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Clomid for Infertility: What You Need to Know

For over 50 years, clomiphene citrate (also known as clomiphene, Clomid, or Serophene) has been used to help treat infertility. Clomid is an oral medication prescribed for infertility, but unlike more advanced fertility technologies, pregnancy rates with Clomid have not changed over time.

Many people are aware of Clomid as a low-tech, lower-cost option than in vitro fertilization (IVF) and are happy to learn they can try this type of treatment with their existing OB/GYN or primary care physician. While many women are able to conceive with Clomid, for those who don’t, the decision about when is the appropriate time to move on to a different treatment can be unclear.

WHEN IS CLOMID USED FOR INFERTILITY?

Clomid is most successful as the first line of treatment for women who experience irregular or absent menstrual cycles. Clomid can also be used for women who ovulate normally, but who have otherwise unexplained infertility. Clomid treatment generally results in a 10 percent pregnancy rate per cycle, even when combined with intrauterine insemination (IUI).

Women who do not ovulate due to low body weight or hypothalamic amenorrhea (when menstruation stops for several months) rarely respond to Clomid.

CLOMID PREGNANCY RATES

The goal of treatment with Clomid is to normalize or induce ovulation by taking a 50 mg dose per day on days 3 through 7 of the menstrual cycle. Eighty percent of women taking Clomid will successfully ovulate and 10 to 12 percent will conceive per cycle.

IUI-Success-Rates-2006 - Shady Grove Fertility

Though Clomid is generally well tolerated by most people, in some cases it can lead to changes in a woman’s cervical mucus and have endometrial effects that can negatively impact success rates. There is no evidence that shows increasing the dosage of Clomid will result in an increase in pregnancy rates. Increased dosages of Clomid may actually worsen the side effects.

Another factor that limits the success of Clomid is that many people have other unknown infertility factors. A previous study showed that 87 percent of women who ovulated but failed to conceive with Clomid had an additional cause of infertility such as pelvic lesions, tubal disease, endometriosis, male factor infertility, or a combination of these factors. Diagnostic testing such as a hysterosalpingogram (HSG), semen analysis, and ultrasound should be performed prior to Clomid treatment to rule out other fertility factors.

It’s important to note that a woman’s age plays a major role in pregnancy rate outcomes regardless of the diagnosis.

Your physician may recommend you combine Clomid with intrauterine insemination (IUI) if Clomid alone does not result in a pregnancy.

HOW MANY CYCLES OF CLOMID SHOULD YOU TRY BEFORE MOVING ON?

There are several factors that may influence how many cycles of Clomid you should attempt before moving on to a more advanced line of treatment under the care of a reproductive endocrinologist.

Patients with polycystic ovary syndrome (PCOS), anovulation, or irregular periods taking Clomid without ultrasound monitoring:

  • Women under 38 should attempt no more than six cycles.
  • Women 38 and over should attempt no more than three cycles

Patients taking Clomid with ultrasound monitoring:

  • Women under 37 should attempt no more than three to four cycles.
  • Women 37 or older should move on to more advanced treatment immediately.

Every patient’s treatment plan is unique and the type of treatment is based on the age, diagnosis, and medical history of the patient. We take a stepped-approach to treatment, starting with the simplest, most affordable treatment options first and move up to more advanced treatments only if needed. More than half of all treatment cycles we do are considered low tech.

The Emotional Aspect of Treatment

It’s important to consider the psychological toll that multiple unsuccessful treatments can have on couples.

When thinking about moving on to another form of treatment, it is important to consider how many cycles you have attempted, your age, and the guidance from your physician based on data-driven decisions. While we consider the facts and statistics based on each patient’s situation, we encourage our patients to do what feels right for them.

In addition to evaluating the medical recommendations, we understand the emotional and financial aspects of infertility can weigh heavily on the decision to begin treatment or move to a new level of care. At Shady Grove Fertility, we offer a variety of clinical, financial, and emotional resources to help you find the answers and support you need to take the next step towards building a family.

Medical contribution by Ryan Martin, M.D., of Shady Grove Fertility’s Bala Cynwyd, PA office.

Editor’s Note: This post was originally published in November 2011 and has been updated for accuracy and comprehensiveness as of July 2017.

For more information or to schedule an appointment, please call our new patient center at 1-877-971-7755.

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16 Comments

  1. amanda

    November 6, 2015 - 11:21 am
    Reply

    I been trying over 10 years to get pregnant with one tube due to a ectopic pregnancy in 2005.

    • Shady Grove Fertility

      November 11, 2015 - 12:11 pm
      Reply

      Hi Amanda – Have you spoken with a reproductive endocrinologist to learn more about your options? Given your medical history, you may want to consider scheduling a consultation. To do so, please contact our New Patient Center at 1.877.971.7755 or visit http://bit.ly/SGFappt.

  2. @PathologyChief

    May 26, 2016 - 1:18 pm
    Reply

    Good introductory article for the general public! -@PathologyChief

  3. Amber

    July 14, 2016 - 4:05 pm
    Reply

    You will not treat me because my BMI is too high.

    • virginia gonzalez

      July 24, 2016 - 12:07 am
      Reply

      I have never been to shady Grove fertility but I’m pretty sure they’re really good and don’t think because you have a high BMI you can’t get pregnant you can my BMI is higher than 30 and I did IVF and the first one I got pregnant… I wish this helps you think differently …

      • Diana

        July 26, 2016 - 3:06 pm
        Reply

        No, it’s true. Shady Grove keeps their BMI requirements super low so they publish better results. I went there and was incredible disappointed because they wouldn’t even talk to me about taking Clomid (which does not require anesthesia btw, which is what Shady Grove said was the reason for their BMI requirements). If you are looking for better options Amber, go to John Hopkins – they have a BMI requirement thats 50 and most people can meet it. Even if you have a higher BMI , they will work with you in treatment options.

        Good luck

        • Nell

          July 26, 2017 - 2:24 pm
          Reply

          Many people can’t conceive because of things they can’t control. Your BMI is something you can control. So lose weight. If you want it badly enough, do it.

  4. trusha kyada

    August 6, 2017 - 11:24 am
    Reply

    HI,
    can you suggest me how can i take clomid. on period 1st day or 3rd day i want start.

  5. Renu k

    August 14, 2017 - 10:58 am
    Reply

    Hello Trusha,
    By following my physician’s recommendation I have taken Clomid for 2 cycles so far, between the days 5 to 9, without any results :-( . But I have read some doctors suggest to take them between the days 3 to 7 of period cycle.
    I hope this is helpful.

  6. Missy

    September 2, 2017 - 12:38 am
    Reply

    Losing weight isn’t always the best option. It can throw your body into hypothalamic amenorrhea which is not an easy thing to treat.

  7. Anna

    October 6, 2017 - 11:02 pm
    Reply

    Today’s is the 6th of October, my last period started 21 August and I started clomifene citrate on 25 August, ovulated on the 31st….. but until now no period, I went for a scan and ultrasound last Tuesday and was told no pregnancy…. I’m 45 years old, have not been on contraception for 16 years, my periods regular and on time every month,and ovulate naturally as well…. when do you suggest I go for another scan? I don’t know and I’m so confused… please help me

  8. Kelly

    October 13, 2017 - 3:18 pm
    Reply

    Clomid worked for me. Last year, at age 52, I got pregnant on my first cycle of Clomiphene Citrate 50mg x 3/day from day 9 to day 13. I was a late bloomer and didn’t start my period until I was 18 years old and my OB/GYN said that may have help me get pregnant at my age. I had no complications with my pregnancy. Clomid works!

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