Ovulation Induction

Occasionally women need to have their ovulation induced when they are having problems conceiving. Clomid is a fertility medication that induces ovulation. We usually start this medication at 50 mg. (one tablet) daily on days 5-9 of your menstrual cycle (please see instructions below). If the lower dosing fails to induce ovulation we may increase the dosage to no more than 150 mg. per day.

After taking the Clomid, one of three things may occur:

• Ovulation will be induced, but you will not get pregnant. In this case, you will have a period between days 27-30 of your cycle.
• Ovulation will be induced and you will get pregnant. You will not have a period and you should visit our office for a pregnancy test.
• The dosage of Clomid may fail to induce ovulation. In this case, you will not have a period and will have a negative pregnancy test. We will most likely increase the dosage at this point.

If your period does start, then repeat the cycle with Clomid again. Mark the days on your calendar with the instructions below to ensure that you are following them correctly. If you have a period between days 27-30 after taking Clomid, then the medicine is working correctly. You should continue taking the medication and have intercourse at the time of ovulation.

If you fail to have a period, but your pregnancy test is negative, you are not pregnant. We will induce a period with Provera (please see information on this). During your next cycle, we will increase the Clomid to 100 mg. to be taken days 5-9 of your cycle. We will continue to increase the dosing up to 150 mg. per day if you do not ovulate when taking the lower dosage.

Instructions for your calendar
When your period begins, mark this as "day 1" on your calendar. Count and mark the number of days until "day 5" and mark this on your calendar. This is the day you will begin taking Clomid. Take the medication on days 5, 6, 7, 8, and 9. You may then label the calendar on the days you may ovulate (most likely between days 12-15). It may help to buy an ovulation prediction kit at the local pharmacy to be sure you are ovulating. Then count and label your calendar on "days 27-30". This may be when your period begins again. If your cycle has not begun by "day 31" please call our office.

Remember:

• Clomid is a fertility medication. One important side effect is the possibility of multiple births. The probability of having twins while taking this medication is 8% (meaning 8 out of 100 women will get pregnant with twins). The chance of having more than twins is greater than normal, but fairly rare.
• Recent studies suggest that Clomid may increase the risk of developing ovarian cancer later in life. Please discuss this with your health care provider, especially if there is a family history of ovarian cancer.
• You may be asked to return for progesterone levels to assess how well the Clomid is working.