Have you been evaluated for PCOS? With long cycles and a possibility that you are not ovulating at all, those are some strong indicators of PCOS.
Are you seeing an OBGYN or have you moved on to a specialist (reproductive endocrinologist)? An RE could really help you out with this.
Clomid is a good answer for a lot of women, but I know a number of women who don't ovulate on their own that ended up being Clomid-resistant. Meaning they never ovulated on Clomid either. They had better success with Femara.
I have PCOS, or at least suspected PCOS. Mine is more non-traditional because I do ovulate on my own and I do not experience all of the PCOS side effects. I also do not have cysts on my ovaries, which is a lot of times what is happening when you don't ovulate or get regular cycles. I am currently in my TWW of my 4th cycle of Clomid.
With Clomid, chances are your doc will start you on 50mg and you will take it for 5 days towards the beginning of your cycle. Some doctors recommend days 5-9, others days 3-7. Those seem to be the norm, but I have heard great stories of women just taking it days 1-5 too. My OBGYN has told me to take it days 5-9, but this cycle I figured it couldn't hurt anything to move it up. So I did days 2-5. Seems to have been my best cycle yet!
Your doc should then instruct you to start taking OPKs around days 10-12 so that you don't miss your LH surge and ovulation. You take them at least once a day until you get your positive. With long cycles you could end up taking a LOT of OPKs, so I recommend getting the Wondfo dip strips from Amazon.com or something equivalent to them. You can get 50 tests for $20. I actually take the OPKs twice a day just to be safe. Normally I get 2 days of positives, so I probably would not have to. However, THIS cycle I only got 1 positive and my temp spiked the next day. I had a really quick LH surge on this dose of Clomid. So if I wasn't taking them twice a day I would have missed it.
Once you get your first positive, you are supposed to have
the next 3 days. Then, 7 days after your positive OPK you are supposed to go in for your progesterone test. My doctor likes to see this over 10, but anything above a 5 can indicate you did in fact ovulate. Women without issues often can see a level of 30 even. If your level is less than 10, they may try to tell you that you did not ovulate.
If you don't get a positive OPK by day 21, they may want you to come in for the progesterone test anyhow to see if you may have missed it.
If your progesterone levels do confirm ovulation and they are in a normal range, chances are they will keep you on that same dose for your next cycle. If you levels are not satisfactory, they will bump you up to 100mg more than likely. Then... you go through it all again. If progesterone levels are still not satisfactory, they will bump you up to 150mg. Most doctors will not go higher than 150mg, but I have heard of occasions where they went up to 200mg. Generally you should not do more than 6 cycles of Clomid because of the increased risk of ovarian cancer. They say if it hasn't worked for you by 3-4 months, it probably won't work for you. 'Work' does not necessarily mean pregnancy. If ovulation can be confirmed and your progesterone is good, the Clomid did work. BUT if after 3-4 months no ovulation on Clomid can be confirmed, chances are you are Clomid resistant.
Some of the side effects I have experienced are severe bloating, hot flashes, ovulation pain, pinching/pulling/tingling on both ovaries for most of my cycle, and a slight increase in depression and anxiety. For me... the worst is the bloating and hot flashes, as those seem to be every day of the entire cycle. BUT every woman is different and so are her side effects.
Hope that gives you a pretty good rundown of Clomid.
Good luck and lots of
!!!
