October 25, 2014

Clomid Questions

I found your website from someone who posted about it on the bulleting boards and I can’t stop reading it!
I took Clomid once and it made me ovulate but not get pregnant. My doctors says that it was successful because before Clomid I didn’t even ovulate. She told me that the chance of getting pregnant each time I ovulate is 20%. Why is it only 20% and what can I do to make it 100%? Does that make sense?

ROBERTA, Alabama

 

Dear Roberta,

Clomid works its very best when it is given to women who normally do not ovulate on their own, but then end up ovulating while on the Clomid. It is not as helpful when given to women who already ovulate on their own. Remember that the average woman with normal fertility does not always get pregnant every single month. In fact, the monthly odds of getting pregnant are about 20-25%. If you are a woman who does NOT ovulate on your own, but is fortunate enough to respond to Clomid, then it is an approximate, but fair estimate that the Clomid now has converted you from having zero chance of pregnancy that month (had you not ovulated) to having a normal chance, provided that the sperm and tubes do not contribute any problems, and that normal chance is about 20-25% in most cases.

The question of why normal fertile women or women who respond to Clomid do not have a 100% chance of conceiving with each ovulation is a good one.

One way to look at it is to realize that few things in life are 100%. This is not purely a philosophical answer, but rather one based on reality. If you have normal vision, normal hand-eye coordination and normal arm strength, then you have the capability to wad up a piece of paper and throw it into the wastepaper basket across the room. You can probably succeed on a fairly regular basis, tossing it in every few tries, but you can NOT do it 100% of the time.

Now let’s consider what has to happen in order to get a successful conception. First of all, you must have ovulation. But even assuming that you do ovulate, the egg, which explodes out of the ovary into the general area of the Fallopian tube now has to be lucky enough to be scooped up by the tube. This does not always happen. On my old blog, I posted a description of how egg pickup by the tubes can be compared to the actions of a swimming pool sweeper. So, if the egg is successfully picked up, then it may or may not encounter a sperm. Even if sex occurs within the correct window period, the egg is microscopic and the few sperm that reach its general neighborhood may still not collide with it. Even if the sperm does hit the egg, it may not have the strength left, so to speak, to successfully fertilize it. And even if the sperm and egg do result in a fertilized embryo, that particular sperm or that particular egg may not have perfectly normal DNA. Without perfectly normal DNA, the embryo will stop growing and fail to implant. With all that can go wrong, it is a wonder that pregnancy occurs naturally at all, but it does. And it does so about 20-25% of the time.

Your doctor is on the right track. However, if you still don’t get pregnant after ovulating several times on the Clomid, then it’s time to look at stronger ways of getting the job done, such as IUI or even IVF. Remember that even though something is only 20% and not 100%, if it’s done enough times it will eventually succeed. Thank you for your question. 


 

Hello!  Your website is great.  It is so informative and helpful.  i was
wondering if you could give me some insight……

For starters, I would like to give you some background.  i started my
period at 12 years old, cycles every month, every 32-37 days, minor to
moderate pms type symptoms, no issues really.  I got on birth control at 24
years old only to prevent pregnancy.  I had no probs with bcp, regular
periods, minimal symptoms.  i stopped bcp july 2007 to conceive.  since then
my cycles have been bonkers:

1st cycle-  33 days, +opk day 22, prob ovulatory
2nd cycle-  35 days, +opk day 17, prob ovulatory
3rd cycle-  54 days, prob late ovulation based on my symptoms
4th cycle-  56 days, definite ovulation day 44 by BBT
5th cycle-  69 days, no temp shift, a few random +opk, ended with
progesterone for 7 days
6th cycle-  35 days, took clomid 50 mg days 3-7, no +opk, no temp shift,
ended with 7 days of progesterone
7th cycle (current)-  clomid 100 mg days 2-6, saw RE day 7, US on day 12
showed a "bunch of small follicles with 45 on the left and 55 on the right,
lining 3.6 mm", estradiol 69, told to take 150 mg clomid for next 5 days
(days 12 through 16), then comeback in for US and bloodwork day 19

my questions are as follows:
1)  is this common to do back to back clomid? 
2)  what are the chances it will work/make me ovulate?
3)  does it sound like i have pcos?  (no hirsutism, bmi 21)
4)  if this does not work, do you think femara would be a better option or
maybe going straight to injections?

