Objective: To determine whether newer monitoring techniques, including urinary detection of the LH surge and vaginal ultrasound, offer an advantage over basal body temperature (BBT) charts alone in achieving pregnancy using clomiphene citrate (CC). Design: Randomized clinical trial. Setting: Infertility patients in an academic research environment. Patient(s): Forty- five women undergoing ovulation induction with CC. Intervention(s): The women were assigned randomly to receive either low- or high-technology ovulation monitoring for a total of 3 ovulatory cycles. Both groups were followed with BBT charts. The high-technology group also was monitored with urinary LH kits and vaginal ultrasound. Main Outcome Measure(s): Cycle fecundity rates for each technique were compared statistically with use of life-table analysis. Result(s): Forty-five patients were studied during a total of 134 cycles. The overall cycle fecundity rate was 8%, 10% (8 of 81 cycles) for the low- technology monitoring group and 6% (3 of 53 cycles) for the high-technology monitoring group. These rates were not statistically significant when evaluated by Fisher's exact test (P = .53) or when using life-table analysis and a log-rank test (P = .48). Conclusion(s): These data suggest that, for initial attempts at ovulation induction with CC in unselected patients, high- technology monitoring of ovulation offers no increase in fecundity over low- technology monitoring.