The Femara vs. Clomid debate has probably crossed your path if you’re trying to conceive. But which of these two fertility medications should you choose?
Femara vs. Clomid. Or said another way: letrozole vs. clomiphene.
If you’re considering your TTC options, you might have heard of these fertility medications and so many others—and now you’re wondering which one to pick.
Is there a difference? Are there side effects? Which is better?
The answer as to which is better isn’t so straightforward.
Both Femara and Clomid are important players in the fertility game—and both have their pros and cons.
Let’s stack them up against each other and see how they fare.
In this article: 📝
- Why take Femara or Clomid?
- Which is better, Femara or Clomid?
- What are the side effects of letrozole vs. Clomid?
- Will Femara work if Clomid didn’t?
- So, which is better: Femara or Clomid?
Why take Femara or Clomid?
Both of these medications help stimulate ovulation.
If you’re on the TTC journey, your doctor may recommend urine or blood tests to check your ovulation patterns.
If the results show that you’re either not ovulating or not ovulating regularly, you could be a candidate for Femara or Clomid.
These drugs are also sometimes used to treat unexplained infertility and may be combined with intrauterine insemination (IUI) or natural cycle monitoring cycles.
Which is better, Femara or Clomid?
We’ll start by giving a bit of background on each of these medications.
What is Femara?
Femara is the brand name for a drug called letrozole, initially used to treat breast cancer in postmenopausal women.
It’s an anti-estrogen drug and an aromatase inhibitor.
A what? An aromatase inhibitor lowers the amount of estrogen in the body.
It does so by getting in the way of an enzyme called—you guessed it—aromatase that produces the estrogens that cause certain cancers to grow.
So can you use letrozole for fertility?
Yup! When estrogen levels are lowered, the hypothalamus—your hormones’ control center—sends a message to your pituitary gland to tell your ovaries to get to work.
And this can increase your chances of getting pregnant.
Femara is taken orally as a 2.5mg tablet that you take once daily for five days
You usually start taking it on the third day of your period.
What are the pros of Femara?
Femara might be a good option if Clomid hasn’t worked for you in the past.
There’s also less chance of having more than one baby (although this could be a con if you’re trying to have twins).
And there’s good news for those with PCOS.
A 2014 study found that Femara was more effective for women with PCOS, promoting ovulation and leading to successful pregnancies.
Oh, it’s cheaper, too, and its side effects aren’t as bad.
What are the cons of Femara?
That’s not to say that there aren’t any side effects, unfortunately.
We’ll get to that in a minute.
What is Clomid?
Clomid, or clomiphene, also stimulates ovulation.
It does this by blocking your estrogen receptors, which tricks your brain into thinking that the levels of this hormone have dropped.
This dip signals your pituitary gland to release FSH (the follicle-stimulating hormone) on the double, which may prompt you to ovulate.
If you’re not seeing a fertility specialist yet, you might find that your GP or OB-GYN prescribes Clomid as a first port of call.
Clomid is also taken orally—as a 50mg pill.
You typically take it on the third, fourth, or fifth day of your cycle and continue for five days.
What are the pros of Clomid?
Clomid has been around a pretty long time in fertility terms—over 50 years.
And it’s usually the one that doctors choose if you’re opting for IUI, though Femara can also be used.
What are the cons of Clomid?
Yep, Clomid has some side effects, too.
One of the most common ones is the thinning of the uterine lining.
Estrogen is a major player in thickening the uterine lining to favor the implantation of the embryo.
But as Clomid reduces the amount of circulating estrogen, the thickness of the lining can be impacted.
While Letrozole or Femara may also have this effect, the thinning isn’t as severe.
Also, Femara is cleared from the body earlier than Clomid, allowing the uterine lining to not be affected as much, and thicken again.
Doctors don’t normally recommend that you use Clomid for more than six cycles, as this can decrease your chances of getting pregnant over time.
What are the side effects of letrozole vs. Clomid?
Both of these drugs can work but can also cause some side effects.
If you take either drug, you’re likely to experience some side effects that can feel similar to PMS, including nausea, vomiting, headaches, and muscle aches and pains.
(Not a lot of fun, we know.) Unless you’re in severe discomfort, these symptoms are common.
In addition, Femara can cause:
- Weight gain
- Bone or muscle pain
It can also increase your cholesterol levels and decrease your bone mineral density.
If you have pre-existing cholesterol or bone density problems, mention these to your doctor.
Clomid can also cause some of Femara’s side effects, as well as:
- Ovarian enlargement
- Stomach aches
- Tender breasts
- Visual spots
- Hot flashes
If, while taking Clomid, you experience abnormal bleeding, blurred vision or other vision problems, abdominal or pelvic pain, or your skin and eyes become yellow, call your doctor immediately.[
Will Femara work if Clomid didn’t?
As you might guess, we can’t give you a definite yes or no answer to this.
Fertility is complicated, and there are a lot of factors that go into it.
If Clomid didn’t help stimulate ovulation, you ovulated but didn’t get pregnant, or you experienced bad side effects, then Femara might be an alternative.
Your doctor will advise if it’s worth a shot or if you should try something else.
So, which is better: Femara or Clomid?
Your chances of getting pregnant with Femara and Clomid are much the same.
Discrepancies in results usually depend on how old you are, if you have any other fertility issues, and the quality of your partner or donor’s sperm.
In the study mentioned above, researchers found that 62% of women who took Femara got pregnant, compared to 48% of women who took Clomid.
While this might sound promising, this study showed different results—showing a live birth rate of 23% for Clomid and 18% for Femara.
So the best thing to do is talk to your doctor about which option is right for you.
They will be able to advise you based on your medical history, where you’re at in your TTC journey, and what has or hasn’t worked for you in the past.
We know—the TTC journey can be tough.
You don’t have to do it alone.
There’s a whole Peanut community out there that will help you through.
Hang in there. We’re cheering you on!
Looking for more to read as you continue your fertility journey? Start here:
TTC Meaning: The Language of Trying to Conceive
4 Fertility Hormones Every TTC Woman Should Know
20 Must-Know Pregnancy and Motherhood Acronyms
Bicornuate Uterus: What It Is & the Causes
Blighted Ovum: Symptoms & Support
Is Pooping a Lot a Sign of Pregnancy?
What to Understand About Egg Freezing
AMH Levels: What Do They Mean?
Can You Get Pregnant If You’re Not Ovulating?
Should You Pee After Sex While Trying to Conceive?
Do Prenatal Vitamins Help You Get Pregnant?