When Should You Start Clomid?

When Should You Start Clomid?

There is much confusion about when to start taking Clomid for the highest chance for success. It actually depends on why you are taking Clomid.

I get many questions from women who have been given Clomid by their doctors but are not sure when they should start taking it. The answer depends on the reason you are taking Clomid.

Two phases of ovulation

The process of ovulation actually involves two phases. The first phase that must happen before the egg is released from the ovary, is the egg must mature. The egg is contained in a small cyst called a follicle. As the egg matures, the follicle grows larger. This follicle growth can be seen and measured on ultrasound. Once the egg has matured, then it is released from the ovary. This is what most people think of when they hear the word "ovulation". Here is the most important fact for you to remember. To work best, Clomid needs to be started before any follicles have started to develop in the ovary. 

When to start Clomid to induce ovulation

Clomid for women is used in two different situations. First, there are women who do not ovulate on their own. This group of women use clomid to try to get ovulation to occur. Fertility experts call this "induction of ovulation". If a woman does not ovulate, she also does not have any follicle development. In this group of women, Clomid can be started anytime.

Do a baseline blood test and ultrasound

At infertility treatment centers, I will have women who don't ovulate come into the office for a baseline blood test and ultrasound so i can make sure that she doesn't have any follicle development. I look for two things. First, there should be no large follicles or cysts in either ovary and the levels of estrogen and progesterone should be low. It does not matter whether she has had a period recently or not. Once I confirm there are no developing follicles, I can start those women on clomid right away.

When to start Clomid if you already ovulate

The second group of women who take clomid, are women who already ovulate but are hoping to improve their chances for getting pregnant. The idea here is that women normally release only one egg each month, so there is only one chance that the egg will be a healthy egg that can fertilize, develop into a blastocyst and implant into the uterus. To establish a pregnancy by using a fertility medication like Clomid, the hope is to get more than one egg to develop so that there is more than one chance to get an embryo to implant. Fertility experts call this "superovulation". Since this group of women already ovulate on their own, it is important to start clomid early in the cycle, before a follicle has started to develop. If we call the first day of a full flow period day one, then Clomid can be started any time in the first few days after that. day two, three, four or five. It doesn't matter! As long as a follicle hasn't started to develop yet, there is no difference in the chance for pregnancy. if you start clomid on day two or day five or any day in between.

Expert tip: when you Shouldn't start Clomid

Here is an expert tip: On any given month, it is sometimes possible to have abnormal hormone production from the ovaries or leftover cysts from the previous month's ovulation. You don't want to start Clomid if either of these situations is true. This is especially common if you took Clomid in the previous month. In order to make sure that your body is ready, get an ultrasound and blood test on the second or third day of your period to look for cysts and abnormal hormone production each month before starting Clomid.