KIM, North Carolina

 

 

Dear Kim,

Let’s look at the big picture. It has been nine months since you went off the OCPs. While we would love it if you had regular ovulatory cycles, the harsh fact, based on the detailed information that you provide about your cycles,  is that you don’t , at least not on a consistent basis.  Your RE has chosen Clomid as the first line treatment for you. Let’s assume that you have had your thyroid and prolactin checked already. The goal is straighforward at present. GIVE CLOMID. MONITOR to see if ovulation occurs.

I have to admit I don’t quite understand what the 45 and 55 mean. I can’t imagine that your RE counted 45 and 55 small follicles in your ovaries. I’m wondering if you meant that he saw a very large 45mm follicle. That wouldn’t quite make sense either, because if you had 45mm and 55mm follicles, your E2 (estradiol) would be expected to be higher than 69 pg/ml. In any case, to answer your specific questions, some RE’s will start patients on Clomid and if there is no response, they will add injectables. I have never tried to give a higher dose of Clomid within the same cycle. It doesn’t mean that it won’t work, but time will tell. Again, it’s a good thing that you are being monitored so we will at least know what’s going on.

As for what the chances are that it will make you ovulate, at this point, the decision has already been made, so we should just be patient and see what the monitoring shows. After something is done and committed, I try to minimize thinking about what the chances are, but instead focus on carefully tracking what DOES happen. Having said that, I’ll venture a guess that someone who does nothing on Clomid 100mg, will probably not do much on Clomid 150mg givin within the same cycle.

As for whether or not you have PCOS, the smartest things would be to get more information before answering that. There are several questions I need to know before venturing an opinion. I will agree with you that you being so slender would make it atypical for you to have it. BUT there are exceptions. If you haven’t already read this story, you might find it interesting.

So what if Clomid doesn’t work? Your RE knows more about you than I do, so I would defer to him/her. My general approach is to start with some investigation into the causes of the poor ovulation. This starts out with better understading the patients lifestyle (nutrition, stress level, exercise, overall wellness). This might then include checking TSH, prolactin and insulin resistance. Another factor that influences the choice of letrozole vs injectables is the patient’s preference. Is this someone who begs to avoid needles if at all possible and wants to go as conservatively as she can? Or is this someone who is determined to get pregnant as quickly as possible? Most of my patients go on to injectables rather than try letrozole.

Thanks for the question. Feel free to leave a comment with an update on your story. Good luck!

  • Rebecca Florida

    Hi. Thank you for your site. I am 36 years old, have PCOS. I have been on metformin for 8 years. Been TTC for 2 years now, Last month I ovulated with 100mg of clomid however when I did the 21 day progesterone test it showed my level was only 7.1 which RE says was low, so he upped the dose of clomid to 150mg saying that should make my progesterone higher this month, well I didnt ovulate at all this month that I can tell(I use opk) is that possible, should I stay on the 100 mg of clomid and maybe get progesterone supplements instead or moveo n to injectables. thanks

    Rebecca
    Florida

  • inthosejeans1981

    Hi I have PCOS and my husband and I hav tried for 3 yrs to get preg. but due to PCOS no results. My dr. has put me on provera to bring on my period and I started clomid 100 mg on 4 th CD it is now CD # 7 and I am still on my period. Can you tell me if after I finish the last dose will it make my period stop, so I can ovulate.

