Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CLOMIPHENE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed2002

Factors influencing pregnancy rates with a combined clomiphene citrate/gonadotropin protocol for non-assisted reproductive technology fertility treatment.

OBJECTIVE: To determine the effectiveness of a combined clomiphene citrate/gonadotropin protocol in a general infertility population and to evaluate factors influencing pregnancy rates obtained with this protocol. DESIGN: A retrospective chart review. SETTING; University-based infertility clinic. PATIENT(S): Two hundred forty-eight patients undergoing 658 cycles of minimal stimulation (MS) protocol from 1996-2000. INTERVENTION(S): Patients underwent treatment with clomiphene citrate and gonadotropin, often followed by intrauterine insemination. MAIN OUTCOME MEASURE(S): Clinical pregnancy rates. RESULT(S): Overall, the clinical pregnancy rate was 7.1% per cycle (n = 248 patients and 658 cycles). The age range of the patients was 24-47 years (mean +/- SD = 36.5 +/- 4.9) with 8.7% noted to have ovulatory dysfunction. Pregnancy rates varied significantly (P<.05) with patient age (9.3% in women <40 years vs. 2.4% in women > or =40), duration of infertility (9.0% in women with < or =3 years of infertility vs. 2.2% in women with >3 years of infertility) and number of follicles produced during stimulation (9.1% in women with > or =3 follicles vs. 4.6% in women with <3 follicles). CONCLUSION(S): The effectiveness of the MS protocol in a general infertility population with a predominantly ovulatory status is much less than that previously reported in a younger patient population with a significant rate of ovulatory dysfunction. This protocol does not appear to lead to pregnancy rates higher than that reported for clomiphene citrate/intrauterine insemination (IUI) cycles. The clinical pregnancy rates using a minimal stimulation protocol are particularly compromised in women over 40, those with a longer duration of infertility or those who produce few follicles during stimulation.

Adult↗
PubMed2002

A randomized controlled trial of laparoscopic ovarian diathermy versus gonadotropin therapy for women with clomiphene citrate-resistant polycystic ovary syndrome.

OBJECTIVE: To compare the effectiveness of laparoscopic ovarian diathermy with gonadotropin ovulation induction for women with clomiphene citrate-resistant polycystic ovary syndrome. DESIGN: Randomized controlled trial. SETTING: A tertiary referral fertility clinic. PATIENT(S): Women with anovulatory infertility secondary to clomiphene-resistant polycystic ovary syndrome. Inclusion criteria were age of <39 years, body mass index of <35 kg/m(2), failure to ovulate with 150 mg of clomiphene citrate for 5 days in the early follicular phase, >12 months of infertility, and no other causes of infertility. INTERVENTION(S): Laparoscopic ovarian diathermy versus three cycles of urinary or recombinant gonadotropins. MAIN OUTCOME MEASURE(S): Cumulative pregnancy and miscarriage rates. RESULT(S): Cumulative pregnancy rates were 28% at 6 months for laparoscopic ovarian diathermy and 33% for three cycles of ovulation induction with gonadotropins. There were three miscarriages in each group. Women in the laparoscopic ovarian diathermy arm of the study had four additional spontaneous pregnancies 6 to 12 months after surgery. CONCLUSION(S): There was no statistically significant difference in pregnancy or miscarriage rates during the 6-month follow-up period or the three cycles. Laparoscopic ovarian diathermy is a safe and effective alternative to ovulation induction with gonadotropins.

Adult↗
PubMed1976

Effect of dexamethasone and clomiphene citrate on peripheral steroid levels and ovarian function in a hirsute amenorrheic patient.

