I have had two cycles with 100 mg of Clomid and intrauterine insemination using donor sperm and have yet to be successful. I am doing these treatments in my OB-GYN's office. How long after I get my ovulation-inducing shot (Pregnyl) should I have the insemination done? My doctor doesn't seem to be very sure of the time frame. My temperature is rising the day after the shot. Does this mean the day after is too late? Also, I am having abdominal pain 24 hours after the insemination; is this normal?

Dawn

There are many different protocols guiding physicians on how to use clomiphene (Clomid) and perform intrauterine insemination (IUI). Often I have patients perform a daily urine LH test at home to pinpoint the time of ovulation. These kits, which cost about $25-$35, are accurate about 85 percent of the time. In some situations, we choose to monitor the follicles with ultrasound. When the follicles grow to about 18mm and the uterine lining is developed to 7mm or more, we give an hCG injection to trigger release of the eggs.

Following clomiphene therapy, I recommend a single insemination performed about 36-38 hours after the hCG injection. This means that I often have my patients take the hCG at about 6-8pm, and I then perform the IUI early on the second morning after the hCG shot.

Pain after insemination may be related to ovulation. Pain can occur before, during or even after ovulation. It is not a good predictor of exactly when you ovulate. If you run a fever or have pain and sharp cramps, it may be a reaction to chemicals called prostaglandins in the inseminated sperm sample that may have been incompletely removed during processing. If you run a fever or develop foul-smelling discharge, or if the pain persists, please let your physician know.