What Is the Clomid Success Rate for Ovulation and Pregnancy?

Will Clomid help you get pregnant? Learn what the Clomid success rate is for ovulation and pregnancy—and what to do if it doesn't work for you.

The primary purpose of Clomid (clomiphene citrate) is to induce ovulation in people who are either not ovulating or ovulating irregularly. Between 70% and 80% of people with a uterus will resume ovulation from treatment with Clomid. If you conceive while taking Clomid, people often call it a Clomid pregnancy.

Remember that while you may be primarily familiar with Clomid and perhaps IVF treatment, there are, in fact, many more fertility treatment options for you to consider. Always talk to your health care provider if you’re concerned about the next step or if Clomid isn't working as you hoped it would.

Clomid success rate for ovulation and pregnancy

Parents / Chelsea Damraksa

What To Expect During Your First Month of Clomid

Depending on which research studies you reference, the effectiveness of Clomid varies depending on the cause of infertility.

Keep in mind that those without any fertility problems have about a 25% chance of getting pregnant in any given month. If you don't get pregnant after one month, don't panic. Needing more than one cycle is common.

Odds of Getting Pregnant on Clomid

A literature review considered several studies on Clomid. Altogether, the Clomid success rates for just over 5,000 people with ovaries were included. In this study, they found:

  • 73% eventually ovulated on Clomid
  • 36% eventually achieved pregnancy
  • 29% gave birth

The birth rate is lower than the pregnancy rate due to miscarriages, but Clomid itself doesn't seem to increase the risk of miscarriage.

However, Clomid success is also dependent on why you can't get pregnant. Another study looked at success rates for couples diagnosed with unexplained infertility. Couples were randomly assigned to one of three groups: not given any drugs, treatment with just Clomid, or treatment with unstimulated intrauterine insemination (IUI).

The most effective treatment group was the IUI group, who achieved a 22% live birth rate. The Clomid-only treatment group was 14% and the couples who received no treatment at all had a 17% birth rate, better success than getting treatment.

The Best Day To Start Clomid

Clomid is taken for five days. Treatment can be started as early as on Day 2 of the menstrual cycle or started on as late as Day 5. However, most health care providers either have you take Clomid on days 3, 4, 5, 6, and 7, or they have you take it on days 5, 6, 7, 8, and 9.

Does it matter which protocol your health care provider chooses? Yes and no. In order to induce ovulation, treatment follows the Day 5 through 9 option. If your health care provider wants to "enhance" ovulation, you'll likely take Clomid on Days 3 through 7.

When it comes to pregnancy and ovulation success rates, however, studies have not found an advantage or disadvantage. Your odds of getting pregnant are similar no matter which Clomid start date protocol your health care provider prefers for you.

What To Expect After Six Months of Clomid?

If Clomid doesn't help you get pregnant after six months, your health care provider might suggest you try something else. There are a few reasons for this:

  • If Clomid hasn’t helped you conceive after six months, the odds of it working on month seven or eight are very low. Remember that your fertility naturally declines with age. If something isn't working, it's best to move on.
  • Extended treatment with Clomid may lead to fertility problems of its own. People who have gone through several Clomid cycles may have thinner endometrial linings, which can impede with embryo implantation. (This will correct itself after time away from Clomid and is not a long-term adverse effect.)
  • Some early research on Clomid found a possible increased cancer risk in people with ovaries treated for more than six cycles. To mitigate this risk, you should not take Clomid for more than six cycles.

Optimal Dosage of Clomid

Your health care provider will likely start you on the lowest dose first, which is 50 mg. If you don’t ovulate on 50 mg, your health care provider may try one more cycle at the same dose, or increase your dosage by another 50 mg.

If you ovulate, and you just don’t get pregnant, then your health care provider will keep you at the dose you’re on. Increasing the dosage doesn’t increase your odds of getting pregnant.

Your health care provider will want you on the lowest possible dosage, just enough to trigger ovulation, but not more than that.

Side Effects of Clomid

One possible side effect of Clomid is thickened cervical mucus. Cervical mucus is vital to fertility and helps the sperm survive the vaginal environment and make their way into the uterus and eventually to the egg. Other possible side effects include:

  • Hot flashes
  • Headaches
  • Abnormal vaginal bleeding
  • Breast discomfort
  • Upset stomach
  • The risk of a multiple pregnancy (conceiving twins)
  • Developing ovarian cysts
  • Visual disturbances

Higher dosages can also increase your risk of developing ovarian hyperstimulation syndrome. If you're concerned about any side effects you're experiencing, as always, contact your health care provider.

When Clomid Doesn't Work

Clomid is not the magic fertility drug that some people mistake it to be. It works well in the right circumstances—but it can be completely unsuccessful in the wrong ones. If there are additional problems besides irregular or absent ovulation, success will be lower.

It's questionable how successful Clomid therapy is for couples diagnosed with unexplained infertility. Also, Clomid does not always work well for people who are dealing with age-related infertility, with low estrogen levels, or people with primary ovarian insufficiency (formerly known as premature ovarian failure.) It may also not work in people whose ovulation problems are caused by a thyroid issue.

Discuss the best course of action with your health care provider.

What If I Don't Ovulate?

If you don't ovulate while taking Clomid, there are some things your health care provider can try before suggesting other treatments.

If Clomid does help you ovulate, but after six months of treatment you still have not gotten pregnant, the next step may be a referral to a fertility clinic (if you're not already being seen at one). Or your health care provider may suggest gonadotropins (injectable fertility drugs).

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Sources
Parents uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Predictive Factors of Conception and the Cumulative Pregnancy Rate in Subfertile Couples Undergoing Timed Intercourse With Ultrasound. Front Endocrinol (Lausanne). 2021.

  2. Clomiphene citrate—end of an era? A mini-review. Hum Reprod. 2005.

  3. Clomifene citrate and intrauterine insemination as first-line treatments for unexplained infertility: are they cost-effective? Hum Reprod. 2011.

  4. Clomiphene. MedlinePlus. 2017.

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