Clomiphene Risks: What You Need to Know Before Taking It

When you're trying to get pregnant and ovulation isn't happening, clomiphene, a selective estrogen receptor modulator used to trigger ovulation in women with infertility. Also known as Clomid, it's one of the most prescribed fertility drugs in the world. But it's not a harmless pill—many people don't realize the risks until they experience them. Clomiphene works by tricking your brain into thinking estrogen levels are low, which pushes your body to produce more follicle-stimulating hormone (FSH) and luteinizing hormone (LH). That sounds good, right? But your body doesn’t know it’s being tricked. That’s where things get messy.

The most common clomiphene side effects, physical reactions that occur in a significant number of users, including hot flashes, mood swings, and bloating are uncomfortable but usually mild. But then there are the less talked-about ones: blurred vision, ovarian hyperstimulation syndrome (OHSS), and multiple pregnancies. OHSS can turn dangerous fast—swollen ovaries, severe abdominal pain, nausea, and even fluid in the lungs. And while twins are often seen as a bonus, triplets or more? That’s a high-risk pregnancy with serious health consequences for both mother and babies. Clomiphene increases the chance of multiples by up to 10%, and that’s not a small number when you’re dealing with preterm birth, low birth weight, or NICU stays.

Not everyone should take it. If you have liver disease, unexplained vaginal bleeding, ovarian cysts (other than PCOS), or a history of visual problems, clomiphene could make things worse. Even if you’re healthy, long-term use isn’t recommended. Studies show that using it for more than six cycles doesn’t improve your chances—and might raise your risk of ovarian tumors. And here’s something most clinics won’t tell you: clomiphene can thin your uterine lining, making it harder for an embryo to implant, even if you do ovulate. That’s why some women take it for months and still don’t get pregnant.

What about the alternatives? letrozole, an aromatase inhibitor increasingly used as a first-line fertility drug due to better success rates and fewer side effects is now preferred in many cases, especially for women with PCOS. It’s not FDA-approved for this use, but real-world data shows it works better and carries lower risks than clomiphene. There’s also gonadotropin injections, though they’re pricier and require more monitoring. The point isn’t to scare you—it’s to make sure you’re making an informed choice.

Clomiphene isn’t a magic bullet. It’s a tool. And like any tool, it can help—or hurt—depending on how and when it’s used. If you’re considering it, ask your doctor about your specific risks: your age, your hormone levels, your medical history. Don’t just accept the script. Know what you’re signing up for. Below, you’ll find real user experiences, clinical comparisons, and safety tips from people who’ve walked this path before you.