Q&A: Should my Clomid dosage be increased?

by Dr. Randy Morris

I'm 26 and have been trying to conceive for six months. Last month my doctor started me on 50 mg of Clomid. When I went in for the a checkup of my day 21 progesterone level, they told me the level was at 1.1. I was informed that this was within the normal range, but that it wasn't high enough. The doctor now wants to increase my dosage to 100 mg this month. Do you think it is too soon for that? Is it standard protocol to increase the dosage after only one month?

First of all, measurement of progesterone levels are fraught with problems. They only thing you can reliably determine with a progesterone level is whether ovulation occurred. A level over 2.5 or 3.0 indicates ovulation. Because of the variability in progesterone levels, there is no evidence to indicate that a "higher" level is better than a "lower" level.

There is also no evidence to indicate that once a woman is ovulatory, that there is any benefit to increasing the dose of Clomid. However, there is probably little harm to higher doses and many physicians will use 100 mg as a starting dose for couples with unexplained infertility.

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