As estrogen levels increase, the hypothalamus signals a corresponding decrease in the production of FSH. Clomiphene citrate competes with estrogen receptors at the hypothalamus occupying them so that the hypothalamus "interprets" lower estrogen levels and signals continued production of FSH by the pituitary gland. This supports follicular development. Once the follicles reach maturity, the hypothalamus signals the pituitary to release a spike of luteinizing hormone, which then stimulates ovulation.

Clomiphene Citrate FAQ

How does the hypothalamus work?

The hypothalamus can be thought of as the "reproductive hormone regulator". It monitors the levels of numerous hormones including follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen and others. It causes the pituitary to increase or decrease hormone production based upon a feedback mechanism termed the "hypothalamic-pituitary-ovarian axis".

The hypothalamus sends "signals" to the pituitary via gonadotropin releasing hormone (GnRH). At the beginning of an ovulatory cycle, the hypothalamus signals to the pituitary to increase production of FSH. FSH is responsible for follicular recruitment (each follicle contains one egg) and supporting the follicles as they grow and mature. As healthy follicles develop, they produce estrogen and its levels are monitored by the hypothalamus.

When is clomiphene citrate most effective?

Clinical data clearly demonstrate that clomiphene citrate is most likely to be effective in the first three ovulatory cycles. Once ovulation begins to occur regularly, there is no advantage to increasing the dose.

What are the success rates of clomiphene citrate?

Very high. Clomiphene citrate is an excellent treatment choice for many women with ovulatory disorders. It often results in a much desired pregnancy, with minimal expense to the couple.