A 22-year-old infertile woman with amenorrhea and mild hirsutism failed to experience uterine bleeding following withdrawal of progestin therapy and failed to ovulate or menstruate following treatment with clomiphene citrate in doses up to 200 mg/day for 5 days. Clomiphene citrate, 200 mg/day, plus 10,000 IU of human chorionic gonadotropin given on day 13 also failed to induce either ovulation or menses. Serum androgen levels were: cortisol, 186 ng/ml; dehydroepiandrosterone sulfate, 6400 ng/ml; dehydroepiandrosterone, 17.92 ng/ml; androstenedione, 4.68 ng/ml; testosterone, 1.28 ng/ml; and dihydrotestosterone, 0.75 ng/ml. Upper limits of normal values for these androgens in our laboratory are, respectively: 140, 2500, 8.0, 2.3, 0.5, and 0.35 ng/ml. The dexamethasone (Dex) suppression test indicated predominantly an adrenal source of the hyperandrogenism. Except for androstenedione the levels of all androgens measured returned to normal following treatment with 0.5 mg of Dex/day. Four months of this treatment had a beneficial effect on the hirsutism but failed to induce ovulation or menses. Clomiphene citrate, 100 mg/day for 5 days, given concurrently with Dex therapy resulted in ovulation and conception. Adrenal androgen excess has been postulated to be a cause of ovarian dysfunction. Our data support this postulate.

Adult↗
PubMed1978

Effect of clomiphene citrate on plasma levels of immunoreactive luteinizing hormone-releasing hormone, gonadotropin, and testosterone in normal subjects and in patients with idiopathic oligospermia.

The effect of clomiphene citrate on plasma immunoreactive luteinizing hormone-releasing hormone (LH-RH), gonadotropin, and testosterone levels was investigated in 10 patients with idiopathic oligospermia and in 10 normal volunteers. A daily 100-mg dose of clomiphene citrate induced a marked, significant increase in plasma immunoreactive LH-RH levels, followed by significant increments in gonadotropin and testosterone values. No significant differences were detected in LH-RH, gonadotropin, and testosterone levels between controls and patients with oligospermia either under basal conditions or during clomiphene treatment.

Adult↗
PubMed1983

Comparison of the effectiveness of placebo, clomiphene citrate, mesterolone, pentoxifylline, and testosterone rebound therapy for the treatment of idiopathic oligospermia.

Forty-six subfertile men with idiopathic oligospermia were randomly assigned to 6 months of treatment with a placebo, clomiphene citrate (25 or 50 mg/day), mesterolone (100 mg/day), or pentoxifylline (1200 mg/day) or 4 months of testosterone enanthate treatment (100 or 250 mg on alternate weeks). Treatment with the placebo, mesterolone, pentoxifylline, and testosterone rebound therapy did not result in a significant increase in the mean sperm concentration or pregnancy in the partners. Clomiphene citrate at both dosages significantly increased the mean sperm concentration without improving sperm motility or morphology during the 6-month treatment period. Pregnancy rates of 36.4% and 22.2% were observed in partners of men receiving clomiphene citrate 25 mg/day and 50 mg/day, respectively. This study also illustrates the difficulties in identifying suitable patients for and assessing the efficacy of different treatment regimens.

Adult↗
PubMed1984

Treatment of infertile women with a deficient postcoital test with two antiestrogens: clomiphene and tamoxifen.

Twenty-two infertile women with repeated deficient results in the postcoital test received clomiphene citrate or tamoxifen. The patterns of luteinizing hormone, follicle-stimulating hormone, prolactin, 17 beta-estradiol (E2), and progesterone were examined during the follicular and periovulatory phases of the menstrual cycle, as were the cervical mucus characteristics. Under clomiphene treatment, an overproduction of E2 was observed (P less than 0.01), which did not result in an improvement of the cervical mucus characteristics. The pH of the endocervical mucus was lower (P less than 0.01). Under tamoxifen treatment, the serum E2 levels were higher (P less than 0.05) and normalized. Higher spermatozoa penetration meter scores were observed during the preovulatory and periovulatory periods, whereas the pH of the endocervical mucus was not lowered. These data support that tamoxifen may be preferential to clomiphene in treating this kind of infertile woman.

Adult↗
PubMed1984

The effect of time of initiation of clomiphene citrate on multiple follicle development for human in vitro fertilization and embryo replacement procedures.

Clomiphene citrate has been utilized for ovarian stimulation for human in vitro fertilization and embryo replacement (IVF-ER) procedures quite successfully. The optimal time and the amount of drug necessary for optimal development have not been identified. In this investigation, 58 patients participating in a human IVF-ER program were stimulated with clomiphene citrate, 150 mg/day for 5 days, beginning on day 3, 4, 5, or 7 of the menstrual cycle. Maximal numbers of oocytes recovered, fertilized, and transferred occurred when stimulation was initiated on the fifth day of the cycle. It is concluded that if clomiphene alone is utilized for multiple follicle development, cycle day 5 is optimal for drug initiation.

