# Is it normal to stay on same dosage of Clomid even if it doesn't work?



## Orlinik28 (Jan 3, 2014)

Hi

I have been lurking on the site for a while but this is my first post.

Brief background, I was diagnosed with PCOS at 17 (I have the syndrome but do not have cysts on my ovaries).  I do not ovulate naturally and never have. In March 2013 I went to see my GP about receiving fertility treatment and saw a Consultant in October. I was prescribed Provera and Clomid 50mg for 6 months.

After taking the Provera for 5 days, AF arrived 11 days later (the longest 11 days of my life!) and I started the Clomid on CD2.  I had a scan on CD12 and the largest follicle was 6.6mm.  I was therefore told I either would not ovulate or would have a 6 week cycle. Had a blood test on CD21 but do not know the result. By CD42 nothing had happened. Took a HPT, it was negative so started taking Provera again. I am now waiting for AF to arrive. 

I am 99% sure I did not ovulate last month however the nurses will not review my treatment until I have completed three cycles and won't tell me the blood results until then either. I am only allowed to have 6 cycles of Clomid, therefore, this seems like a massive waste of three cycles and time. This is particularly true as it takes me approximately two months to complete a cycle when it takes 'normal' people one month.

My question therefore (sorry about the massive explanation!) is whether anyone has found that Clomid has worked for them on the second or third cycle when it didn't the first time, on the same dosage?

Any advice would be greatly appreciated.

Thanks x


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## Puglover1980 (Mar 7, 2013)

How utterly stupid not to tell you your blood test results! You're essentially going in to your next cycle blind, which is not a good idea. Clearly your instincts are telling you this too!

I actually commented on a similar post the other day, so am going to copy and paste if you don't mind...

It's definitely true that clomid _can_ have a cumulative effect, so in theory it's possible for 50mg not to work one month then work the next. However, I've got quite a lot of experience with clomid and I've seen far more instances of a dosage working one month and then failing to work the next than the other way round. Crucially, my consultant always told me that if a lower dosage doesn't work there's no point continuing with that dosage - you increase by 50mg the next month, up to a maximum of 200/250mg. If you appear to be clomid resistant, another drug/protocol should be tried. With clomid it's important to take the lowest dosage possible to induce ovulation though, as taking an unnecessarily high dose can cause more harm than good (can negatively impact EWCM, thickness of lining etc.). So if 50mg works for you, there's no benefit in increasing to 100mg if you don't fall pregnant. I hope that makes sense.

So basically you need to know whether you ovulated on 50mg. It's silly to go ahead with another cycle at the same dosage without having that information. As you say, it's only recommended that you do a maximum of six clomid cycles, so you want to make sure they count!

To be honest, I'm surprised with your history that you were started on such a low dosage! I have severe PCOS (periods were always very irregular and stopped many years ago) and was put straight onto 100mg.

From everything you've said, I'd say you can be confident you didn't ovulate on 50mg. Generally speaking, clomid will make you ovulate 5-10 days after you take the last tablet (in my case it was usually 11 or 12 days after the last tablet), and at the most you'd have a period 16 days later (probably closer to 12-14 days later depending on your luteal phase, which you don't know because you've never ovulated) unless you were pregnant. Had the 50mg of clomid worked, I would have expected you to have ovulated by around CD18 at the latest, meaning a period by CD34 at the latest. You made it to CD42 and no positive test, suggesting you didn't ovulate.

Of course there are always exceptions to this - I have heard of the occasional rare occurrence where clomid has resulted in a very late ovulation (much later that it should have done). However, this is not very common.

Trust your instincts and be more pushy with your doctor. If I were in your shoes I would want to be increasing the dose to 100mg for this next cycle. If 50mg didn't work last time, it probably won't work this time either.

Loads of luck. I'm a firm believer in clomid but it's key that you find the dosage that works for you. x


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## Orlinik28 (Jan 3, 2014)

Hi Puglover1980, thank you for your detailed response.

I might ring the Fertility nurses tomorrow and see if they will tell me my first blood test result/will consider upping the dosage.  As I've got 6 months worth of tablets I'm having to fight really hard with my conscience not to up the dose myself.  I won't but I'd be lying if I said I wasn't tempted!

Thanks again. Its really helpful to hear other people's experiences/opinion.

x


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## Bluebell84 (Jun 18, 2013)

What dose are you on? I didn't ovulate on 50mg but did on 100mg. Can you not ask the hospital to send your blood results to your GP... Then they can give them. No point doing 50mg if it isn't working? X


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## Bluebell84 (Jun 18, 2013)

Sorry I've just seen you were on 50mg... I only took it for one month as it didn't work. You need to know really whether you ovulated. How frustrating for you!! 

Good luck

Ps i would be very tempted too ;-)


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