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Expert Q&A

	By Craig Sweet, M.D. Reproductive Endocrinologist

I took Clomid 50 last cycle, and there was ovulation but no pregnancy. Is it likely that I will need a higher dose next time or could the 50 be enough for additional cycles? Also, is there any chance I could ovulate 2 eggs after stopping Clomid?

Clomid is readily used in the reproductive world. If one is already ovulatory, using Clomid on top of a normal cycle is probably not very useful. If a patient is not ovulatory, many physicians will choose between Clomid and Femara (Letrozole). Letrozole works in a slightly different way and tends to encourage the release of only a single egg, whereas Clomid more often results in the release of one to three eggs. Letrozole is contraindicated in an ongoing pregnancy, but it is a great option for those with ovulatory dysfunctions once other causes have been ruled out. While the "American" (i.e., more is better) way would be to increase the dose, there has never been any proof that this really helps once ovulation is documented at the lower dose, and some of the adverse effects of Clomid may accumulate with the higher dosages.

In answer to the second question, there is NO greater tendency to polyovulate (ovulate more than one egg) the month following the Clomid treatment. Interestingly, there does seem to be an increase in the rate of twinning during the month following the discontinuation of oral contraceptives, a bit of reproductive trivia.

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