Clomid, or clomiphene citrate, or Serophene is a medication that is commonly used for the treatment of infertility. Clomid was originally developed for treatment of anovulation. The medication will often induce ovulation in women that do not develop and release an egg (ovulate) on their own, such as in women with polycystic ovaries.
Clomid is also frequently used to stimulate extra follicles develop in the ovaries of women that already ovulate without medications.
Clomid, Serophene, or clomiphene citrate (generic name) is a medication that is commonly used for the treatment of infertility. It is often used to attempt to induce ovulation in women that do not develop and release an egg (ovulate) on their own.
In these cases the hope is that there will be an improvement in the chance for getting pregnant by increasing the number of follicles developing in the ovaries – and therefore the number of eggs releasing. This is called controlled ovarian hyperstimulation or superovulation.
What is the protocol for taking Clomid?
- Clomid is generally started early in the menstrual cycle and is usually taken for 5 days either from day 3 through 7 or from day 5 through day 9
- “Day one” is counted as the first day of menstrual bleeding
- Clomid is usually started at a dose of one tablet, or 50mg daily
When will I ovulate on Clomid? Timing intercourse after Clomid treatment:
It is best to have intercourse on the day of ovulation if possible. Some women will prefer to use ovulation predictor kits which are urine tests that the woman can do at home. These kits are designed to detect the presence of the LH surge in the body. The LH surge in the blood begins approximately 36 hours before ovulation. The ovulation prediction test is usually done in the mornings. Sex on the day it turns positive or the next morning is best for fertility.
In many women, the menstrual cycle is lengthened somewhat by Clomid. This is only a temporary effect while on the medication. Clomid cycles on the average are a few days longer than the average menstrual cycle length in the same woman without Clomid.
Ovulation is usually about 14 days prior to the start of the next menstrual period. Therefore, if the menstrual cycle length is known for a woman’s typical Clomid cycle, then sex can be timed to fall about 12 to 16 days prior to the “expected” date for the next period.
- For example, if the woman has a 32 day cycle length on Clomid, then she is probably ovulating on about day 18
- A good plan for her would be to have sex on about days 16, 18 and 20
Clomid and artificial insemination, IUI
- Infertility specialist clinics will often add intrauterine insemination to clomiphene cycles in order to increase the chance for pregnancy
- Insemination is particularly beneficial for women that already ovulate on their own and are using Clomid to get extra egg production
- Success rates with inseminations -IUI
Clomid treatment success rates in women that already ovulate
Can I conceive with Clomid treatment?
There are many variables involved in a fertility situation. Some important factors involved in guessing the chance for Clomid being effective include:
- The cause of infertility, which is often unknown
- The female age
- Sperm quantity and quality
- Duration of infertility
- Possible presence of endometriosis
- History of any previous pregnancies
- Many other factors
An excellent study published in 1998 reviewed results from 45 other published studies of fertility treatments for unexplained infertility. The study attempted to determine an “average success rate” for various forms of fertility treatment for couples with unexplained infertility. As a brief summary of this study, they found:
|Type of Treatment||Approximate Chance for Pregnancy Per Month|
|Try on own – no treatment||1.3-4.1%|
|Insemination, no ovarian stimulation||3.8%|
|Clomid + intercourse||5.6%|
|Clomid + insemination||8.3%|
|Injectable meds + intercourse||7.7%|
|Injectable meds + insemination||17.1%|
How many cycles of Clomid should be tried before moving on to other treatment options?
- Female age is an issue – fewer cycles should be done with an older woman
- Clomid probably should not be used at all if the female is 40 or older because of the significantly reduced fertility potential
- If she is under 38 years old and the sperm is good, 3 months of clomiphene cycles (with good ovulation) are often tried
The patient’s own sense of urgency, financial considerations and other personal factors will often be part of the decision about when to move on to other fertility options.
When is it time to move on to IVF treatment?
Some couples will choose to do injectables and insemination before IVF and others will go straight from Clomid plus insemination treatments to IVF.
For women under 35 in our in vitro fertilization program we see pregnancy success rate statistics of about 65% for getting pregnant with one IVF attempt and about 55% for a live birth rate (miscarriages account for the difference).