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How Long Should I Be on Clomid?
After you have had a basic fertility work-up that indicates you are not ovulating regularly or not ovulating at all, your fertility doctor may prescribe Clomid (clomiphene citrate). Clomid is most often used to stimulate ovulation in women who have infrequent or absent ovulation (anovulation).
What Is the Dosage for Clomid?
Clomid is an oral fertility drug that comes in 50 milligram (mg) tablets. The standard dosage is 50 mg a day for five consecutive days, usually starting on the second, third, fourth or fifth day after menstruation begins.
The fertility doctor will determine your response to Clomid and whether you are ovulating through a number of means which may include: your menstrual pattern, ovulation predictor kits, measurement of serum progesterone levels or the basal body temperature (BBT) chart. If ovulation does not occur at the 50 mg dosage, the fertility doctor will increase Clomid by 50 mg increments in each cycle until you ovulate.
It is important to note that even though dosages in excess of 100 mg are not approved by the Food and Drug Administration, your fertility doctor will determine the right dose for you.
How Long Should I Stay on Clomid?
Recommendations are that you stay on Clomid for a maximum of six months.
“Estrogen normally has a negative effect on the pituitary,” says David Kreiner, M.D., a New York fertility doctor with East Coast Fertility. “Clomid blocks estrogen and leads to pituitary FSH production and ovarian stimulation.” Clomid causes the pituitary gland to secrete more FSH, and the higher level of FSH spurs the development of ovarian follicles that contain eggs. If the treatment is successful, about a week after the last table of Clomid is taken, the pituitary gland releases a luteinizing hormone surge, which causes the egg to be released.
“Women who are likely to conceive with Clomid usually do so in the first three months of therapy,” Dr. Kreiner says, “with very few conceiving after six months.”
Because Clomid has an anti-estrogen effect, it can have an adverse effect on the cervical mucus and endometrial lining. “Clomid may thin out her cervical mucus, preventing the sperm’s entrance into her womb,” Dr. Kreiner says.
In addition, a study done many years ago indicated that women who used Clomid for more than 12 cycles developed an increased incidence of ovarian tumors. “It is therefore recommended by the American Society of Reproductive Medicine (ASRM), as well as the manufacturer of clomiphene that Clomid be used for no more than six months, after which it is recommended by both groups that patients proceed with treatment including gonadrotropins (injectable hormones containing FSH and LH) to stimulate the ovaries in combination with intrauterine insemination or in vitro fertilization,” Dr. Kreiner says.