  • http://fertilitylifeclomid-questions jose

    I was on clomid 50mg for one cycle.it didnt work then i took 100mg it didnt work yet I was ovulating before and even when I took clomid every month.Iam 43years old.should I increase to 150mg even when I do respond on 50mg?I have done all other tests and I have no problem.I have 2kids and my 2nd born is 10years and I had divorced with their father.I got married 2008 May but no pregnancy after taking 2courses of clomid.
    Am I too impatient?my major worry is my age.Please dr advise me.

  • Cindy

    Hi I have been taking 150 mg of clomid for 3 cycles now. The first one my cycle was 32 days and the ovulation monitor peaked on day 20. The next cycle was 33 days and the ovulation monitor peaked on day 22. This cycle was 36 days and I am on day 18 of my cycle. Is it normal to have long cycles and not ovulate until later? My doc seems to think I should have already ovulated.

  • IVF-MD

    It is possible and common for Clomid cycles to be longer than natural cycles. In general, people try three Clomid cycles and many get pregnant. If not pregnant after three cycles, it might be time to consider something more effective. Good luck!

  • dan

    should Clomid make my cycle regular

  • IVF-MD

    Clomid mainly acts in the cycle that you take it. It might help you ovulate in the cycles that you take it, but after you stop, your cycles will revert back to their original state.

  • Katie

    Hello,
    Im on my 7th round of 150mgs of Clomid CD3-7. Im currently on CD 20 & got a positive OPK today…My cycles are very irregular. I started 150mgs of Clomid in Dec 08 & my cycles were 26-29 days long, until I took a month off from the Clomid in Feb 09..I then had a 48 day cycle that had to be brought on by Provera.(Im assuming my body got thrown out of wack from stopping the Clomid one month Correct??)After I started my period from the Provera, I continued with the 150mgs of Clomid each month. My cycles became longer. They are now anywhere between 32-37 days…My Lutel Phase is 14days & I seem to be turning an OPK around the right time. (I think) I calculated back last month (June)14days from the start of this months cycle(July 8th) & I turned a positive OPK on exactly 14days from the start of my period on July 8th. Ok, now that Ive given you a run down of whats been going on with me here are my questions:
    1.- Does this mean Im DEFINATLY ovulating??? I have not been getting any B/W nor U/S done. I have just been taking the Clomid & doing OPK’s with timed intercourse.
    2.- What is my success rate of acheiving pregnancy this month?? Are my odds high because Im on my 7th month?? Or does this mean thr Clomid is not working for me??
    3.- I got pregnant w/my 1st baby after 3months of doing exaclty what Im doing now,but sadly lost the baby @ 15wks. I then got pregnant with my now 4 1/2 yr old son doing the exact same thing as Im doing now as well. Why is it taking longer this time around??
    Do I need to be swithched to something different to acheive pregnancy?? If so, what medication would be my next option???
    Thank you so much, I cant wait to hear back from you so I can have some understanding as to whats happening with me.
    I really appreciate it,
    Sincerely,
    Katie -TTC Baby #3 for 17months (7months of 150mgs of Clomid on CD3-7)17 BFN’s….Really ready for my BFP!!!

  • IVF-MD

    Katie, starting out with unmonitored Clomid is a reasonable way to begin, given that it has worked in the past. However, if it hasn’t worked after three cycles, it might be time to consider doing one monitored cycle or moving on to other options.

  • edee

    Started clomid 50mg in april 09-non ovulitory. 100mg june -non ovulitory. finally july prgesterone level indicates ovulation but no conception, now this cycle repeates clomid 150mg with negative pregnancy test and missed period (5days late). I am assuming i didnt ovulate because of no period,but didnt have progesterone level checked because md didnt think it was necessary. Im wondering what the likelyhood that I did or did not ovulate after second cycle of previous ovulatory dose. And if not what is the next step?

