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Q. Should I raise the dosage of Clomid 50 mg to 100 mg to get pregnant?

Answered by
Dr. Poonguzhali Liston
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Dec 16, 2021

Hi doctor,

I am a 24-year-old female. My husband and I have been trying for the last six months for a baby. But I discovered that I had PCOS (polycystic ovarian syndrome) and diabetes three months back. Now diabetes is under control as I am taking Metformin 500 mg twice a day. I am walking and exercising regularly and trying to bring my weight in control.

My periods are shifting by one day from when I am taking Clomid (Clomiphene) 50 mg as an online doctor recommended me to take for conceiving. In the first cycle of Clomid, I had my period at 29 days instead of 28 days.

This is the second cycle I tried with Clomid from day 3-7 this month, and today I got my periods at almost 31-32 days. Usually, my periods are very correctly timed at sharp 27-28 days.

Does this mean my body is attempting to get pregnant but is not able to? Will Clomid 100 mg dose help me? And I am afraid that if I do not get pregnant in this third cycle with Clomid 50 mg, then some side effects might occur.

I want to conceive naturally, and if not possible, within a year atleast with the help of IVF (in-vitro fertilization), which is the last option but right now am seeing if Clomid can help me (Fertomid 50).

Please help, doctor.

Regards.

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#

Hello,

Welcome to icliniq.com.

I can understand your concern.

Yes, Clomid can help in ovulation. It induces the growth of one ovum, which usually does not occur in PCOS. But this ovulation has to be followed up with either follicular study (scan to see whether ovum is growing and ovulation is happening) or with urinary LH (luteinizing hormone) monitoring which again shows whether ovulation has occurred.

Clomid only helps in the growth of the ovarian follicle, but taking Clomid without monitoring the growth is useless. So before you decide to change the dose of Clomid or try other means of conception, I would suggest following the cycle with a scan or LH monitoring.

And also, the change in period length is normal and may be due to the lifestyle changes you have presently made. I would also like to see your reports and your husband's investigation to give you better advice. A voice call would be easier and more convenient to explain.

Regards.

Hi doctor,

Thank you for your reply.

I will get back to you with the report and update on this chat. My husband is a doctor himself. He did tell me to monitor ovulation. But I wanted your advise. Also doctor not only this time my period is late by two days but I saw light spotting on my pad yesterday night which I thought was my period. It is been 12 hours almost. I am not bleeding. The pad has super light spotting it is not even red. Now morning I saw light brownish blood just stuck but still no bleeding. Yesterday before the spotting there was stretchy mucus type discharge which is thick. I am wearing a pad now again just to observe. But when though I have PCOS I always used to bleed regularly. It is strange that this time there is no blood at all only spotting. I will update you in 3-4 hours doctor. How to monitor LH doctor?

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Hi,

Welcome back to icliniq.com.

LH can be monitored with LH urine kits very similar to the urine pregnancy test. In a 30 day cycle, it is good to test the LH starting from day 13. And also, with spotting, it would be good to take a pregnancy test because even in early pregnancy, there may be spotting. So wait and take a pregnancy test tomorrow if spotting is light.

Hi doctor,

Thank you for your reply.

Is it possible that I will be getting late periods with clomid? Because I observed spotting yesterday night. Today there is no trace of blood much. Yes doctor tomorrow morning I will take urine pregnancy test. But will that be effective? Should I go for HCG (human chorionic gonadotropin) blood test after 4 days if my cycle has not come this time. I will surely follow the LH urine kit doctor if I am not pregnant this time. Sorry if I will bother you again in the next 36 hours. Will update you as I am anxious.

#

Hi,

Welcome back to icliniq.com.

Urine pregnancy kits are highly sensitive and can detect pregnancy one day after your missed period. No worries, you can update me as frequently as you want. Clomid does not change the period length. Beta HCG is needed only if you want to double-check pregnancy.

Thank you doctor,

From six hours again, I am noticing no discharge at all. My pad is clean. Now, I walked my usual stretch for an hour, and I saw a pinkish-red clot. Technically, I suppose to have my second day where I bled heavily, but no bleeding occurred this time. I am hopeful of pregnancy, but I am scared to see my test negative in UPT. Should I take withdrawal bleeding, or should I wait a month without doing anything? Also, if upt is negative in case tomorrow, how long should I wait till I test again? I have a pregnancy kit with me.

