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Adverse effects Common adverse drug reactions associated with the use of clomifene (≥1% of patients) include: vasomotor flushes (or hot flashes ), abdominal discomfort, visual blurring (dose-dependent), and/or reversible ovarian enlargement and cyst formation. Infrequent adverse effects (0.1–1% of patients) include: abnormal uterine bleeding, nausea, and/or vomiting. Rare adverse effects (<0.1% of patients) include: reversible alopecia and/or ovarian hyperstimulation syndrome.[2] In comparison to treatment with purified FSH, the rate of ovarian hyperstimulation syndrome is low when using clomifene. Clomifene can lead to multiple ovulation, hence increasing the chance of twins (10% of births instead of the normal ~1%) and triplets; some parents-to-be then opt for fetocide (selective reduction) to reduce the number of fetuses. Off-label use in the treatment of male hypogonadism Clomifene citrate has been found very effective in the treatment of secondary male hypogonadism in many cases. This has shown to be a much more attractive option than testosterone replacement therapy (TRT) in many cases because of the reduced cost and convenience of taking.

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