  • Holly

    This is what hapened to me with clomid. I was married for 6 years, cacasion… at 25 I wanted to have a baby, so i stoped taking my birth control. and tried by having intercourse with my husband, I didnt end up pregnant that month, so i did a internet search, and found out i could have a better chance by taking lomid, so with out seeing a doctor, i ordered 100mg clomid and it was sent to me from India. I took it for the 5 days, and was told that i would prob ovulate about 7 to 10 days after my last pill. I live in NY and never cheated on or even thought about doing so, the day after my last clomid pill, i went shoping, i stoped by a gas station, and got gas, went in and had to use the bathroom, while waiting for my turn, a black male started talking to me, before i could even relize what i was doing, (like my body took over) i was in the mens restroom, with the black male behing me doing the unspeakable… when i got home i was like what is going on with me. i never cheated again, i belive this (clomid drug) made me feel so worked up that i let this stranger have me, not even knowing any thing about him, name or nothing. well i blocked it all out.. 4 days later i started having intercourse with my husband.. ended up pregnant. (with triplets) nothing never crossed my mind. I had my babies, they were all real dark black when born. my husband left me, and i dont even have a clue as to there father. so another words, i ovulated the very day after my last pill. i had never heard of this.. i know have 3 babies, but hurt the rest of my life trying to explain to my family and friends how this happened. when I dont even understand myself. has any one else heard of this hapening? thanks for listening Holly N.Y.

  • Debby

    Need help and advice re: clomid and over stimulation. First cycle was on 50 mg and second cycle 100 mg. Now doc says I’m overstimmed, I have 8 follicles now and she didn’t give me the injection. Said I still have a good chance of getting pregnant w/out injection. Anyway, she said to take OPK but I still haven’t seen a positive result. They thought I would have ovulated last week. Now I feel some pain and abdomen feels tender and bloated. Do you think I will ovulate soon or not at all? If follicles are large enough and you don’t ovulate is that not good? Any advice would be appreciated.

  • IVF-MD

    Eight follicles on Clomid alone is unlikely, but not impossible. Whether or not to proceed with intercourse, IUI or to cancel the cycle depends on factors such as patient’s age and patient’s past treatment history. In other words, if this is the very first time in your life that you ever ovulated and you are 22 years old, I would most likely cancel the cycle for fear of triplets. However, if you have failed multiple cycles in the past and are 41, I would be thrilled and go all out to try and make this pregnancy happen! Good luck!

  • utopianacres

    I have been ttc for over a year now. im 31 and i have pcos. i have been on metformin 850mg twice a day for a year. im on my third cycle of clomid. first two i did ovulate on 50mg but unsuccessful. Now on my third cycle of 100mg and no positive ovulation at day 20!!!! im confused. i have little faith in this drug—when should i switch to another?

  • Dee

    Need some advice:
    My husband and I have been trying to conceive for two years, my consultant put me on Clomid and I have just finished my first 50mg dose (the doctor carried out all the fertility tests and they all came back clear!)
    I had my scan last Tuesday to see if I had released any eggs and had released 2!
    What are the chances of me getting pregnant on my first month of Clomid?
    My period isn’t due for another 2 weeks, will I have to wait until then to do a pregnancy test?
    What are my chances of having twins because I released to eggs?
    Any advice, stories or comments would be great!!!

  • Cheryl

    Looking for your thoughts:

