**Core Concept**
Clomiphene citrate is a selective estrogen receptor modulator (SERM) used in the treatment of infertility in women with polycystic ovary syndrome (PCOS). It works by stimulating the hypothalamic-pituitary-ovarian axis to increase follicular growth and ovulation.

**Why the Correct Answer is Right**
Clomiphene citrate has several side effects due to its estrogen receptor modulating activity. The common side effects include hot flashes, visual disturbances, breast tenderness, and mood changes. These side effects are often related to the estrogen receptor modulation in the brain and breast tissue.

**Why Each Wrong Option is Incorrect**
**Option A:**
This option is incorrect because visual disturbances are a known side effect of clomiphene citrate, particularly due to its effect on the retina and the optic nerve.

**Option B:**
This option is incorrect because clomiphene citrate can cause an increase in the risk of ovarian hyperstimulation syndrome (OHSS), a potentially life-threatening condition characterized by ovarian enlargement and fluid accumulation.

**Option C:**
This option is incorrect because ovarian cysts are a known side effect of clomiphene citrate, particularly due to the increased follicular growth and ovulation.

**Clinical Pearl / High-Yield Fact**
It's essential to monitor patients on clomiphene citrate for signs of visual disturbances, such as blurred vision or double vision, as these can be indicative of a more serious side effect.

**Correct Answer: D.**