When do you Ovulate on Clomid

birth control pills

Clomid is also referred to as clomiphene citrate.  It is one of the first drugscontraceptive-pills-849413_960_720 a fertility specialist will use in a woman who is suffering from ovulation problems.  Clomid acts like an anti-estrogen on the pituitary gland, making the pituitary gland put out more luteinizing hormone (LH) and follicle stimulating hormone (FSH). These, in turn, act on the ovaries, telling them to stimulate one or more follicles prior to ovulation.  Of course, this means that the ovaries, the hypothalamus, and the pituitary gland must be fully operational in order to work.  Clomid works best on women who don’t make enough estrogen.

How is Clomid Used?

In the beginning, Clomid is taken at a dose of 50 mg per day for five days in the beginning at the cycle.  It can be started the 3rd, 4th, or 5th day after the menstrual bleeding has started.  It is taken for five days in a row.  If 50 mg of Clomid does not work, then 100 mg of Clomid are used each day in the same way that 50 mg of Clomid was used.  Sometimes, the doctor will add human chorionic gonadotropin (HCG) intramuscularly on any day of the cycle between days 14-18 of the cycle.

Eventually, a plan of action works and you begin to have ovulatory cycles that produce at least one viable egg.   You ovulate after taking the Clomid on about the 12th through 18th day of the cycle.  The doctor must monitor you very carefully when Clomid is used to make sure that it is working.  If 100 mg of Clomid are used along with HCG and no ovulation occurs, taking more of these medications is not going to help and other methods must be used to try and retrieve a viable egg.

In order to monitor the Clomid cycle, the doctor usually does the following:

  • A baseline ultrasound is done on days 2-5 of the cycle to make sure that there aren’t any left behind from a previous cycle.Fetal_Ultrasound
  • Blood levels of estradiol are taken at 4-6 days after the last pill is taken.
  • The growth of the follicles is monitored on ultrasound to see if any follicles are growing.
  • A test is done on the sperm before ovulation to make sure there is enough viable sperm to fertilize the egg.
  • The LH surge that occurs at the time of ovulation is measured using a urine LH screening test.
  • The progesterone level is checked 7-9 days after ovulation to make sure that the follicle is supporting the fertilized egg adequately.

Clomid is used for three to six months to see if follicles are forming.  If they are not forming, then a laparoscopy may have to be done to see if there is anything going on in the pelvis that can’t be seen on ultrasound.

How do I use Clomid?

Remember that day one of the cycle is the first day of the menstrual cycle.  Once you begin to bleed, you need to make an appointment with your doctor to see if an ultrasound shows residual follicles from previous menstrual cycles.

Begin taking Clomid on the 3rd, 4th, or 5th day after you start bleeding.  Ovulation is expected to occur between five and ten days after you stop taking the last pill of Clomid.

You need to have intercourse at least every other day for the week before and up until the day you expect to ovulate. If you decide to use an LH detection kit, you need to start collecting your urine for the test beginning about 3-4 days after you have taken the last Clomid pill.  If you don’t see an LH surge on the LH detection kit, the doctor will give you a shot of HCG if there appears to be a follicle that has begun to grow and is at least 20 millimeters in size.

You should have another ultrasound and a blood test for estrogen between 4-6 day after you have your last Clomid pill.  At day 21 to 25 of the cycle, 2919_Hormones_Initiating_Labor-02you need to see the lab for a progesterone test to see if the progesterone level is high enough to support a fertilized egg. If there isn’t enough progesterone in your system, the doctor will prescribe progesterone for you, which is taken as a shot or as a vaginal suppository.  This usually starts with three days after you ovulate.  If you don’t get a period after 14-16 days after ovulation, pregnancy tests should begin to see if you are pregnant.

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