In today’s episode, I will answer questions such as What if you have tried clomid and you
didn't conceive? Should you try again? How many times should you use Clomid before quitting or
moving on to some other fertility treatment? What are the odds for achieving pregnancy on
the 1st try or the 5th? Stay tuned to the end of this video for my Infertility TV Bottom Line
Clomid is one of the most commonly used fertility medications for females. It is inexpensive,
easy to use and has low risks. It is therefore one of the first fertility
treatments that doctors will try. Clomid is used in women for two different reasons.
One reason is to try to get ovulation to occur in women who don’t ovulate.
The second is to try to increase the chance for pregnancy in women who already ovulate.
Clomid is usually given for five days in a row. After that, it is important to monitor
for ovulation. This can be done in the doctor’s office with blood tests and ultrasounds or at
home with an ovulation test kit. On the day of ovulation, pregnancy is attempted by having
intercourse or by placing sperm into the uterus. This is known as an intrauterine insemination or
IUI. One week later, a blood test can be done to verify ovulation occurred. The week after that,
another blood test is performed to see if pregnancy has occurred.
The time from when you started Clomid until the pregnancy test
is referred to by fertility doctors as one Clomid cycle. How many times
should you repeat a Clomid cycle before deciding to move on to something else?
There isn’t going to be a single number for everybody. Part of that decision process is
going to be based on non medical factors such as whether they have insurance coverage for treatment
or whether they are squeamish about using injections which are often used in the next step.
Some medical factors include a woman’s age and her partner’s
sperm quality. Older women have lower success rates and so may move on more
quickly. Couples with very very low sperm numbers or poor sperm motility have lower
success rates with Clomid and so they may want to move on more quickly also
Another question is whether Clomid becomes less effective over time. Most studies only
give an overall chance of success but don’t distinguish success rates based on how many
attempts a couple has tried. Therefore, I looked at our own data here at IVF1. We have treated
patients with Clomid thousands of times. I looked at patients in whom the female partner was under
the age of 35. Since patients don’t stay with us for their entire pregnancy, I will give you
the ongoing pregnancy rate. These are patients who had a viable pregnancy on ultrasound when we sent
them back to their obstetrician. Studies show that this is pretty close to the delivery rate.
On their first attempt with Clomid, just over 14% of our patients produced an ongoing
pregnancy. In their 2nd and 3rd cycles it was just over 13%. On the 4th and 5th tries,
11% of the patients were pregnant. We didn't have very many couples who did a 7th or 8th cycle,
but the few we did have still had about an 11% pregnancy rate.
Many doctors want to push their patients on to other
treatments like IVF after only a few attempts. As you can see, this is not
mandatory since pregnancy rates per cycle are still very reasonable even through 8 cycles.
Our InfertilityTV Bottom Line is this. There are medical and non medical reasons
why patients may want to stop using Clomid and move on to other treatments. If however,
the female is young, ovulation is occurring and sperm numbers
are reasonable, it is ok to consider doing a higher number of Clomid cycles