Mr. and Mrs. D return to the clinic and state they have decided to pursue the use of clomiphene citrate.


TSH: 7; Prolactin: 3

Mrs. D is confirmed to have hypothyroidism and is given the diagnosis of being infertile.

Mrs. D is prescribed levothyroxine sodium 50mcg daily and advised to continue taking folic acid 1mg daily. Clomiphene citrate 50mg is prescribed for Days 3–7 of her menstrual cycle. It is discussed with the patient that there is a possibility of multiple pregnancies.

Mrs. D is informed to return on Day 13 of her menstrual cycle for an ultrasound to determine response to the therapy. The patient should be called with the results to report on follicle development and thickening of the endometrium. Based on her menstrual history, Mr. and Mrs. D are advised to begin coitus on Day 12, then daily or every other day until Day 20 of her menstrual cycle.