Hello
Thanks for your query.

As you have mentioned you have no issues regarding fertility, it is not clear to me why you are undergoing a cycle of stimulation of ovaries using Clomid ( clomiphene citrate ). Clomiphene stimulates the ovaries to produce follicles and helps patients who have difficulty in ovulation.

Gonadotropins ( injections ) are given to further enhance the follicle number and size when multiple stimulation of ovaries is desired, as when patients fail to respond to clomiphene, or are going in for ART ( assisted reproductive technologies ) when more than one follicles are desirable for success.

A follicle size of 12 mm on day 7 of your cycle is normal. A follicle grows at the rate of 1 - 2 mm per day, and by day 14 in a 28 day cycle, it reaches a size of 20 - 22 mm, when it is considered a mature follicle, and is ready for rupture ( ovulation ). In your case, as you have not mentioned any fertility problems, and the size on Day 7 is good enough, you need not consider taking further injections for follicle size. You can continue monitoring the cycle with follicular monitoring serial ultrasounds as advised by your Infertility Specialist, and I think the follicle will continue to grow normally without further stimulation.

Normally, on day 14, the endogenous LH surge within the body causes the mature follicle to ovulate. If the patient has hormonal imbalances, or when clomiphene/ gonadotropins are used for stimulating the ovaries, this sometimes fails to happen, and the patient needs a trigger of HCG injection for bringing about ovulation. You can continue to monitor the cycle, and if natural ovulation does not occur, consider taking a trigger. Please remain sexually active in the peri ovulatory period to maximize chances of conception. Also, with artificially stimulated cycle with clomiphene, you need luteal phase support in the form of progesterone, after ovulation. Please discuss this with your consultant.

Regarding when you will ovulate, if you have normal 28 - 30 day cycle, you would most probably ovulate around day 14.

Take care, and feel free to ask for further clarifications. Kindly close the thread and rate the answer if your queries have been addressed.

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Hello
Your follicle size on day 7 is good enough, so if this response to clomiphene continues, you should ovulate around day 14, but it is not 100 % sure, specially since you have delayed cycles. To be absolutely sure of ovulation, you need to keep track of the follicle growth with serial ultrasounds.
There is no home remedy to increase follicle number or size, however, with a good response to clomiphene, you should not require injections if the follicular monitoring is progressing at a good pace. You cannot judge successful ovulation by a single ultrasound. Serial scans are done.
Alternate day intercourse is fine, but when the follicle reaches critical size for ovulation, it is best to have daily intercourse for 5 days. Ovulation is also confirmed by ultrasound. Please get that done too.
In order to have a healthy semen turnover, you can have alternate day sexual activity from day 7 - 9 onwards, and then daily activity once ovulation is indicated and confirmed.
Take care.

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Hello
You have already taken 3 cycles of clomiphene.
I hope you are taking them under the direction of an Infertility Specialist.
It should not be taken blindly without supervision and monitoring, as there are risks like ovarian hyperstimulation etc.
If your HSG is normal, you can take upto 3 more cycles of clomiphene.
It is not at all necessary to take clomiphene continuously every month, in fact , it is better with a break in between, to rest the ovaries .
Also, upto 6 cycles of clomiphene maybe taken, so you can safely go for 3 more, before you discuss an alternative mode of treatment with your Specialist.
You can try combining clomiphene stimulation with IUI ( intra uterine insemination ) to increase your chances of conception every month. But ensure that you have a complete follicular monitoring every cycle that you are on clomiphene.
Take care.

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