From the Guidelines
Yes, Clomid (Clomiphene) is used for Polycystic Ovary Syndrome (PCOS) as it can stimulate pituitary gonadotropin secretion by antagonizing hypothalamic-pituitary oestrogen receptors, making it a simple method of inducing ovulation in infertile women, particularly in cases of anovulation secondary to PCOS 1.
Key Points
- Clomiphene citrate is a selective oestrogen-receptor modulator that can induce ovulation in women with PCOS.
- It works by stimulating pituitary gonadotropin secretion, which can help induce ovulation in women with anovulation secondary to PCOS.
- While there are no randomized clinical trials evaluating the use of clomiphene citrate for the treatment of infertility in women with Functional Hypothalamic Amenorrhoea (FHA), it is still used as an oral ovulation inducer in PCOS patients.
- The Endocrine Society’s 2017 recommendations suggest a possible test of treatment with clomiphene citrate for women with a sufficient endogenous oestrogen level, but its use as a first-line treatment for FHA is not recommended due to uncertain chances of success 1.
Important Considerations
- The effectiveness of clomiphene citrate in inducing pregnancy in women with PCOS is not clearly established.
- Prolonged use of clomiphene citrate may be more effective in inducing a return of menses, but its impact on pregnancy rates is unclear 1.
From the FDA Drug Label
Clomiphene citrate is indicated for the treatment of ovulatory dysfunction in women desiring pregnancy. Impediments to achieving pregnancy must be excluded or adequately treated before beginning clomiphene citrate therapy Those patients most likely to achieve success with clomiphene therapy include patients with polycystic ovary syndrome Clomiphene citrate should not be used in patients with ovarian enlargement except those with polycystic ovary syndrome
Yes, Clomid (Clomiphene) is used for Polycystic Ovary Syndrome (PCOS), specifically for the treatment of ovulatory dysfunction in women with PCOS who desire pregnancy 2.
From the Research
Clomid (Clomiphene) Use in Polycystic Ovary Syndrome (PCOS)
- Clomiphene citrate has been traditionally used as the first-line treatment for ovulation induction in PCOS 3.
- However, the European Society of Human Reproduction and Embryology (ESHRE) recommended the use of letrozole as first-line therapy for ovulation induction in anovulatory PCOS women in 2018, due to better pregnancy and live birth rates 3.
- Studies have compared the efficacy and safety of clomiphene citrate and letrozole in ovulation induction for women with PCOS, with some finding that letrozole may be as effective as clomiphene citrate 4, 5.
- Clomiphene citrate has been found to alter uterine receptivity, which could affect its efficacy in achieving pregnancy 6.
- For women with PCOS who are resistant to clomiphene citrate, combination therapy with metformin or laparoscopic ovarian drilling may be considered 7.
Efficacy of Clomiphene Citrate in PCOS
- Clomiphene citrate has been shown to induce ovulation in 60-85% of PCOS women 7.
- However, the pregnancy rate with clomiphene citrate may not be significantly different from that of letrozole 4, 5.
- The use of clomiphene citrate in combination with letrozole may potentially improve fertility outcomes in PCOS subfertility 3.