    Almost two years ago I went off birth control in hopes of my husband and I conceiving our first child. After going off the pill, I had unexplained amenorrhea (but had always been irregular which is why I went on birth control nearly 15 years ago) and the only thing that seemed to give me a menstrual cycle since going off the pill was if I took some form of progresterone to induce a cycle. This past February my OB started me on 50mg of clomid and I did not ovulate or have a period. About a month or so later we tried 100mg and nothing happened again. On the final round, in May I took 150mg of clomid and not only ovulated but also conceived. Unfortunately I had some concerns along the way and at 10 weeks I discovered there was no longer a heartbeat (at 7 weeks there was) and I was suffering a miscarriage. After grieving and healing for a period of time and making sure my HCG levels were close to zero, we decided to presume trying. Almost two months ago I spotted off and on for two weeks but my OB said that likely was not a period. Then last week I went in to see if we could induce a cycle as it has been nearly 3 months since my miscarriage. At this time my OB prescribed progesterone as well as 150mg of Clomid(since that was what it took last time) to take after I have my period. A day after my appointment I started finally having my period without any assistance from progesterone which was a major milestone. My concern, however, is whether or not I should still take the Clomid especially at the higher dosage of 150mg. I have read that it is best to start out low. Given that I actually had a period on my own, I question if my body may be more in balance than it used to be and if it taking the clomid would interfere with what may happen naturally with my body. Of course I am due to start clomid this evening (CD 5) and I have yet to hear back from my doctor’s office about my dilemma. Any feedback is greatly appreciated!

  • Misty

    I have a question about my clomid and becoming pregnant. I have been on birth control for 12 years. I have been off of it for 1 year and 5 mnths. with only having 3 periods in that time. I went to the dr and they gave me clomid 50mg and provera to have a cycle I followed all directions and did not ovulate on 50 mg so they increased my doseage to 150mg I was successful in ovulating on that doseage. I had a period on day 34 started taking my clomid again on day 3 of my period and finished my 5 day cycle of clomid now I am past due on my period for this month this is day 37 and I was wondering if I could possibly be pregnant or did the clomind not work this time around????? I am just wondering if anyone else experienced this having clomid work one month and not the next… Please help me I am desperate to find answers

  • IVF-MD

    Yes, Misty. It’s possible for someone to ovulate on Clomid one month and then not ovulate on the exact same dose in a different month.

  • Misty

    Should I start taking my provera again to start my period and then start my clomid as the Dr has instructed???

  • Tara

    I already have once child who just turned 3. We had him without any outside assistance, but it took 2 yrs. We have tried Clomid this month for the first time, because my husband’s sperm isn’t shaped the way it should be (some of it) and the Dr. thinks that we will have a better chance of sperm penetrating the egg if I take Clomid. I already ovulate normally and after taking this med. I have 8 follicles. I tested for ovulation between days 12-18 and nothing, but they saw the 8 follicles when I called and asked what was going on. I was going to have artifically insemenated, but I had already ovulated according to blood work. They told me to go ahead and have intercourse and come back in 10 days so they can check my ovaries and test for pregnancy. My body is acting pregnant, but is this possible if I only had sex once and don’t know when I ovulated, because we were waiting on the insemenation process???

  • Vanessa

    I started taking 100mg of clomid and went in for an ultrasound to see if I would ovulate. The dr had me come in on day 14 for an ultrasound and said that she didn’t see anything and I probably wouldnt ovulate. Then a few days later I started getting really bad cramps and also hot flashes. Then I went in on day 29 of my cycle for a pregnancy test which came back negative and my doctor had me start provera yesterday and gave me 150 mg of clomid to take on days 3-7 of my next cycle. I feel like i may have gone in for a pregnancy test too early and I feel there was maybe a chance that I did ovulate and I may be pregnant. I am wondering if now starting the provera could be harmful?

  • jen

    i am thinking of going on clomid i conceved 3 children naturally but started having periods every other week ( i used to do this before my kids) : i also don’t ovulate norally . I want to take it to try to get pregtnant for a last time twins run in y familly my mom, and grandma on both sides are along with several twin cousins, if i have twins i will ask my doctor for a historectoy. I am 27with all children concieved naturally but not at the normal time. I ovulate right after my periods.

  • kate

    pls i need urgent advice. i have taken three courses of 100mg of clomid ending today wrongly. i took the treatment from the first day of my menses instead of from the 5th day and i’ve not gotten pregnent. now that i just discovered my mistake can i begin the treatment all over without any side effect?

