CLOMIPHENE & INTRAUTERINE INSEMINATION
INSTRUCTIONS FOR PATIENTS

Clomiphene (also called Clomid or Serophene) is a fertility medication. It has been shown to induce menstrual periods in women who were not menstruating or ovulating. Further research showed that clomiphene could help certain non-ovulating women get pregnant by stimulating the ovaries to produce an egg. It has been shown to be safe and effective in numerous women with ovulatory disorders. Clomiphene can also be used in women who already ovulate to enhance ovulation so that more than one egg may be produced each cycle. This will often increase the chances of getting pregnant.

In various studies involving women with abnormal menstrual cycles, 50-90% of the women who qualified for clomiphene treatment achieved ovulation. Approximately half of the women who ovulated also successfully conceived—generally within the first 3 ovulatory cycles on clomiphene therapy.

It may take a couple of months to establish the most effective dose of clomiphene for you. Once you are taking the proper dose, you should ovulate between 5 and 8 days after the last tablet is taken. If you do not conceive in that cycle, you will usually have your period 3 weeks after the last tablet.

Approximately 90% of clomiphene-induced pregnancies result in single deliveries. Nearly 10% of the pregnancies result in twins, and less than 1% are triplets.

Clomiphene therapy may occasionally cause side effects, including hot flashes, breast tenderness, headaches, dizziness, fatigue, nausea and vomiting. Occasionally, abnormal ovarian enlargement with symptoms of abdominal discomfort and/or pain can occur.

GENERAL DIRECTIONS

1. Begin taking clomiphene on the 5th day of the menstrual cycle, and continue for 5 days.
2. Start checking your ovulation predictor kit (OPK) on about day #16. Remember that the OPK turns the day before you ovulate. Once the OPK has turned, you do not need to test any more that cycle. If the OPK has not turned by day #18, you may stop testing because you probably will not ovulate that cycle.
3. Call the office when your OPK turns to schedule an appointment for that day and the next for intrauterine inseminations (IUI). If the OPK turns on the weekend, then the IUI will be done on Monday. Semen should be collected by masturbation, but without the use of lubricants or soaps as these can damage the sperm. Collect the semen in the sterile container that we have given to you. The semen specimen should arrive in the office within 30 minutes of collection. The semen will then be prepared for insemination into the uterus. This whole process takes about an hour.
4. If you have chosen not to do IUI, then you should have intercourse every other day beginning by the 12th day of your cycle until after the OPK indicates that you have ovulated.
5. You should make an office appointment for day #30—34 of the cycle. At this visit the doctor will do a pelvic exam to look for ovarian enlargement. We will probably be able to tell you if you have conceived at this time. If pregnancy did not occur, then we will assess your cycle to see if adjustments need to be made for the following month.

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