Ovulation Induction
Pregnancy: X — discontinue immediately if pregnant
Clomifene
Brand names: Clomid, Serophene
Adult dose
Dose: 50mg once daily for 5 days starting on day 2–5 of cycle
Route: Oral
Frequency: Once daily × 5 days per cycle
If no response: increase to 100mg for next cycle. Max 150mg/day. Max 6 treatment cycles (increased ovarian cancer risk with longer use).
Clinical pearls
- Selective oestrogen receptor modulator (SERM): blocks negative feedback → increased FSH/LH
- Indicated for anovulatory infertility (PCOS most common)
- Stop immediately if visual symptoms — clomifene-associated visual disturbances (rare but irreversible if untreated)
- Multiple pregnancy risk — counsel patients; monitor with USS
- Maximum 6 cycles: epidemiological concern for ovarian cancer risk with longer use
Contraindications
- Ovarian failure (primary)
- Hepatic disease
- Abnormal uterine bleeding (undiagnosed)
- Ovarian cysts
- Pregnancy
Side effects
- Multiple pregnancy (8–10% twins)
- Ovarian hyperstimulation syndrome (OHSS)
- Hot flushes
- Blurred vision (stop if visual disturbance)
- Mood changes
- Ovarian cysts
Interactions
- Gonadotrophins — additive ovarian stimulation
Monitoring
- USS monitoring of follicle development (cycles 1–2)
- LH surge monitoring or USS to confirm ovulation
- Signs of OHSS (abdominal pain, bloating, weight gain)
Reference: ESHRE/ASRM PCOS Guidelines 2023; NICE Fertility NG156. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators