My wife's ob now wants her to do 4 rounds of clomid before getting a referral to a fertility clinic. the first round of 50 mg of clomid was not successful. she is now on the 2nd cycle of 100 mg of clomid. the ob has not found any issues with my wife th

I would only do the: 100 mg , no more, if she does not ovulate on the 100 mg then she needs referral, that is what i would do, if she ovulates on the 100mg i would do it one more month, if not preg the 2nd month of the 100mg then i would refer and i assume she is also taking estrogen and Progesterone with the clomid (clomiphene).

Routine treatment!: Trying the Clomiphene is not unreasonable first step before referral to a fertility specialist! also, you should have a semen analysis.

Probably OK: In general, it is not uncommon to perform a trial of Clomid (clomiphene) before referring to a reproductive endocrinologist. The trials can be from 3-6 months depending on the initial findings and reasons for using clomid (clomiphene). Have your wife talk to her doctor if she has concerns about her specific treatment.