Day 1, (first of bleeding, not spotting):

Schedule BASELINE ULTRASOUND. Ultrasounds are done to look for residual ovarian cysts that could interfere with the effectiveness of treatment. This is done at the beginning of each treatment

cycle days 1-5, but ideally on days 2, 3 or 4. At the onset of any bleeding, call the clinic at 952-806-0011 and schedule your baseline ultrasound. A BASELINE ULTRASOUND IS REQUIRED EACH MONTH PRIOR TO PRESCRIBING MEDICATIONS. BASELINE ULTRASOUNDS ARE NOT DONE ON THE WEEKEND.

If you expect your menses to begin on a weekend, call Friday to schedule appointment the following Monday or Tuesday.


Days 3-5:

Clomid or Letrozole is started and taken once daily for 5 days. Your clinician will determine the medication dosage and day you should start the medication (generally started day 3, 4, or 5 of your cycle). You will be informed of this information on the day of your ultrasound.

Days 10-15:

Follow-up ultrasounds and any labs are done to evaluate your response to treatment. We will be monitoring the size and number of developing follicles by ultrasound. We will instruct you in use of LH testing based on ultrasound findings.

Ovidrel (HCG) injection is a medication used to trigger ovulation. This may be utilized in addition to LH testing to help with the timing of intercourse or inseminations. The timing of administration of Ovidrel (HCG) will be based on ultrasound and lab findings. If this has been prescribed as part of your treatment plan, you will need to schedule an appointment for “injection training” to learn how to self-administer this medication. Your husband/partner can also be taught to give the Ovidrel if you feel you are unable to administer it to yourself. If Ovidrel is used in conjunction with inseminations, the injection will be administered at 8 pm on the day indicated by your clinician (generally the night before the first insemination). If Ovidrel is used in conjunction with timed intercourse, you will be instructed on when to give the injection.

3rd night after LH surge or Ovidrel administration:

Progesterone supplementation may be started. All patients using Letrazole will use Prometrium 200 mg twice daily intravaginally for 2 weeks.

Day 7-8 after ovulation:

In the first cycle, you will have blood drawn 7-8 days after ovulation to determine if the progesterone level is adequate. (This does not need to be done if you are already taking progesterone supplements).

Day 15 after ovulation:

If you have not started a normal period, take a home urine pregnancy test. If on progesterone and pregnancy test is positive, you should continue taking your progesterone supplement until 12 weeks of pregnancy and call your provider to discuss further instructions. If the test is negative, you should stop the progesterone supplement and call us with the first day of your next period to schedule a baseline ultrasound to start a new treatment cycle.