Clomiphene Protocol

At the onset of flow, before day three, you need to be seen for a check. A Clomiphene check will be required each month prior to prescribing. The Clomiphene check allows us to review your previous treatment cycle and or ultrasound ensures that the Clomiphene has not stimulated the development of ovarian cyst. If your period begins on a Friday, contact your doctor immediately to arrange appointment. You may be asked to postpone the baseline evaluation until cycle day three falls on a Sunday.

If your exam is normal and the Clomiphene is working properly, it will again start on day three of your cycle.

IF YOU THINK YOU MAY BE PREGNANT, DO NOT TAKE CLOMIPHENE, NOTIFY YOUR DOCTOR!

You will begin by taking a single Clomiphene 50mg tablets daily from the third to the seventh day.(In certain situations your physician may recommend starting late. Or when you are scheduled for ovarian reserve testing, you may be asked to take clomiphene from cycle day five through nine). During treatment cycle, one to three days after your last Clomiphene tablets, both FSH and LH will be checked. If the LH is three times the FSH level, then you may have post ovarian syndrome and Clomiphene is unlikely to work for you.

Women with high levels may demonstrate diminished ovarian reserve. For those couples where a combined clomiphene\FSH\Intrauterine insemination protocol has been advised, a gonadotropin injection of 150 units or FSH ( Follistim\Gonal-F) or HMG (Pergonal, repro Humegon) will be administered on day 8,9 or 10.

An ultrasound may be scheduled three days later.

On cycle day 12 you will begin daily urine testing to detect LH surge, the ovulation will occur within 24-36 hours after LJ surge. The LH urine test is best performed on second urination of the day. ( usually between 9 am. and noon. If things are ready ( follicle 18-22 mm and endometrium 0f 8mm HCG injection is given to trigger release of egg (s). If things are almost ready, you are checking your urine and hCG may be given 1-2 days later. If follicular development has occurred but the uterine lining has not yet developed, an oestrogen level may be checked but the uterine lining has not yet developed, an estrogen level checked and found low, the cycle will be cancelled and next month a larger dose administered. Frequently the male partner chooses to abstain from intercourse in order to “save things up” for the big day. We advice against this strategy. There is no reason to postpone sex just because the woman is on Clomid.