How to take clomid or femara

are you starting clomid or fuh mara for

ovulation induction well I'll walk you

through my protocol today coming up hey

everyone dr. west Davis back with you

again today I make weekly YouTube videos

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please consider subscribing so I'm gonna

walk you through today how I run a cycle

of clomid Orpha mara really day by day

what do we do how do we break it down so

you'll understand what to do when you go

home with your prescription and you're

getting ready to start a cycle for

ovulation induction if you haven't yet

check out my videos on evaluation of

infertility and PCOS has a lot of the

evaluation that I would do prior to

starting a cycle of kilometer from era

is included in those videos now the most

common reason that I would use clomid

Orpha mara is for what we call auditory

dysfunction people who are not ovulating

regularly we do also use it for what we

call unexplained infertility a patient

or partner have been evaluated and

there's no obvious reason to explain

their infertility sometimes we do

clémence or Fumero with or without

insemination and the cycle is really

really pretty much run the same so I'm

just going to walk you through that

cycle now so basically everything starts

with the first day of your period we

call that day number one I'm gonna put a

little calendar right up in here and I'm

just gonna walk you through it so day 1

is the first day of your period I

usually start climbing or Fumero on day

3 day 5 is also fine I've just always

run day 3 cycles there's really no proof

that ones that you better than the other

so we start medication on day 3 usually

50 milligrams of clomid or 5 milligrams

of Ameri that's one dose per day for

five days so that gets from day three to

day seven typically if this is your

first cycle especially I'm gonna do a

follicle check between day ten and

twelve and I'll show you what that looks

like up here on the screen typically

we're trying to get the ovary to produce

a follicle that is somewhere in the 18

to 20 millimeter range that's what you

expect just before ovulation

now we're either going to do a trigger

shot with HCG at that point to trigger

ovulation or track for ovulation with

all with an ovulation predictor kit

either way when we

a positive on opk or we do a trigger

with HCG the following day is the day

that we do an insemination

if inseminations are being done now I do

also recommend daily intercourse in the

days leading up to the follicle check as

there is evidence that daily intercourse

does result in higher rates of

conception and if you don't know yet I

have a video that talks about maximizing

your natural fertility I'll put a link

up here in the corner that shows you

that one there are several things you

can do and I discuss them in more detail

in that video so about two weeks later

now we're talking about roughly day 24

25 26 somewhere in there you're either

gonna get a period or you're not and

certainly by 8:28 you'd expect to have a

period either way I recommend do a

pregnancy test somewhere in that

neighborhood as if you are pregnant we

should be picking up right around them

if the pranks test is negative and the

whole cycle just repeats starting over

again on day 3 I think that this reason

we'll do 3 to 6 cycles of clomid and

Orpha Mara before moving on to more

advanced techniques so there are a

couple other wrinkles to my protocol

that I'll discuss now some people don't

have a regular cycle and so they really

don't have a period to start off on

their day one and there actually is

evidence that if you induce a period for

those people you may actually reduce

their fertility I don't typically start

a period any more by giving somebody

Provera for a few days to start a period

and then go for day one I just typically

jump in there and I'll do an ultrasound

first to check the ovaries make sure

things look quiet and assuming they do

then I'll just jump in and then I'll

give them the prescription that day tell

them to start it up basically on this

protocol you'd call that day three and

then we deceivin about a week for a

follicle check another thing that I'll

do is if you come back for the follicle

check and there's no follicle developing

and I'll show a picture of what that

looks like up here if there's no

follicle developing then I will just go

ahead and increase the dose right there

on the spot so if you're on 50

milligrams of cologne that we'd bump it

to a hundred typically max dose is about

a 150 on clomid there's no evidence to

go and Beyond there that really improves

fertility rates or if you were on five

milligrams of Ameri you can bump it up

to seven and a half if you've done all

those things and we're still not seeing

ovulation one last trick is adding

metformin might be a benefit in that

situation so I will sometimes do that

for a cycle or two okay so that's how I

run my

mara cycles I hope you found that

information interesting if you have

questions please feel free to put them

in the comments below and as always

thanks for watching and have a great day