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How to Take Clomid (Clomiphene) for Infertility

How to Take Clomid (Clomiphene) for Infertility

Clomid (Clomiphene) typically requires a prescription from a gynecologist that may not be the same as a fertility specialist. Clomid can be combined with IUI or is more commonly given to take at home in sync with intercourse. This guide will give you an idea of how the cycle looks and how to take Clomid for infertility. However, it is important to note that treatment using Clomid in Australia may differ across various specialists.

How long does it take for Clomid to make you ovulate?
How long does it take for Clomid to make you ovulate?

Cycle Day 1

The first day of your reproductive cycle is the day you begin menstruating. It is also known as the start of the follicular phase

If you have problems conceiving even after trying for over six months, it may be worth seeing your doctor or a fertility specialist. They may recommend that you take Clomid (Clomiphene), which can help improve your chances of conceiving naturally.

Clomid works by increasing the amount of estrogen in your body. Estrogen helps stimulate egg development and make cervical mucus thicker, making it easier for sperm to travel through the reproductive tract during ovulation.

Treatment with Clomid usually takes place over two menstrual cycles: one cycle on Clomid and one cycle off Clomid (called a “rest” cycle). You will take one pill daily for five days during each treatment cycle and then take two pills daily for two days (for nine days).

Doctors can prescribe a pattern for irregular periods. If you are not pregnant, they will assess your hormones to see if Clomid is right. Your doctor might prescribe a form of progesterone called Provera if you have irregular periods. Provera will induce a period, but you might want to take a pregnancy test beforehand to ensure you don’t get pregnant.

When should I take clomiphene for fertility?
When should I take clomiphene for fertility?

Cycle Days 2–3: Baseline Ultrasound

baseline ultrasound is the first step in determining if Clomid is right for you. The ultrasound exam will give you a picture of your follicles and ovaries to see how your body responds to treatment.

Ultrasound: If you’ve had a baseline ultrasound, you know your ovarian response. If not, this test can help your doctor determine how many follicles are developing and when they’ll be ready to release an egg. The process is known as ovulation induction or controlled ovarian hyperstimulation (COH). COH aims to stimulate the ovaries to release one or more mature eggs during ovulation. 

This test typically takes about 30 minutes and involves using a probe that emits sound waves at different frequencies. These waves pass through the abdominal wall into your pelvis, where the ovaries are located. The probe returns information about the size and shape of your ovaries and uterus and whether any fluid-filled cysts (follicles) exist on them.

Cycle Days 3–5: Start Clomid (Clomiphene)

If you get a positive ovulation test, stop taking Clomid and wait for your period or resume birth control if you were taking it while on Clomid. If you don’t get a positive ovulation test after five days of taking Clomid, continue to take it until you get one, or your doctor advises otherwise.

You will take one dose of Clomid a day for five days, as long as your doctor clears you. You can take the first dose on any day of your cycle but not the first day. Depending on the regimen, doctors prefer to prescribe Clomid on particular cycle days.

Typically, doctors prescribe Clomid on cycle days 3, 4, 5, and 6. However, some doctors prefer to prescribe Clomid on day 3 of your menstrual cycle. While other protocols exist, they don’t affect the pregnancy success rate.

Taking the Clomid at a specific time every day would be best. Some people experience more benefits from taking it before bedtime, whereas others do best when they wake up for work. Either option is fine, but you should be consistent with your schedule to get the most out of the drug. If you’re on a Clomid cycle, it might be best to stick to a plan once you start unless you speak to your doctor.

Cycle Days 3–9: Clomid (Clomiphene) Begins to Work

Clomid (Clomiphene) does not typically induce ovulation. With your first dose of Clomid, the medication will begin to react and lead to ovulation. The hormone FSH signals the ovaries to grow and mature eggs. As the follicles mature, they release estrogen, which signals the brain to slow down the production of FSH. Reduction in FSH level, in turn, slows down the stimulation of the ovaries. Clomid works by tricking your brain into sensing you have low estrogen levels. It does this by blocking estrogen from attaching to its receptors.

Blocking the receptors and the circulating estrogen levels in your bloodstream tricks your brain into thinking you have low estrogen levels. The body senses no more oocytes and produces more hormones, stimulating the ovaries to release an egg. Even after stopping Clomid treatment, side effects may continue for the whole month.

Clomid Mechanism of Action
Mechanism of action of Clomid (Clomiphene Citrate)

Treatment for Infertility During Cycle Days 10–21

If you are using a basal thermometer or a fertility monitor, you will want to be sure you are taking your temperature every morning before getting out of bed. The temperature shift when you get up in the morning is different from one taken while sleeping. After waking up, the first thing you should do is take your basal body temperature.

If you are not monitoring your basal body temperature, you should record daily vaginal bleeding and other ovulation symptoms such as sore breasts or headaches.

Most doctors do not monitor Clomid (Clomiphene) treatment cycles since they assume you have an ovulation predictor kit. While many reproductive endocrinologists don’t, several fertility doctors monitor Clomid cycles.

They do so for two primary reasons: Two mature follicles raise your odds of conceiving twins. If you want to avoid twins, and your doctor can’t guarantee them, tell them in advance. In case more than one follicle develops, your doctor will most likely cancel the cycle and ask you to avoid conceiving.

If you were planning on doing an IUI or a trigger shot, you wouldn’t be given that treatment to avoid higher multiple pregnancies, which carry risks for both you and your future children. Your doctor may want to delay your cycle so that they can adjust your medications accordingly. If you were to ignore this, you could become pregnant and at a high risk of miscarriage. It’s better to wait until it’s time for your subsequent treatment.