  • Renee

    I got my clomid late this month and took 25mg yesterday and today (on days 9 and 10 of my cycle). Is it possible that it can help me ovulate after just a few doses, or should i take the rest on day 11, 12 and 13? And does it really matter if I take it later in my cycle?

  • Jules

    Hi guys!

    I’ve just come across this website and it seems to be very helpful, with everything I’ve read this far.

    I’m on my third cycle of clomid 150mg and I’m hoping for some miracle or inspiration or at least something that I could do to increase my chances of getting pregnant this month, I’ve been trying to conceive for about a year now, which is a lot longer than expected I’m seriously hoping that 150mg Clomid does it for me.

    Does anyone else have success stories on 150mg clomid?

    What can I do differently?

    I do take folic acid on a daily basis, is there anything else I could do?

    Baby dust to all ttc…

    Jules

  • April

    My husband and I have been trying for a baby for 6 years. He has been tested and came back with great numbers. At first, we figured out that I wasn’t ovulating, and IF I actually did it was extremely late. My thyroid, FSH, and several other things were tested and came back normal. I asked if I could possibly have PCOS since I’m a bigger girl, but everything tested fine so I was told I do not. The next step, my Dr started me on Clomid. First round was 50mg (ended in a 47 day cycle). I didn’t ovulate the first cycle, but we continued with the 50mg for two more months (ended with a 30 (15 day LP) and 31 day (11 day LP) cycle) and I ovulated (or had a temp shift that indicated ovulation). I wasn’t completely sure that I was really ovulating so on the fourth round I asked if we could do a follicular scan. I was given 100mg that cycle and the u/s showed two large follicles. They thought that I would ovulate within the next few days but I didn’t show my temp shift until a week and half later. I got a faint positive test at 9 days after ovulation. On 11 dpo, there was no line. I was brought in for a +/- blood test, which came back negative (ended with a 35 day (13 day LP) cycle). I started the next cycle with another 100mg. I requested a progesterone test, because I feared that maybe my lining was thinning with the drug. My progesterone came back as 25.2. I thought that was a great number, and my temping chart went triphastic, was late for my menstrual cycle by 3 days, but wasn’t pregnant (ended with a 33 day (18 day LP) cycle). I didn’t test early that cycle. Now I’m on my current cycle, the dr continued me on 100mg but instead of taking it 5 through 9, I was to take it 3 through7. I am on CD13 right now, and have still not ovulated. Is there something else that I should be doing? I’m getting alittle defeated with the lack of success. I am grateful for my cycles getting regular finally after always being irregular. I just really would like to know what is wrong with me that I am not able to conceive. Do you have any suggestions for what my next step could be?

  • Mala Cronin

    Hi, I have almost completed my first cycle of clomid 50mg day 2-6 (currently day 24) after 5yrs try to conceive with my husband. I have PCOS and I am Anovulatory.  I have the side effects of Hirsuitism , but i am not overweight. I have tried diligently to put on weight , but I struggle immensly with it. All of my blood tests have come back in healthy range except for the Gonadol hormones. I am 173cm tall and weigh 53kg. I began menstrating when I was 9, very irregular, maybe3 or 4 periods until I was 11 and then regular until I was 16 when they suddenly went from clockwork to every couple of months, sometimes with my periods lasting up to 2 months. the longest period without menstruating is 5 months, where I demanded I be referred to a specialist. I was prescribed Primolut N and Clomid. I was wondering if you could shed some light on why I may have PCOS when it predominately affects women who are overweight and If this will affect my chances on conceiving? I would be so grateful for your insight as I have been trying for so long, and have had so many doctors refuse to test me, or listen to me because of my age ( I am 22). Thank you.Mala
    Australia

  • Jalea4321

    Hello I just turned 44 years old and my new husband and i would like to have a child.
    i have a couple questions. Is it that clomid can stop your period and if it dose, will it come back?