Short answer: Usually 5 to 10 days after the last pill. The Clomid (clomiphene citrate) label says ovulation most often occurs 5 to 10 days after a course, and that intercourse should be timed to match. A course is 5 days of tablets, often started on or about day 5 of the cycle, so ovulation commonly falls around days 14 to 19. Your clinic may confirm it with tests.
The Clomid label (Dosage and Administration) starts with 50 mg a day for 5 days. If there has been bleeding, either natural or brought on with a progestin, the course starts on or about day 5 of the cycle; if there has been no recent bleeding, it can start at any time. MedlinePlus describes the same pattern: once a day for 5 days, beginning on or about day 5.
The label then says ovulation most often occurs 5 to 10 days after a course, and that intercourse should be timed to coincide with the expected time of ovulation. Counting from a day 5 start, the last tablet is on day 9, which puts the usual window at about days 14 to 19. Cycles vary, so this is a guide, not a fixed date.
The label says a basal body temperature chart or other tests may help the patient and doctor tell whether ovulation happened, and that tests to determine ovulation may be useful during this time. It also says a pelvic exam is needed before the first and each later course, to rule out pregnancy, ovarian enlargement or a cyst.
Which tests your clinic uses is its choice. Writing down the first day of bleeding, the 5 tablet days, any test results and intercourse dates gives the clinic a clear record for each cycle.
| Situation | What the label says |
|---|---|
| No ovulation on 50 mg | Next course 100 mg a day for 5 days, as early as 30 days later, after ruling out pregnancy |
| Ovulation on 50 mg | No advantage to raising the dose in later cycles |
| Higher dose or longer course | Above 100 mg a day or beyond 5 days is not recommended |
| No ovulation after 3 courses | Stop and re-evaluate |
| 3 ovulatory cycles without pregnancy | Further treatment not recommended |
| Total use | Not recommended beyond about 6 cycles |
The label says most patients who are going to ovulate do so after the first course.
In the label's clinical trials, pregnancy occurred in about 30% of 7,578 patients. Of the pregnancies, 7.98% were multiples, mostly twins (6.9%). In a large trial in women with polycystic ovary syndrome (Legro 2014), ovulation occurred in 48.3% of clomiphene treatment cycles, and 19.1% of women had a live birth over up to five cycles; letrozole did better on both, as covered in letrozole vs Clomid.
The label also warns about visual symptoms such as blurring or flashes, and ovarian hyperstimulation; see OHSS warning signs. Dose Track can remind you on each tablet day and keep cycle notes in one place.
Read more on Dose Track: Clomid dosing schedule · Clomid side effects · Letrozole vs Clomid · Female fertility: what the evidence shows · PCOS: what the evidence shows