Cycle Days 15–25: Trigger Shot

Your doctor may prescribe the hormone human chorionic gonadotropin (hCG) and Clomid. The combination is called a ‘Trigger Shot’ because it triggers ovulation within a day or two, which may help better time IUI or intercourse. 

An hCG shot acts a lot like an LH surge. The rise in hCG concentration releases an egg from the ovaries, signalling the follicles to release eggs. Infertile women are commonly given the trigger shot on their seventh day of Clomid. However, the trigger shot is given later if a woman’s follicles need more time to mature before ovulating. 

If you take a pregnancy test within seven days of receiving a trigger shot, the test may turn out positive even if there is no pregnancy. The hCG from the trigger shot can interfere with the pregnancy test. 

Ovidrel is given as a subcutaneous injection
Ovidrel is given as a subcutaneous injection

Cycle Days 10–17: Intercourse/IUI and Ovulation

You should expect to ovulate 5 to 10 days after taking your last Clomid pill. If you took Clomid (Clomiphene) on days 3 through 7 of your cycle, you would likely ovulate between days 10 and 16. On the other hand, if you took Clomid on days 5 through 9, your next ovulation would probably happen around days 12-17 in your cycle. 

Doctors usually order a progesterone blood test during the 19-21 days. However, if your doctor suspects that you might have ovulated later than day 21, they might adjust the timing of the test. 

Your doctor may prescribe a progesterone vaginal suppository if you produce too low levels. The added progesterone can help determine whether or not Clomid triggered ovulation. One method for testing progesterone levels is to look for a surge after ovulation.

Cycle Days 19 or 21: Blood Test for Progesterone 

After ovulation, the two-week wait will either end with a positive pregnancy test or your period. The two weeks can be hard to endure, and all you can do is wait. It is not uncommon to experience mild ovarian hyperstimulation syndrome (OHSS) after taking Clomid (Clomiphene). Still, you should contact your doctor if the symptoms are severe or if you are worried about them.

As the symptoms of pregnancy and side effects of Clomid overlap, you might be confused regarding your pregnancy status. Hence, you must talk to your fertility expert if you are confused. 

Cycle Days 21–35: The 2-Week Wait

You have made it through the first half of your Clomid cycle and are now eagerly awaiting your 2-week wait. You should start feeling a bit better than you did at the end of the first week. Your PMS symptoms should have subsided, and you may be noticing changes in your body, such as breast tenderness, bloating, and fatigue.

If you are using OPKs or an ovulation predictor kit, you should start testing every day beginning on CD 21 through to 35. Buy ovulation tests to detect your LH surge 

In case you are not using OPKs or an ovulation predictor kit, you should continue checking your cervical mucus each morning throughout your 2-week wait. If it is stringy, sticky, or gummy, ovulation is approaching. If your cervical mucus appears watery, then this means that ovulation has already occurred. Once again, if no signs of ovulation are present, it is important to continue checking every day until CD 35 because there can be a delay between O (ovulation) and P (peak fertile period).

Many women will have experienced a surge in their basal body temperature (BBT).

Cycle Days 28 and 35: Pregnancy Test

Day 28 and Day 35 Six days before your missed period is a good time to take a pregnancy test. You might need to get a beta pregnancy test in the middle of your two-week wait and then again at the end.

They may order blood work only at the end or ask you to take an at-home pregnancy test between days 28 and 35 of your cycle with instructions to call if you get a positive result.

If your pregnancy test is positive, that means you’re pregnant. When this happens, your doctor will ensure the pregnancy develops well and double-check to see if you are expecting twins. Understandably, being excited after struggling with infertility can be a bit nerve-wracking.

Pregnancy Test Kit
Fertility2Family at-home pregnancy test kit

What to do if Clomid (Clomiphene) is Unsuccessful

If your pregnancy test is negative, you might have to get tested again. If you get your period during the waiting time, the pregnancy cycle probably didn’t work. When a cycle of IVF doesn’t work, it can be upsetting. Remember that you can try again; sometimes, changing the treatment will help.

Fertilization may not have occurred, the implantation process was unsuccessful, or your body might be having a rejection response. You shouldn’t adjust your treatment just yet. May need to have another go or two at this. People trying to get pregnant usually need to try more than once, both with natural conception and fertility treatments. Your doctor may prescribe a higher dosage if you did not ovulate on your first donation.

The typical start for Clomid is 50mg, but many women will not ovulate at that dosage. Your doctor might prescribe a higher dosage if you cannot ovulate on the initial dosage of Clomid. But if that doesn’t work, the fertility experts might consider other treatment options. 

Your alternative options may include taking Clomid with metformin or switching to the drug Letrozole. If three to six cycles of Clomid fail, your fertility specialist will most likely consider an alternative treatment plan. Some doctors recommend moving on after the third cycle if the patient doesn’t get pregnant. If you use the steps in the next article, you can avoid taking Clomid, which has a significant chance of failing.

Benefits of Using Clomid (Clomiphene) Over Other Infertility Medications

Clomid has several advantages over other fertility drugs:

  • It’s relatively inexpensive. A course of treatment with Clomid costs less than $100 in Australia.
  • It’s safe for most people who take it. Side effects are rare but include bloating and breast tenderness in women and mood changes in men.
  • You can take Clomid at home without requiring a doctor or nurse monitoring. The process is very convenient for women who work full time or don’t have access to transportation during their fertile period each month.