issues first. If that doesn’t work then Clomid may be a viable tool to get you over the hump! (No pun intended!)