Initial treatment often includes the use of fertility drugs to stimulate egg production, especially in women with polycystic ovaries. These are prescribed if there is a problem with ovulation (the release of an egg each month). Common fertility medicines include:
- clomifene – encourages the monthly release of an egg (ovulation) in women who don't ovulate regularly or who can't ovulate at all
- tamoxifen – an alternative to clomifene that may be offered to women with ovulation problems
- metformin – particularly beneficial for women with polycystic ovary syndrome (PCOS)
- gonadotrophins – can help stimulate ovulation in women, and may also improve fertility in men
- gonadotrophin-releasing hormone and dopamine agonists – other types of medication prescribed to encourage ovulation (NHS choices 2017)
Some women may get pregnant using fertility drugs alone or they may be offered them in combination with other treatments such as IUI and IVF.
Most of the women we spoke to had been offered Clomid. This often marked the start of their journey through fertility treatment. (We did not interview anyone who was successful with fertility drugs, although they are often successful.)
For Janine and her husband taking Clomid was the first step on what she described as a “treatment escalator” which went on to include ICSI, donor eggs and eventually adoption. But for others, Clomid is all that is needed to achieve a successful pregnancy. Those who attended more than one clinic or compared notes with other couples, were sometimes surprised to find that standard practice varied at different clinics and that there are “no easy answers” as to which treatments to try in which order. Belinda, for example, changed clinics and was given different advice.
Lulu was not keen on trying fertility drugs but eventually tried a few months of clomiphene (Clomid). She got pregnant but then miscarried.
Clare lost a lot of weight before starting on clomiphene (Clomid) which she hoped would be a ...
Here’s the Clomid. Go away and try. I reckon you’ll be pregnant by Christmas.” So we rushed out the clinic, absolutely thrilled. You know, I’d lost all this weight. This was the magic tablet I was going to take to make me ovulate and to get me pregnant. We started taking them in September and we had naively very high hopes that that would be it, I’d be pregnant on the first cycle. And it didn’t happen. October, took them again. It didn’t happen. The drugs were starting to make me feel quite depressed as well, so that was making things worse. Took them again in November. And during that cycle we actually decided that we weren’t entirely happy with the hospital, and we’d go and pay for a private consultation. And we went to our local private fertility clinic, which we’d, you know, never considered before, and were told that not only was my polycystic ovarian diagnosis completely incorrect, but the scan showed that the Clomid was hyperstimulating my ovaries and I was produce, producing far too many follicles. And the scan further showed that I actually had blocked tubes, and I wasn’t going to be able conceive on Clomid. It would have to be IVF.
Belinda and her husband found there is considerable uncertainty about the benefits of taking clomiphene (Clomid), and not enough research to inform their decision.
I suppose there are some choices. It is like initially, we when we were seen at the first clinic, and they suggested going on Clomiphene, just like a normal tablet which you take each month just for a few days. And so initially was just to take that for six months, and if that hadn’t worked then we would progress on to IUI. But then when we changed clinics, they were saying, well they haven’t really found Clomiphene that useful for unexplained infertility. They did say like we could carry on with that if we wanted to, but they were suggesting IUI instead. So – and then when we saw the consultant at the local hospital then he was saying he thought that Clomiphene was a better option. So it was just made us feel like we were going back to where we were to begin with. And we tried that for a couple of months and it didn’t work, so we just decided to go ahead with the treatment. And, yet, it is so much cheaper you are talking about the price of a prescription rather than something like £900 so there is a big difference in the price. But yes, the problem is there isn’t enough research done so you don’t know exactly how successful treatment is to compare the two of them. Because of course they have always been done with people like with different problems and like different age groups and things so you can never really do a direct comparison between the two. So we did find that really difficult and I don’t know, we are both people who like answers to problems and like things to be straightforward and there is no easy answer to it and you just have to go with what you feel is right. And at the time we just decided that we felt it was right to continue with the treatment plan that we had got, rather than going back to may be where we had been at the beginning. Because we decided it was a step backwards rather than a step forward. And yes, it might have saved us money but you don’t know.
Clomiphene (Clomid) can have unpleasant side-effects for some women, even if they felt they had been warned and prepared for a state of “hormonal hell”. Lulu (see above) said it was “like having PMT (pre menstrual tension) ten times over”. After three months on clomiphene, Maggie stopped because she felt “I’m moody, I’m spotty and I can’t have kids”.
Maggie tried Clomid for three months but the mood swings, flushes, spots and weight gain were...
I’d read about Clomid being described as hormonal hell, so I guess I was fairly prepared for this, for some adverse side effects. The consultant had been fairly honest with me as well, and had given me a big long list of the things that I could potentially expect. I guess really that’s what they have to do to make you aware of there are, you know, thing, there’s no such thing, there’s nothing without complications. So w-, the fertility drugs, Clomid I did find affected my mood swings certainly. I would find myself feeling very very angry. And I knew that it was irrational and unreasonable, but I just found myself feeling full of fury. And it, that was very very difficult. I’ve always been a fairly chilled out kind of person, and to feel this rage was really just something completely new for me and very difficult to deal with, and not pleasant for people around me either. So that, the, the mood swings were one thing. I also did gain an awful lot of weight, and I found that my skin changed as well. I’d always had a fairly good skin. Even as a teenager I’d never had a particular skin problem. And, but with Clomid I found along my jaw and on my chin I would have horrendous spots, which again really did affect my self-esteem. I was like, “God, you know, I’m moody, I’m spotty and I can’t have kids.” It felt fairly miserable. The other thing, the weight gain, and also extremely bad hot flushes as well. I would feel this kind of, this heat rising up from me. It felt like it was rising up from my stomach, and I would know that my face would be scarlet and I would be sweating. And this was in winter. And combined with the spots and the weight and the anger, it really wasn’t great. So I tried Clomid for three months. And then we went to see our fertility specialist, who said, “Okay, you know, that hasn’t worked. We’ll move on to IUI.”
Martha had secondary infertility; a prescription for clomiphene was the first step. She found the...
Another woman who took clomiphene for three months reflected that “it is not a pleasant experience and it doesn’t do a lot for your sex life either I’m afraid”.
Last reviewed July 2017.
Last updated July 2017.