Is it that important to start it on that day? What are the best days to take Clomid for success? What happens if clomiphene citrate is started earlier or later? Read on.
Typically a woman's ovaries recruit a "dominant" follicle early in her cycle (days 5 – 7 of the cycle). This is the follicle that will subsequently grow to a size of 16 – 22 mm and ovulate. Once the "dominant" follicle is selected, other follicles will not grow.
If clomiphene citrate is started after day-5, it will not be effective in selecting multiple follicles since by that time a dominant follicle will already been selected.
When clomiphene citrate is started on day- 5, it is just in time to stimulate the recruitment of multiple follicles.
If a woman starts Clomid earlier than day 5, it is possible to stimulate multiple 'dominant follicles', which may result (theoretically) in a higher incidence of multiple gestation pregnancies. While some physicians may choose to begin Clomid on days 2, 3, or 4, there is not a significant increase in pregnancy rates.
However, from a nursing perspective, it is much more convenient to start clomiphene citrate on day-5. It gives time for the patient to come in for a baseline ultrasound (to confirm there are no cysts) and bloods (at InVia Fertility Specialists we like the estradiol level to be less than 100 pg/mL).
Of course in patients who do not ovulate, clomiphene citrate can be started on ANY day since these patients do not have menses. It is a good idea (in these patients) to do a pregnancy test prior to starting clomiphene citrate.
