Wait for your period to begin. The first day of bleeding is “day 1 of your cycle.” If you typically spot for a few days before the bleeding begins, count the days of spotting as your period. The first day of any kind of bleeding constitutes day one of your cycle.
Call our office when your period begins for a “Clomid Check” appointment. If your period begins on the weekend, call our office on Monday. We will need to see you sometime between the 1st and 5th day of your cycle.
When you come into the office, we will perform a pelvic exam with or without an ultrasound. We want to exclude the possibility of your having an ovarian cyst of significant size that would cause us to wait a while prior to prescribing the clomid (Should you have a cyst on the ovary then we will wait one more month then reassess, as clomid may cause the cyst to greatly enlarge and burst).
After the exam, we will give you 1) your prescription for Clomid, and 2) a prescription for 1 vial of Human Chorionic Gonadotropin, and 3) your husband’s semen preparation request slip, and 4) we will set up your next appointment for follicle scanning beginning on Day 12. If you require multiple clomid tablets daily to produce ovulation, be sure to take tablets as a single daily dose, and not at separate times during the day. You will need to take the medication on 5 consecutive days, beginning on day 3 or 5 of your cycle (doesn’t matter which). For example: If you require 50mg Clomid, you will take one tablet once daily for 5 days. If you require 150mg Clomid, you will take three 50mg tablets together at once daily for 5 days.
We will have you come in on day 12 of your cycle (we do this on weekends also. If I’m not on call then one of my partners will see you in the office) to perform an ultrasound to see if your ovaries contain a follicle of sufficient size. If the follicle is too small, then we will have you return the following day to recheck the follicle. If it is of sufficient size, then we will give you an injection of HCG (which you will have brought with you). Then you will schedule your next appointment (for the artificial insemination) for the following day. Inseminations are performed in the morning, as this is time when the semen preparation will be done. It is important to then call the Andrology Lab and set up your husband’s appointment. Don’t forget to bring your request form with you to the andrology lab.
When you come in the following day, we will perform the insemination. You will need to undress from the waist down, and we will place a speculum into the vagina. We will ask for your vial of prepared sperm that you picked up prior to your arrival at our office and aspirate it through a small diameter catheter into a small syringe. We will then insert the catheter into the uterus (sometimes can produce a bit of cramping) and inject the sperm into the uterus. After removing the catheter and speculum, we will ask that you lay still for about 5 minutes, thinking happy thoughts. After 5 minutes, you’re free to go.
To make sure that the dose of Clomid is the correct dose to produce ovulation, you will need to have your blood drawn on Day 21 of your cycle. This will be done each cycle until we have confirmed that the dose of clomid you are taking is the correct one. After we have established the correct dose, we will no longer need to check this. On Monday thru Thursday, you may have your blood drawn in our office. If Day 21 lands on a Friday or on the weekend or a holiday, you will need to have it drawn at a lab close to your home or at the hospital (make sure you have a request form from our office when you go to have it drawn).
If your period does not start on schedule (usually on Day 28), use a home pregnancy test and let us know… If your period begins, give us a call and we’ll start the process over again.