Whenever a couple has been trying to conceive for a year without any success, the first thing that they will do is schedule a visit with the doctor and start taking the next step. The next step is that the doctor would check the man’s sperm count and quality and see if that checks out. And the doctor would run several tests on the woman to see if her hormone levels check out. Ultrasounds would be done to check the structural part of her reproductive system, as well as a hysterosalpingogram (HSG) would be done to check to see if her fallopian tubes are functional. At this point, the couple would be referred to a fertility specialist. If everything structurally checks out with the woman, including that the hysterosalpingogram indicated that the tubes are fine- then it is possible that she is not ovulating on a regular basis. Even if the blood work indicates that there is no obvious hormonal issue present, she will be given a drug called clomiphene citrate, also called Serophene or Clomid, which is the most common term for this drug. If the man in fact has an issue with his sperm count and quality, then the fertility specialist will suggest intrauterine insemination (IUI) to be done to help conception happen. This way, a tube that injects his washed sperm will go into her cervix and bypass the long way through the fallopian tubes and insert the sperm right into the uterus right around the time ovulation is expected. Even if a woman who has to have IUI done who ovulates regularly may be put on Clomid to help time ovulation, as it would be monitored via ultrasound and bloodwork. Now that we are talking about a woman who has to take Clomid due to the fact that she may not be ovulating regularly due to having a condition such as polycystic ovarian syndrome (PCOS) which can cause anovulation- and/or has to do IUI due to her partner having poor sperm quality. One thing that will frequently cross a couple who has to go through fertility treatments involving the woman having to take Clomid is what are the chances of conceiving twins?
How Clomid Works
Before we go into that, let’s talk a little bit about Clomid and how it works. Clomid was the first fertility drug in 1967 that became part of the market that came in injection form at the time. Now it is available as a tablet, and the dosages range from 50mg to 200mg. Side effects can range from having hot-flashes, moodiness, breast tenderness, nausea and fatigue. They are rather uncomfortable but not serious. Clomid is usually taken from day 5-9 of a woman’s cycle (or it can be taken from day 2 to day 6 of the cycle). What the drug does is that it tricks the brain into thinking there is not enough estrogen and it ends up sending out hormones that stimulate follicular growth and egg maturation. Hence, it triggers ovulation, and again the growth of the follicle is monitored through ultrasound and bloodwork. Because Clomid is a safe drug, couples do often wonder the statistics of ovulation happening, and pregnancy resulting. Here are important points to take in about Clomid’s effects:
- 80% of women will ovulate while taking Clomid within the first 3 months.
- 40% of women will conceive while taking Clomid within the first 3 months.
- The live birth rate for women taking Clomid is between 30% to 60%.
- Couples have a 10% higher chance of conceiving twins than they would naturally.
That is right! Many couples who have to use Clomid whether it is due to anovulation on the woman’s part, or the need for IUI due to the man’s poor sperm quality - or if both reasons are happening at the same time- these couples are concerned about how likely they are to have Clomid twins.
Odds of conceiving twins on Clomid
Now that it is known that the odds of achieving a twin pregnancy on Clomid is 10% higher than it would be naturally- the couple will have to find a way to embrace the possibility. This statistic is relevant for an increased chance of having fraternal twins, meaning two eggs being released at once, being fertilized by two different sperm. This statistic does not apply to identical twins- when one single fertilized egg splitting into two embryos. Even though a 10% higher chance is not significantly higher, the odds are still increased. Therefore, it may be recommended for the couple who is trying to conceive while Clomid is in the picture to educate themselves on what a twin pregnancy involves. A twin pregnancy has more complications than a singleton pregnancy, due to the fact that expected weight gain is 40 lbs instead of 25 lbs for a single baby. Therefore, the risk of gestational diabetes and pre-eclampsia due to extra weight gain, extra stress and pressure on the body from carrying twins is higher. Women taking Clomid will have to prepare themselves since a twin pregnancy has a slightly higher chance of happening of possibly dealing with extra fatigue and even more nausea and sickness.
How to increase odds of conceiving twins on Clomid
However, if a couple loves the idea of having twins, and wants to know how to increase the odds beyond 10% while the woman is on Clomid- then there are methods to increase the odds of having a twin pregnancy while on Clomid. Firstly, if a twin pregnancy is desired then it is recommended for the woman to not drop too much weight if she is overweight. She can safely carry a pregnancy if she has a BMI of 30, which is somewhat overweight. The extra weight can be encouraging for ovulation to happen especially if Clomid is being taken. The woman should also increase dairy intake whether it is from drinking more milk or eating more cheese. It is best to not eat too much ice cream because too much sugar can inhibit ovulation even while on Clomid. That would defeat the purpose. The hormones in dairy products can help stimulate ovulation even further. It is also known that if there is a history in the family, on either side, that alone can also increase the odds of having twins. However, regardless of whether a couple wants or doesn’t want twins- it is known that the odds of having twins on Clomid is 10% higher than it naturally would. Couples can either embrace the possibility of that happening or increase the odds even more if that is what they want!