Timed Intercourse (TI)

Ovulation Inducing Drugs and TI

Clomid

One of the first steps to infertility treatment is the use of ovulation inducing drugs. The most commonly prescribed drug is Clomid, short of Clomiphene citrate. This drug is an ingestible tablet that is taken once a day for 5 days – either days 3-7 or 5-9 of your cycle. Usually a doctor will start with a 50mg and increase after failed cycles or non-response.[1]

Clomid is an estrogen blocking drug that triggers the body to produce the hormones needed to produce eggs. The doctor may ask you to come back for ultrasounds and blood tests to see if you are ovulating. If you are not, a trigger shot of human chorionic gonadotropin (HCG) may be perscribed to help the body release an egg.

Clomid is not suggested for more than six cycles – three in some cases (such as age or monitoring.)[2] If Clomid does no produce results, your doctor may move onto another drug: Femara.

Femara

Femara (or Letrozole) is also an oral tablet that stimulates ovulation. However, studies have shown that Femara may have better results for women with PCOS or unexplained infertility.[3] Femara is also prescribed when Clomid has not induced ovulation in multiple cycles. The starting dose is 2.5mg but can increase to 5mg or 7.5mg if needed.[4]

Femara is similar to Clomid in that it is taken on cycle days 3-7 or 5-9 to induce ovulation. Femara is usually prescribed for 3 cycles only before moving on.

During ovulation medication use. Timed intercourse (TI) will be needed. If you took the drugs on days 3-7, ovulation should occur between days 14-19. For days 5-9, ovulation should occur between days 16-21. During this time, it is important to have intercourse in order to conceive. [5]

If conception is not attained after ovulation medicine is used, the OBGYN will refer you to an RE for further testing and the next step: intrauterine insemination (IUI). Clomid and Femara can also be used during IUI as well as in vitro fertilization (IVF). More information on IUI and IVF is available on their respective pages in the menu above.

[1] Galan, Nicole. 2016. “How Does Clomid Work for Fertility?” Healthline. 2016. https://www.healthline.com/health/pregnancy/how-does-clomid-work.

[2] Shady Grove Fertility. 2018. “Clomid for Infertility: What You Need to Know.” Shady Grove Fertility. 2018. https://www.shadygrovefertility.com/blog/treatments-and-success/clomid-for-infertility/.

[3] “New Treatment Increases Pregnancy Rate for Women with Infertility Disorder.” 2014. National Institutes of Health (NIH). 2014. https://www.nih.gov/news-events/news-releases/new-treatment-increases-pregnancy-rate-women-infertility-disorder.

[4] Gurevich, Rachel, Sadaty, Anita. 2017. “Femara (Letrozole) for Treating Infertility in PCOS.” Very Well Family. 2017. https://www.verywellfamily.com/letrozole-femara-for-fertility-success-rates-safety-1960195.

[5] “Letrozole Guideline.” n.d. Roswell Ob/Gyn. Accessed April 30, 2018. http://roswellobgyn.org/letrozole-guideline.html.