The doctor attempts to initiate clomiphene therapy so that the woman ovulates on or around day 14 of a regular 28-day cycle. The simplest, most widely used dose starts with one daily 50 mg. If a woman ovulates at this dose, there is no advantage to her increasing the dosage. In other words, more of the drug isn't necessarily better. Some doctors increase the dose up to 250 mg.
Women tend to have side effects much more frequently at higher doses.
If the dose of clomiphene is too high, the uterine lining may not respond completely to estrogen and progesterone stimulation, and may not develop properly. As a result, a woman's fertilized egg may not be able to implant in her uterus. Because Clomiphene binds to estrogen receptors, including the estrogen receptors in the cervix, it can interfere with the ability of the cervical mucus glands to be stimulated by estrogen to produce fertile mucus. If this occurs, adding a small amount of estrogen beginning on cycle day 10 and continuing until the LH surge may enhance cervical mucus production. Visual symptoms such as spots, flashes or blurry vision are less common and indicate that treatment should stop .