Black Cohosh improves side effects of Clomid
A possible reason for low pregnancy rates in patients using Clomid during assisted reproductive techniques (ART) (IUI, IVF, etc) is it’s known side effect of thinning the endometrial lining. This is due to Clomid’s direct suppressive effect on cervical mucus, despite it’s ability to raise serum estrogen levels.
The endometrial thickness is an important factor to consider during infertility treatment and can influence the success rates of ART.
Clomid does have it’s place in infertility treatments. Countless studies have shown Clomid to be effective in inducing ovulation, although the number of pregnancies that occur is much lower, one reason being it’s anti-estrogenic effects on the endometrial lining.
An endometrial thickness less than 6-8mm has been shown to be correlated with a lowered pregnancy rate and a higher risk of spontaneous abortion, since the lining can facilitate proper embryo placement.
Drugs, such as ethinyl estradiol, are given adjunctively to patients using Clomid to improve endometrial thickness, with little success. Another drug, Letrozole, is commonly used instead of Clomid, in patients who historically have an issue with endometrial thickness, in patients who have PCOS or a past history of spontaneous abortion. Letrozole has been shown to have more of an estrogenic effect on the endometrial lining, compared to Clomid. Depending on your case, either drug is used.
In this study, Black cohosh, a common herb used in our fertility treatments, was shown to improve the endometrial thickness in patients undergoing cycles using Clomid with unexplained infertility. The other drug commonly used to improve endometrial thickness, ethinyl estradiol, was also used to compare it’s effects.
The treatment group using black cohosh with clomid showed:
fewer days for attain adequate follicular maturation
thicker endometrium lining and a higher estradiol concentration
higher luteal-phase serum progesterone compared to the ethinyl estradiol group
Although this study did not show a significant difference regarding clinical pregnancy rates, many of the side effects clomid can have were mitigated using black cohosh.
In another study done, black cohosh was shown to improve clinical pregnancy rates and again cycle outcomes. The study was done to compare the use of clomid alone or clomid with black cohosh during the follicular phase of the women’s cycle. A positive statistically significant difference was seen in the thickness of the endometrial lining, serum progesterone, and estradiol and LH concentrations in the group using black cohosh with clomid (similar to the results above).
In addition, the clinical pregnancy rate was much higher in the black cohosh group (36.7%) compared to the group using clomid alone (13.6%)
Depending on your case, Black cohosh can be an effective adjunctive treatment for couples using Clomid. It can improve pregnancy rates and cycle outcomes.
In good health,
Dr. Kirti Deol