Your doctor has prescribed Clomid and now you’re feeling nauseated, tired, and a little woozy. Your period is a week late, but is it really pregnancy? In the early stages, it’s hard to tell. If you’ve been hoping for a baby for a while and you’re undergoing fertility treatments, you might alternate between noticing small symptoms and getting excited about possible pregnancy, and ignoring the early signs completely because you’ve had so many disappointments. Even more confusing is the task of distinguishing early pregnancy symptoms from side effects of fertility treatment and fertility medicines themselves. Let’s get a closer look at Clomid, one of the most frequently prescribed fertility medications, to help you understand the early signs of pregnancy after clomid better.
What Is Comid?
Clomid, also known by its other brand names Clomifene and Clomiphene, or simply by its chemical name clomiphene citrate, is a frequently prescribed and proven fertility medication taken by many women who are trying to conceive (TTC). Because Clomid is almost always taken orally in tablet form, it’s easy to take. Clomid improves and regulates the quality as well as the timing of ovulation, and helps increase the chance of pregnancy. For women with irregular menstrual cycles, it can also be very useful.
What Does Clomid Really Do?
Clomid works by stimulating an increase in the amount of hormones that support the growth and release of a mature egg from the ovaries, known as ovulation. Specifically, the drug works by blocking estrogen receptors in the brain. This causes the brain’s pituitary gland to produce a hormone known as FSH or follicle stimulating hormone. Even though FSH is initially produced in the brain, it actually acts on the ovaries themselves, specifically the ovarian follicles, causing eggs to be released.
Because of Clomid’s effect on the ovaries, many doctors prescribe it when a couple comes in for fertility treatment where the woman may not be ovulating, ovulating irregularly or possibly has infertility for which no cause can be found. Usually fertility doctors such as OB/GYNs or Reproductive Endocrinologists (REs) will prescribe Clomid in 50 mg oral tablets to women for about 5 days. In some cases, primary care physicians will also prescribe Clomid as a first treatment prior to referral to a fertility specialist.
Possible Side Effects Of Clomid
What can you expect to feel when your doctor has prescribed Clomid? Fortunately, side effects are usually minimal, and many women don’t even notice they are taking it. Other women may experience irritability, minor hot flashes, mood swings, insomnia, visual symptoms, pelvic pressure or cramping, and dizziness, or fatigue. These symptoms are usually mild and pass quickly. Of course, if you have any allergies to foods, chemicals or medication, you are advised to report these to your OB/GYN or RE before starting Clomid. It’s also important to disclose any medical diagnosis, such as polycystic ovarian syndrome (PCOS) to your physician before beginning treatment.
Because Clomid may cause more than one egg to be released, there is an 8 to 10 percent increased chance of twins, and a less than 1 percent incidence of triplets. A potentially serious condition called ovarian hyperstimulation syndrome (OHSS) can occur, although it is rare. There is no increased incidence of birth defects, stillbirths or miscarriage with Clomid. Nor is there definitive evidence that these medications can cause early menopause or ovarian cancer.
Many fertility doctors use medications known as gonadotropins instead of clomiphenes, as they can be more effective, depending on the diagnosis, the woman’s age and particular situation. Because Clomid is less expensive and can increase chances of pregnancy by 5-10%, it is often used as a first line medication in many cases, especially if the woman is under the age of 35. Once a woman is over 35, many doctors prefer to use other drugs as they are more effective in women who are over thirty five years old.
If your doctor does prescribe a round of Clomid for your infertility, be aware that it is advised Clomid not be used over a certain amount of times consecutively, or over a certain amount of times per 12 months. Follow your physician’s instructions for taking Clomid carefully.
Also, if you have a history of anemia or any kind of blood deficiency, and you plan on taking Clomid, tell your doctor as well as your holistic health care provider (acupuncturist, naturopath, nutritionist etc.) as they can recommend foods and other things to do to ensure a good, healthy uterine lining during the process, so as to aid in a healthy conception and pregnancy.
Clomid Symptoms vs. Pregnancy Symptoms
So how do you distinguish between symptoms that may be caused from taking Clomid and those that may be from early pregnancy? Here are the most common symptoms that can occur, both in early pregnancy and also from fertility medications. Let’s look at each one in turn to see whether it really indicates pregnancy or might be a side effect of the medication:
- Hot flashes:This is not a typical early pregnancy symptom but it’s a common side effect of fertility medications like clomiphene (also known as Clomid or Serophene). If you’re experiencing hot flashes, sweating, chills, or shortness of breath, these symptoms are most likely due to fertility medications, and not from pregnancy.
- Bloating:While bloating may occur later during pregnancy, it’s not common in the early stages of pregnancy. Bloating is a possible side effect of clomiphene (Serophene), so if you’re experiencing this symptom it isn’t likely connected to pregnancy. This could also be signaling a delayed period.
