Clomiphene citrate (Clomid) and intrauterine insemination | Progyny

Updated by the Progyny Clinical Team — September 2025.

What is clomiphene citrate?

Clomiphene citrate (brand name Clomid) is an oral medication that helps stimulate ovulation. It may be prescribed if you don’t ovulate regularly, or if your reproductive endocrinologist (REI) wants to encourage the release of more than one egg.

Clomid works by making your brain think there is less estrogen in your body than there really is. In response, your brain produces more follicle-stimulating hormone, which helps eggs grow inside your ovaries.

What are the success rates with Clomid, with and without intrauterine insemination (IUI)?

Success with Clomid depends on your age and the reason for infertility. As age increases, egg quality declines, which can lower success rates.

• If the main issue is that you don’t ovulate on your own, Clomid is often very effective and can help many people to release their eggs.
• Clomid is commonly used for polycystic ovarian syndrome and can improve the chances of both ovulation and pregnancy.
• When no clear cause of infertility is found, Clomid on its own may not be as effective. In these cases, Clomid is often combined with IUI.

IUI places prepared sperm directly into the uterus with a thin catheter, making it easier for sperm to reach the egg. Using Clomid with IUI can increase the chance of pregnancy compared with Clomid alone.

What is involved in a Clomid and IUI cycle?

On day 3 of your cycle, you’ll have bloodwork and start taking Clomid for five days. Your REI will use ultrasound to track how your body responds to the medication.

About 24 to 36 hours after ovulation, the insemination takes place. If you’re using partner sperm, a semen sample will be collected and prepared in the lab. If you’re using donor sperm, the frozen sample will be thawed and prepared the same way. This process removes substances that could cause cramping if placed directly in the uterus.

Does Clomid increase the risk of twins or triplets?

Yes. The risk of twins with Clomid and IUI is about 8%. The chance of triplets is less than 1%.

Are there cases where Clomid will not work?

Clomid is less likely to be effective if you have:

• Blocked fallopian tubes.
• Very low ovarian reserve, which means there are very few eggs remaining.
• Hormonal conditions, such as high prolactin levels or thyroid issues.
• Hypothalamic amenorrhea, which is a condition where the brain does not send signals needed to start ovulation. It can be linked to very low body weight, stress, or excessive exercise.

Which option is best for you?

Clomid alone and Clomid with IUI each have their own benefits, success rates, risks of multiples, side effects, and costs. Talk with your REI about which approach may be right for you.

If you have questions or concerns, Progyny is here for you. Please contact your Progyny Care Advocate for support.

Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.