Fertogard (Clomifene)

Fertogard is Healing Pharma's clomifene tablet, in a strip of 10 tablets. Clomifene (clomiphene) is a selective oestrogen receptor modulator used to make the pituitary release more FSH and LH.

Clomifene is approved to induce ovulation in women who do not ovulate or ovulate irregularly, including in polycystic ovary syndrome, when they want to conceive.nnIn men it is prescribed off label for secondary hypogonadism and for infertility with low sperm counts, because it raises the body's own testosterone without shutting down sperm production, which makes it an alternative to testosterone replacement for men who want to keep their fertility.

Clomifene blocks oestrogen receptors in the hypothalamus. The brain reads that as low oestrogen and increases its signal to the pituitary, which releases more FSH and LH. In women the extra FSH grows one or more follicles to ovulation. In men the extra LH drives the testes to make more testosterone and the extra FSH supports sperm production. Clomifene is a mix of two isomers: enclomiphene, which does the useful work, and zuclomiphene, which lingers for weeks and has oestrogen-like effects.

In women it is taken for five days early in the cycle, starting with one 50 mg tablet a day, with ovulation checked by tests or ultrasound; the dose is raised in later cycles only if ovulation does not occur, and treatment is usually limited to six cycles. In men it is taken daily or on alternate days at a dose set from testosterone and oestradiol blood tests. Take it exactly as prescribed; higher doses raise the risk of multiple pregnancy and side effects without improving results.

• Hot flushes.n- Abdominal bloating and discomfort, and in women ovarian enlargement or cysts.n- Nausea, breast tenderness and headache.n- Mood swings, irritability and, in some men, low mood or anxiety.n- Visual symptoms such as blurring, spots or flashes, which are a reason to stop and see a doctor.n- Multiple pregnancy, mostly twins, in ovulation induction.n- Rarely, ovarian hyperstimulation syndrome.n- In men, a rise in oestradiol with breast tenderness or gynaecomastia.

Clomifene is not taken in pregnancy, so a test is done before each course. It is not used with ovarian cysts other than polycystic ovaries, undiagnosed vaginal bleeding, liver disease or hormone-dependent tumours. Visual disturbances mean stopping the drug. In men, testosterone, oestradiol and semen analysis are monitored.