How Femara and Clomid Work for Ovulation Induction
- 6 hours ago
- 3 min read
Complete Healthcare | Richland, WA
For women who are trying to conceive and experiencing irregular ovulation or anovulation, two of the most commonly prescribed oral medications are Femara and Clomid. These medications are often first-line treatments in fertility care and can be highly effective when used appropriately.
At Complete Healthcare in Richland, WA, ovulation induction is tailored to each patient’s medical history, hormone profile, and reproductive goals. Below is a clear explanation of how these medications work and what patients should expect.
What Is Clomid?
Clomiphene citrate (brand name Clomid) has been used for decades to stimulate ovulation.
How Clomid Works
Clomid is a selective estrogen receptor modulator. It works primarily at the level of the hypothalamus.
Here is the mechanism:
Clomid blocks estrogen receptors in the brain.
The hypothalamus perceives estrogen levels as low.
The brain responds by increasing GnRH secretion.
This stimulates the pituitary to release more FSH and LH.
FSH stimulates the ovaries to mature follicles.
LH surge triggers ovulation.
In simple terms, Clomid tricks the brain into thinking estrogen is low, which stimulates the ovaries to release an egg.
Who Benefits Most from Clomid?
Women with irregular ovulation
Patients with polycystic ovary syndrome
Women with unexplained infertility and regular cycles
Success Rates
Ovulation rates: Approximately 70 to 80 percent
Pregnancy rates: Approximately 15 to 20 percent per cycle
What Is Femara?
Letrozole (brand name Femara) was originally developed as a breast cancer medication but is now widely used off-label for ovulation induction.
How Femara Works
Femara is an aromatase inhibitor. It works differently than Clomid.
Aromatase is an enzyme that converts androgens to estrogen.
Femara blocks aromatase.
Estrogen levels temporarily drop.
The brain detects low estrogen and increases FSH production.
FSH stimulates follicle development in the ovary.
Unlike Clomid, Femara does not block estrogen receptors directly. It lowers estrogen production instead.
Why Femara Is Often Preferred
For many patients, especially those with PCOS, Femara has become first-line therapy.
Benefits may include:
Higher live birth rates in PCOS patients
Lower risk of thinning the uterine lining
Less impact on cervical mucus
Lower risk of multiple gestation compared to Clomid
Comparing Femara and Clomid
Feature | Clomid | Femara |
Mechanism | Blocks estrogen receptors | Lowers estrogen production |
Uterine lining effect | Can thin lining | Minimal thinning |
Cervical mucus | May decrease quality | Usually preserved |
Twin risk | Slightly higher | Slightly lower |
First-line for PCOS | Historically yes | Now often preferred |
Clinical studies have shown that Femara may produce higher live birth rates in women with PCOS compared to Clomid.
What to Expect During Treatment
At Complete Healthcare, ovulation induction is carefully monitored.
Typical protocol includes:
Cycle days 3 to 5 start of medication
Five days of oral therapy
Ultrasound monitoring is indicated
Timed intercourse or intrauterine insemination
Side effects are generally mild and may include:
Hot flashes
Headache
Mood changes
Breast tenderness
Serious complications are rare but include ovarian hyperstimulation syndrome and multiple gestation.
Which Medication Is Right for You?
Selection depends on:
Age
Diagnosis
Hormone levels
Endometrial thickness history
Prior response to medication
Personal and family medical history
Patients with PCOS often respond very well to Femara. Patients with regular cycles but unexplained infertility may respond to either medication. In some cases, if one medication does not result in ovulation, the other may be tried.
A Personalized Approach in Richland, WA
Fertility care requires precision and patience. At Complete Healthcare in Richland, WA, treatment plans are individualized and based on current evidence, clinical experience, and patient goals.
Ovulation induction is often the first step before moving to more advanced reproductive technologies. Many patients conceive successfully with oral therapy alone.
If you are struggling with irregular cycles or difficulty conceiving, schedule a consultation to review your options.
Call 509-392-6700 to schedule your consultation today.
Complete Healthcare, Richland WA
Richard Lorenzo, D.O.







