When some people hear a woman is using "fertility drugs," the first thing that comes to mind is multiple pregnancies like the McCaugheys of Iowa or the Chukwus of Texas. If managed carefully, the risk of higher order multiples (more than three fetuses) while using fertility drugs is actually relatively low. Somewhere between 5 to 20 percent of the women who become pregnant while using fertility drugs carry more than one baby.

Women in treatment for infertility, including advanced reproductive technologies (ART) such as intrauterine insemination (IUI) and in vitro fertilization (IVF), use drugs to stimulate their ovaries to produce eggs. These drugs fall into two categories: clomiphene citrate (commonly called Clomid or Serophene) given in pill form, and injectible medications given either intramuscularly or subcutaneously, depending on the drug and the patient. These include Humegon, Pergonal, Repronex, Fertinex, Follistim and Gonal-F.

While Clomid works by "tricking" the brain into thinking there is insufficient estrogen and indirectly stimulating the ovaries, injectibles, which contain FSH (follicle stimulating hormone), directly stimulate the ovaries. Injectibles are much more expensive than Clomid; they are also much more powerful. If used correctly, injectibles produce far fewer side effects.

Often a woman in the early stages of infertility treatment starts with Clomid. For some women who don't ovulate or who have a weak ovulation, Clomid may be enough. While some doctors give women Clomid (generally with timed intercourse or insemination) without monitoring its effects through ultrasound viewing and blood tests, this is generally not recommended as it is difficult to assess the drug's effects without monitoring the body's reaction.

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