Normally reproductive age women ovulate one mature egg, from one ovary every month. Some studies show that women may have one anovulatory cycle per year, but there are not many conclusive statistics to prove this theory. For women having good ole normal sex to try for a bun in their ovens, this situation works out just fine. The bazillion sperm to one egg ratio is alright, and the timing is much easier as fresh sperm can live in a woman's body for pretty much ever (not really, but compared to frozen it seems like it), and timing gets a lot less complicated.
For those of us shooting (pardon the pun...okay not really) for some version of the "turkey baster method", one egg just isn't enough. I've read that success rates for IUI (intrauterine insemination) and ICI (intracervical insemination) can be as low as 6% for unmedicated cycles with just one little eggy. For women/couples spending thousands of dollars per cycle, and waiting months for their BFP (Big fat/freaking/f*#$ing Positive) 6% doesn't cut it.
Enter ovulation stimulating drugs. There are several on the market, some in tablet form, others that require injection into the system. These medications stimulate multiple follicles (the casing that grows the egg in the ovary) so that a woman will release multiple eggs per cycle. Clomid is probably the more widely used specific medication that falls in this group, and happens to be the one I use (not because I necessarily *want* to) . Once you raise the odds a little and have 3 or 4 eggs (or more) released each cycle, the success rates jump up to around 25%. STILL not stunning odds, but certainly better than 6%. Studies suggest, at least with Clomid anyway, your chance of multiples is only raised by 10% (twins) and around 1% (triplets). For most women in my position, this is a risk we are not happy to take, but in my case, after months of natural cycles to no avail, the next necessary step. Contrary to popular belief, drugs like Clomid alone are *not* responsible for Kate Gosselin having a dozen kids and being rude to her husband, or for OctoMom ending up in her ridiculous situation, but they are certainly not without risk.
The side effects for these drugs vary BIGTIME. The most prominent one in the drug literature is multiples (see above), but they also focus a lot on PCOS (polycystic ovarian syndrome). Ovulation stimulating drugs can cause cysts to grow, or new ones to form, so most specialists will order a pelvic ultrasound before and after a course of these medications to check for and monitor ovarian cycts. It can also cause "hostile" (I swear that is the word they use) cervical mucus. For women doing ICI, or even normal intercourse, this can be a big issue as cervical mucus helps the sperm travel, and keeps them safe from the acidic nature of our bodies in their trip through the cervix. Other women complain of headaches, crankiness, fatigue, nausea, etc. Mine are pretty inconsequential, in the grand scheme of things. I get cranky for sure, gain 5 lbs when I'm trying hard not to, and feel like I need wheelbarrows to carry around my ovaries. That last part may very well be in my head, but I definitely feel "fuller". My biggest complaint about Clomid is something that isn't in the books. For some reason it makes my ovulation VERY hard to track. When trying to inseminate within 6 hours of ovulation, this little point becomes HUGE. I normally do *not* get an Lh surge the months I take Clomid, and therefore about half of the cycles I use it, I end up missing ovulation completely and sending back $2000 worth of sperm and wasting $220 on shipping a 22 lb tank clear back to Cali. Since it isn't without risk, this makes for a super frustrating situation.
I *hate* that I cannot have decent odds without medication, wasting eggs, and crappy side effects, but I want a child, of my own, and refuse to settle into societies rules of how that has to happen. Hopefully the benefit will outweigh the risk and I can still be proud of my choices.