How does a Clomid cycle work?
Clomid® (clomiphene) is a pill that helps women ovulate. It can also cause the ovulation of multiple eggs in one month. It is the first line of fertility treatment for many women. Women who do not ovulate (have irregular periods) are the ideal candidates for a Clomid cycle.
If you decide to take Clomid, you will be asked to call our office on the first day of your period
You will then be scheduled for a “baseline ultrasound” to be performed anytime between cycle days 1 and 3. This ultrasound is done to make sure that you do not have any cysts in your ovaries that can affect the development of ovarian follicles. If no cyst is seen on the ultrasound, a clomiphene prescription is given for five days, usually starting cycle day 3.
You will then be scheduled to return to Texas Fertility Center in San Antonio for another ultrasound that will be performed typically three to five days after your last Clomid pill. This ultrasound will determine how you are responding to the dose of clomiphene that you are taking.
During this “midcycle ultrasound,” Dr. Munch or Dr. Hudson will measure the size and number of the follicles in the ovaries, along with the thickness of your endometrial lining. During this sonogram, your doctors should see lead follicles at least 15 mm to 16 mm.
Some patients will be instructed to use a trigger shot called Ovidrel®, which takes the place of the LH surge and causes ovulation of the egg at a certain time. Other patients may use a urinary ovulation prediction kit (OPK) every morning. Those OPKs detect the presence of luteinizing hormone (LH), the hormone that triggers ovulation to occur.
Most women will ovulate six to nine days after their last clomiphene pill. Once we know when your ovulation date will occur, we will either schedule an intrauterine insemination (IUI), or advise on the best days to time intercourse.
Office-based ultrasounds help identify successful growth in a Clomid cycle
During the midcycle ultrasound, if no large follicles are seen, then no eggs are responding to that dose of clomiphene. Depending on bloodwork and ultrasound findings, we may escalate to the next higher dose of clomiphene for five days, followed by another “midcycle” ultrasound, or potentially change to a different medication. These ultrasounds will be repeated until follicle development occurs.
A blood pregnancy test will be ordered two weeks after ovulation
Bloodwork is the most sensitive way of knowing if a pregnancy has occurred after a clomid cycle. Our medical team will call you with the result of this test, usually the same day bloodwork is drawn.
If you are pregnant, congratulations! In addition to further blood tests, Dr. Munch or Dr. Hudson will do an ultrasound two to three weeks after the initial pregnancy test, to make sure that the pregnancy is growing appropriately within the uterus. We will repeat the ultrasound exam again a few weeks later to ensure growth of the embryo.
If the pregnancy test is negative, we keep going. Fertility treatment is often a marathon, not a sprint. Another clomid cycle can be attempted when your period starts. If you have not successfully conceived after three to six cycles of clomiphene, Dr. Munch or Dr. Hudson will most likely recommend a change in approach.
Our team at Texas Fertility Center in San Antonio is committed to performing a thorough fertility evaluation and starting you on appropriate treatment as soon as possible, so that you can achieve your dream of having a family. Contact us today to learn if you are a good candidate for a clomid cycle.