ABSTRACT
Clomiphene is the most frequently prescribed fertility drug in America. In the UK it is used by general practitioners as well as hospital specialists as the initial treatment for amenorrhoea or oligoamenorrhoea. The guidelines recommend that treatment with clomiphene is tried for women who ovulate with clomiphene and have no other infertility factors, before embarking on more complex or invasive therapy. Clomiphene works by increasing the secretion of follicle stimulating hormone which in turn stimulates ovarian follicular development. Usually a course lasts five days and starts on the second day of the menstrual cycle. Clomiphene should not be given to women with unexplained infertility as current evidence suggests that it is ineffective, although trials are still proceeding to provide more information of currently unrecognised potential benefits. Clomiphene, danazol and bromocriptine should not be used where investigations show that ovulation is occurring normally, as they will be ineffective and may increase the risks of creating multiple pregnancies.
