Clomid (clomiphene citrate) is commonly prescribed for women struggling with ovulation issues or unexplained infertility. It works by inducing ovulation, which can help increase the chances of pregnancy. When taking Clomid, timing is everything – starting it at the right time in your menstrual cycle is key for success. So when is the optimal time to begin taking Clomid during your cycle?
What is Clomid and how does it work?
Clomid is an oral medication that belongs to a class of drugs called selective estrogen receptor modulators (SERMs). It works by blocking estrogen receptors in the brain, leading to an increase in the production of hormones that stimulate ovulation – follicle stimulating hormone (FSH) and luteinizing hormone (LH).
By increasing these hormones, Clomid induces the ovaries to ovulate in women who are not ovulating regularly on their own. Ovulation usually occurs 5-10 days after finishing a round of Clomid.
Clomid Indications
Clomid is typically prescribed for:
- Anovulation (lack of ovulation): Clomid stimulates ovulation in women whose ovaries do not release eggs regularly on their own.
- Oligoovulation: Clomid may be used to induce regular ovulation in women who ovulate infrequently or irregularly.
- Unexplained infertility: Clomid may be tried when there is unexplained infertility despite normal ovulation.
- Irregular cycles: Clomid can help regulate irregular menstrual cycles.
- Thin uterine lining: Taken before ovulation, Clomid may help thicken a thin endometrial lining.
When to Start Taking Clomid
The timing of when to begin taking Clomid depends on the specifics of your menstrual cycle and dosage schedule:
1. Start taking Clomid on Day 3-7 of your cycle
For most women, the typical starting time is cycle day 3, 4, 5, 6, or 7. Cycle day 1 is considered the first day of full menstrual flow (not just spotting).
Starting Clomid earlier on day 2 or 3 may be optimal for some women. This allows for recruitment of multiple follicles early on. However, starting as late as day 7 may be necessary in women with longer cycles.
Most physicians recommend starting on cycle day 3, 4, or 5 if you have a typical 28-30 day cycle. The goal is to begin taking it just before the anticipated rise in follicle stimulating hormone (FSH) that occurs early in the menstrual cycle.
2. Take Clomid for 5 days
The most common Clomid regimen is to take it for 5 consecutive days in one cycle, then take a break for the next cycle or two before repeating. The typical dosing schedule is to take 50 mg orally once per day for 5 days.
Some physicians may prescribe it for shorter or longer durations between 3-7 days. But taking Clomid for 5 days in one cycle is standard practice.
3. Day 21 Progesterone Test
Approximately 7-10 days after the last Clomid pill, your physician will order a progesterone blood test to confirm ovulation occurred. This is commonly done on cycle day 21, but may be later or sooner depending on your unique cycle.
If the test confirms ovulation took place, repeat the same Clomid regimen the following cycle. If not, your physician may recommend a higher dose, longer duration, and/or adding an injection to trigger ovulation.
How to Determine Cycle Day 1 When Starting Clomid
Pinpointing cycle day 1 is imperative for timing the start of Clomid correctly. Here are some tips for identifying cycle day 1:
- Cycle day 1 is the first day of full flow red bleeding requiring a pad or menstrual product. Spotting does not count as cycle day 1.
- Count the first day of full red flow as cycle day 1, even if flow began the night before.
- If you are not sure if bleeding qualifies as full flow, be conservative and count the next day as cycle day 1.
What if my cycles are irregular?
If your cycles are very irregular, your physician may order a progesterone test, perform an ultrasound of your ovaries, or check a urine LH test to help determine where you are in your cycle prior to starting Clomid.
Clomid Cycle Schedule Examples
Here are two examples of how Clomid timing works in a 28-day and 35-day cycle:
28-Day Cycle
| Cycle Day | Step |
|---|---|
| Days 1-5 | Menstruation |
| Day 3-7 | Take Clomid pills |
| Day 10-14 | Ovulation |
| Day 21 | Progesterone test |
35-Day Cycle
| Cycle Day | Step |
|---|---|
| Days 1-7 | Menstruation |
| Day 3-7 | Take Clomid pills |
| Day 14-21 | Ovulation |
| Day 28 | Progesterone test |
Clomid Dosage
The starting dosage of Clomid is typically 50 mg per day. Some key points about dosing:
- The dosage may be increased to 100-150 mg if ovulation does not occur at 50 mg.
- Doses above 100 mg per day are not recommended.
- The highest success rates are seen at lower dosages (50 mg).
- If ovulation occurs but pregnancy doesn’t, the dosage is not increased for subsequent cycles.
How Many Cycles of Clomid Should You Try?
Most physicians recommend 3-6 ovulatory cycles of Clomid before moving on to other treatments. Success rates start to decline after 6 ovulatory cycles.
Clomid Success Rates
The average success rates with Clomid are:
- Ovulation induction: 70-80%
- Pregnancy: 40-45% after 3-6 cycles
But success rates depend on the underlying fertility issue, age, and dosage/duration used.
Clomid Faq
How long after taking Clomid does ovulation occur?
Ovulation typically occurs 5-10 days after finishing a 5-day course of Clomid. It can occur as early as 2 days after the last dose or up to 12 days after. Cycle day 14 is average for a 28-day cycle.
When should I have intercourse when taking Clomid?
Have intercourse every 1-2 days starting 3 days after your last Clomid pill and continuing for 1 week after ovulation. Ovulation usually happens 5-10 days after finishing Clomid.
What days should I not take Clomid?
Avoid taking Clomid on days 1-2 of your cycle. Starting Clomid earlier than day 3 increases the risk of cyst formation on the ovaries. The latest to start is day 7.
Can I use an ovulation predictor kit with Clomid?
Yes, you can use OPKs with Clomid starting 1-2 days after finishing it. However, OPKs may not work well if you take Clomid, since LH levels may be elevated.
How late can ovulation happen on Clomid?
Ovulation can happen as late as 12 days after the last Clomid dose, but it averages 5-10 days afterwards. The most common timeline is cycle day 14 in a 28-day cycle.
Conclusion
The best time to start Clomid is within the first 5 days of your menstrual cycle, usually cycle day 3, 4, or 5. Take Clomid for 5 consecutive days, then have a progesterone test 7-10 days later to confirm ovulation occurred. If properly timed, Clomid can induce ovulation and increase your chances of pregnancy.