When TTC #1, I was put on clomid. I had symptoms of PCOS, was TTC, and came in on day 90 or something of my first cycle TTC.
My doctor did bloodwork, SA, and and u/s. After provera kick-started my cycle, I was put on 50mg of clomid. I was not monitored.
My OB's plan was to do 3 cycles, then do an HSG and send me to an RE. I got pregnant on the 3rd cycle, so I didn't have to do this.
I know this forum jumps all over people that take clomid unmonitored. I have mixed feelings on this. Clomid has some nasty side effects, but they are also pretty uncommon at low doses. There is also the 6 cycle lifetime max. So there is a risk that you are just wasting the cycles.
I'm kind of middle of the road. I do think that some OB's hand it out like candy, but I also think doing every infertility test and hard-core monitoring for every person that has trouble TTC is costly and unnecessary. Just make sure to be educated so you know what risks you are actually taking.
And 200mg is way high for a starting dose! Make sure to be monitored for that.