Clomid for fertility: how it works, doses, and what to expect

If you are trying to get pregnant and have irregular cycles or ovulation issues, Clomid (clomiphene citrate) is often the first medicine doctors try. It helps your body release an egg by blocking estrogen receptors in the brain, which boosts follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Most people take it early in the cycle to trigger ovulation.

Typical dosing starts at 50 mg once daily for five days, usually beginning on day three to five of your period. If you don’t ovulate, doctors may raise the dose to 100 mg or sometimes 150 mg. Treatment cycles are usually limited to six attempts under medical supervision.

Clomid makes ovulation more likely. Studies show ovulation occurs in about 80% of women treated, but pregnancy rates per cycle are lower, often around 10–15%. If you have polycystic ovary syndrome (PCOS), letrozole may give better odds, so discuss options with your doctor.

Expect some side effects. Hot flashes, breast tenderness, mood swings, and nausea are common. Some people report blurred vision or floaters; if you notice vision changes, stop the drug and contact your doctor right away. Clomid slightly raises the chance of twins; triplets are rare.

Your doctor will likely monitor you with blood tests and ultrasound to check follicle growth and timing. A mid-luteal progesterone test can confirm ovulation. Timing sex or intrauterine insemination (IUI) around ovulation increases the chance of pregnancy.

Know the risks. Ovarian hyperstimulation syndrome (OHSS) is uncommon with Clomid but can happen. It causes swollen painful ovaries, bloating, and, in severe cases, fluid buildup. If you have sudden abdominal pain, severe vomiting, or breathing trouble, seek care.

Practical tips help. Take Clomid at the same time each day. Track your cycle with apps, LH predictor kits, or temp charts to pinpoint ovulation. Avoid smoking, limit alcohol, and aim for a healthy weight — these changes improve fertility overall.

If several cycles with Clomid don’t work, ask about next steps. Options include timed IUI, injectable gonadotropins, or moving to IVF depending on diagnosis and age. Fertility care is personal; good communication with your provider matters.

Quick checklist: start at 50 mg for five days, expect ovulation monitoring, watch for visual symptoms, know twin risk, and discuss letrozole if you have PCOS. If anything feels off, call your clinic.

When to call your doctor

Call if you miss a period while on Clomid, have strong pelvic pain, sudden swelling, heavy bleeding, or vision problems. Also call if you have signs of infection after any procedure, a high fever, or shortness of breath. Keep a record of side effects and test dates to share at your appointments.

Alternatives and next steps

If Clomid is not right or stops working, options include switching to letrozole, using injectable hormones with closer monitoring, or consulting about IVF. Your age, diagnosis, and prior treatments shape the plan. Ask about risks, costs, and timelines so you know what to expect. Get second opinions early.