- Fatigue:This could be a symptom of early pregnancy, but it’s also a common side effect of many fertility medications. In addition, fertility treatment can be emotionally exhausting, so if you’re feeling tired or run down, it doesn’t warrant a pregnancy test.
- Headache:Many fertility medications may cause minor headaches, so if headaches are your only symptom, then you probably aren’t pregnant, as headaches alone usually aren’t an early sign of pregnancy. However, since there’s a chance you could be pregnant, be careful about taking medication to treat your headache and consult your physician.
- Frequent bathroom breaks:Having to take more frequent trips to the restroom is a classic early symptom of pregnancy, but it could also be caused by drinking more water than usual, increased caffeine intake, taking prenatal vitamins, or it could be a side effect of fertility medicines.
- Missed period:This is the classic wake-up call for women across the world, but if you’re taking fertility medicine it could have other causes. Due to their impact on hormone levels, fertility medicines can alter and change the pattern or frequency of your menstrual cycle.
- Swollen breasts:As hormone levels change in the early stages of pregnancy, many women notice their breasts feel tender, achy, or uncomfortable. In fact, breast changes are often one of the earliest signs of pregnancy. However, since coming menstruation also can cause breast tenderness, this can’t be taken as a sign of pregnancy unless accompanied by several other symptoms.
- Appetite changes:The classic pregnancy symptom of food cravings usually doesn’t set in until at least the fifth or sixth week of pregnancy. If you’re experiencing changes in appetite (either suddenly disliking certain foods or really craving others), it could be due to many factors, including stress, hormonal fluctuations, or even fertility treatments. If this continues and is also accompanied by a missed period, you might want to get a pregnancy test.
Remember, the only way to really tell if you’re pregnant is to take a pregnancy test, and then wait, since even pregnancy tests can sometimes be incorrect.
Signs Clomid Is Working
Obviously, Clomid is working if it causes ovulation, but since you can’t directly tell if ovulation is happening, you’ll need to rely on other signs. One of these signs is thinning of your cervical mucus that also becomes clear and takes on the consistency of egg whites. Your basal body temperature will fall somewhat and then rise at ovulation. You’ll need a specially sensitive basal body temperature thermometer if you want to measure this. These can be purchased at most drug stores. Your cervix will also soften somewhat and open. Because of this you may notice mild cramping in your lower abdomen.
During this medication phase, some patients are instructed to chart their basal body temperature and take ovulation tests, while some come into the office for ultrasound scans and blood work. Ultrasounds and blood testing are done to confirm that the follicles are developing properly and are the best way to track whether a woman is ovulating or not. These tests will help the physician get a clear reading on what the ovaries are doing and how a woman is progressing, whether she is trying to conceive (TTC) naturally, or planning an upcoming IUI (intrauterine insemination) or IVF (in vitro fertilization) procedure.
Can Clomid Delay a Positive Pregnancy Test?
Once you begin Clomid, usually on day three or day five of your menstrual cycle, one of three things will happen:
One – Ovulation occurs but you don’t become pregnant. In this case, your period will begin on day 27 to 30 of your cycle. Your pregnancy test will be negative and your physician may elect to repeat Clomid with your next cycle.
Two – Ovulation occurs and you become pregnant. If you have not had a period by day 35 of your cycle, check a home pregnancy test. If positive, make an appointment with your physician.
Three – Ovulation did not occur and you are not pregnant. If you have not had a period by day 35 of your cycle and your pregnancy test is negative, your physician may elect to induce a period with a medication called Provera, and may also choose to increase your Clomid dose on your next cycle.
What If Clomid Doesn’t Work?
If Clomid fails to work, especially after repeated cycles, it may be time to consider other fertility treatments. One of these treatments is to continue using Clomid but pair it with IUI (intrauterine insemination), in which the physician will place sperm directly into the uterus through the cervix using a small catheter.
Women who are less than 35 years old have a 20 percent chance of conceiving per month. For these women, who have tried Clomid plus IUI for 1 to 2 years and have not become pregnant, IVF or in vitro fertilization, would be the next step. IVF consists of harvesting a woman’s eggs. The eggs are placed in a laboratory container and exposed to the partner’s sperm. Once fertilization has occurred, the embryo is then transferred to the woman’s uterus.
Women who are over 35 years old have a 5 to 15 percent chance of conceiving per month. For these women, Clomid plus IUI should be abandoned in favor of IVF after six months of treatment.
If these treatments fail, then egg donation may be the logical next step, especially for older women. Women who are 44 to 45 years old have less than a 5 percent chance of delivering a healthy infant, even with the help of IVF. Women who are over 45 have essentially a zero percent chance using their own eggs, due to non-viability of their eggs, so egg donation in this age group is a good option for these women.
Of course, these decisions are best made in consultation with an experienced fertility expert. For more information see our Fertility Treatment FAQ here.
If you have any questions about Clomid, fertility medication or the fertility treatment process in general, feel free to call our office directly at 310-566-1470 and consult with our experienced team or contact us online here. We are always happy to help you on your path to parenthood!