Many women suffer a great deal of heartache before reaching the thin blue line of a positive pregnancy test. There is a large number of infertility treatments and they do not work for everyone, by any means.

Thousands of women take clomifene citrate, a drug that stimulates the ovaries, as part of their attempt to conceive. But a recent study indicates that, for some patients, clomifene is no more help than “expectant management” – doing nothing. The researchers were studying couples receiving treatment at a clinic for “unexplained infertility”, which means that problems such as blocked fallopian tubes had already been excluded.

This paper, published in the British Medical Journal, is interesting for two reasons. First, the National Institute for Health and Clinical Excellence advises that women with unexplained fertility problems “should be informed that clomifene citrate treatment increases the risk of pregnancy, but that this needs to be balanced by the possible risks of treatment, especially multiple pregnancy”.

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