When to start taking clomid
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
