Infertility — Treatment with Clomid

After you have been evaluated and it is determined that your infertility may involve issues with ovulation, your doctor may recommend that you take Clomid (clomiphene citrate).

Clomid works by stimulating an increase in the amount of hormones that support the growth and release of a mature egg (ovulation). Note: this medication is not recommended for women whose ovaries no longer make eggs properly.

The incidence of spontaneous twins in the United States is 3.1%. The risk of becoming pregnant with twins or more increases with the use of Clomid.

The most common side effects of Clomid use are hot flashes, breast tenderness, mood swings, nausea, visual symptoms, and headache. Call your doctor for medical advice about adverse side effects.

Regimen for Clomid use

  • Clomid is initiated at the starting dose of 50 mg daily for 5 days; the dose can be adjusted if ovulation does not occur. Clomid is given orally, starting on cycle day 3, 4, or 5 for 5 days (cycle days 3-7; 4-8; or 5-9), where day 1 is the onset of the menses.
  • Successful use of Clomid requires monitoring of induced cycles. This can be done by using ovulation predictor kits (OPKs). Two good OPKs are Clearblue® Easy and First Response®. If you’re having a hard time with the OPKs, try a digital monitor.

Patient instructions

  • Day 1 is the first day of menses.
  • Starting on day 3, 4 or 5, take the Clomid tablet(s) daily (50 mg / tablet) for 5 days. You are expected to ovulate between 5-10 days after stopping the last Clomid dose.
  • Using the OPKs, start testing your urine on day 10 of the menses and continue until the test becomes positive, or through day 18. If ovulation does not occur, then you may need to have your Clomid dose adjusted.
  • Have intercourse on the day of positive ovulation, and then every other day for 1 week.
  • A pregnancy test should be checked if no menses begins by 14-16 days after ovulation.
  • Follow up with your physician for a Clomid check, approximately 14-16 days after ovulation.