My body temperature is also slightly up, and feeling nauseated. In the morning, I got brown clots, and now, I have pink clots, and from yesterday, which is my 31st day, there has been no discharge. My husband also told me that we need to wait and watch for pregnancy. It may not be detected so soon. In upt, if it is not favorable, then what would be the other causes? Should I need to wait two to three days again or go for beta HCG? If it is negative, just in case, then should withdrawal bleed be given, or should I retake Clomid 50 this month considering this as a cycle? Sorry to bother you with so many doubts. I need a clear plan of action against what to do. I am so confused.

#

Hello,

Welcome back to icliniq.com.

Please take a pregnancy test tomorrow. You can repeat the test after a day, just to be sure. Serum hCG will remain increased even before urine pregnancy tests become positive. Do not be stressed. Just go ahead and take the test. Delaying will not change the result. So stay positive and do the test. If it is negative, wait for a few days for periods to occur on their own. If it does not happen even after seven days of missed period and negative test, a withdrawal pill has to be taken, and Clomid has to be started from day 2 of the cycle.

Thank you doctor,

Ok, mam, I will do it tomorrow and tell you. Thank you so much for your timely help.

#

Hi,

Welcome back to icliniq.com.

Ok sure. Take care.

Thank you doctor,

Hi mam. Good morning. I tested with a pregnancy kit with my morning sample. The result is positive. In one more kit called a clear response, the line is present but comparatively faint. I thank you doctor. Please see the image and let me know what you think. Does implantation happen now, or how old will the embryo be? What precautions are to be taken as I have a history of PCOS? Shall I go for double confirmation with beta HCG?

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Hi,

Welcome back to icliniq.com.

That is a definite positive result. The lines will get darker as time passes when HCG levels in the blood are increased. To know how far your pregnancy is and to rule out the causes of bleeding, I suggest getting a scan done. More than serum hCG levels, a scan will be more definitive. Also, start taking Folic acid 500 mcg supplementation. Congratulations.

Thank you doctor,

Thank you so much doctor. When should I get scanning done? Is this early period of pregnancy is acceptable to take a scan? Today, I gave blood for beta HCG, and I will get the report tomorrow. Can I start with a folic acid supplement too? Thank you doctor.

#

Hi,

Welcome back to icliniq.com.

You can do the scan after a week.

Thank you doctor,

Mam, please see the beta HCG levels. Is everything normal? Thank you, mam.

#

Hi,

Welcome back to icliniq.com.

Beta hCG remains raised, which is a sign of pregnancy. So please do a scan or a serum beta hCG after a week.

Thank you doctor,

Yes, mam. My last LMP was 45 days back. It is fine, right, as the value is 33 days.

#

Hi,

Welcome back to icliniq.com.

Yes, the value is fine.

Thank you doctor,

I am enclosing my ultrasound scan reports done last week, and please kindly see. As you know, my diabetic levels were out of control, for which my diabetologist has placed me on short-acting and long-acting insulins Fiasp and Levemir. I am currently nine weeks pregnant. My fasting is around 90 mg/dL and PPBS around 150 mg/dL.

The gynecologist has recommended me Ecosprin 150 mg from today. But my diabetologist is not sure about it. Why is Ecosprin being given? I understand that I am prone to pre-eclampsia. But is it safe for the baby? My gynecologist advised me to continue taking Ecosprin 150 mg throughout pregnancy. Would you please suggest to me if I have to take it? If so, precisely from which week and kindly suggest the cause if I should not take medicine. I am not sure about Ecosprin. Would you please help me with your explanation? The tablets taken and the prescription for Ecosprin is also attached. I have not started taking it yet. Regards.

#

Hi,

Welcome back to icliniq.com.

I understand your concern. Tablet Ecosprin is used to prevent preeclampsia, a common co-morbidity occurring in pregnant women with diabetes. Ecosprin is entirely safe in pregnancy and will not affect the baby in any way. Also, in diabetics, the amount of blood supply to the baby may be affected due to constricted blood vessels, and Ecosprin prevents this. So it is safe to start Ecosprin from 12 weeks of gestation safely by continuing your diabetic medication.


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