Adult↗
PubMed1984

Progressive dosages of clomiphene in hypothalamic anovulation.

A group of 89 sterile patients with hypothalamic anovulation were subjected to progressive dosages of clomiphene citrate according to a predesigned program. In order to analyze our results, we divided our patients into seven groups, according to the largest dosage of clomiphene citrate received. Clinical features were revised in relation to the ovulatory dose of clomiphene. Significant differences between groups regarding weight, menstrual pattern, age at menarche, and hirsutism were not found. Obesity increased the dose required for ovulation when it was less than 900 mg/cycle, but had no effect at higher doses. The ovulation rate, pregnancies, prenatal wastage, and side effects of treatment were analyzed; and it was found that the scheme for ovulation induction used, without expensive and sophisticated ovarian monitoring resources, improved ovulation and pregnancy rates with few and unimportant deleterious side effects.

Anovulation↗
PubMed1985

Ultrasonographic assessment of Graafian follicle growth under monofollicular and multifollicular conditions in clomiphene citrate-stimulated cycles.

Growth of the dominant follicle was assessed by means of real-time sector scanning in 52 clomiphene citrate-stimulated cycles in 44 patients awaiting laparoscopic oocyte recovery for in vitro fertilization purposes. Follicular growth profiles under both monofollicular and multifollicular conditions were compared with each other and with a reference growth curve derived from 26 ovulatory cycles in 25 spontaneously cycling women. In the clomiphene-stimulated cycles, growth of the dominant follicle under both monofollicular and multifollicular conditions was significantly faster (P less than 0.01) than in the reference group. There was no significant difference in follicular growth between monofollicular and multifollicular clomiphene-stimulated cycles.

Chorionic Gonadotropin↗
PubMed1991

Cervical mucus score and in vitro sperm mucus interaction in spontaneous and clomiphene citrate cycles.

OBJECTIVE: Assessment of the effects of clomiphene citrate (CC) on cervical mucus score and in vitro sperm mucus interaction. DESIGN: Prospective study of cervical mucus score and in vitro sperm mucus interaction in a spontaneous cycle followed by a CC cycle to compare paired data. SETTING: Tertiary institutional infertility clinic. PATIENTS, PARTICIPANTS: Twenty-two couples with primary unexplained infertility were studied in both cycles. INTERVENTIONS: Clomiphene citrate (150 mg) on days 5 to 9 in CC cycles. MAIN OUTCOME MEASURES: Cervical mucus score and sperm-mucus penetration test score. RESULTS: Mean cervical mucus score in spontaneous cycles was 9.3 (95% confidence interval [CI] 8.4 to 10.2) and in CC cycles 5.6 (95% CI 4.6 to 6.6), P less than 0.0001. Sperm-mucus penetration test score in spontaneous cycles was 11.4 (95% CI 7.6 to 15.2) and in CC cycles 3.9 (95% CI 1.17 to 6.63), P less than 0.01. CONCLUSIONS: Clomiphene citrate has an adverse effect on both cervical mucus score and sperm-mucus penetration.

Adult↗
PubMed1991

Gonadotropin pulsatility in a stimulated cycle: clomiphene citrate increases pulse amplitudes of both luteinizing hormone and follicle-stimulating hormone.

OBJECTIVE: To elucidate gonadotropin secretory patterns during ovarian hyperstimulation for in vitro fertilization. DESIGN: All volunteers who attended the unit during a period of 3 months were prospectively investigated. SETTING: Infertility unit of the University Central Hospital of Oulu. PARTICIPANTS: Normally menstruating tubal infertility patients (n = 8) and healthy women with ovulatory cycles (hospital personnel, n = 11). All patients finished the study. INTERVENTIONS: Clomiphene citrate (CC), 50 mg, was administered on cycle days 5 to 9 and 300 IU of pure follicle-stimulating hormone (FSH) on cycle day 7 and 150 IU on cycle day 8. MAIN OUTCOME MEASURES: Serum samples for luteinizing hormone (LH) and FSH measurements were collected at 10-minute intervals for 6 hours on cycle day 7 (effect of CC) and day 9 (effect of CC/FSH), and the data were analyzed with the Munro computer program. RESULTS: The number of LH peaks was identical in the controls and study subjects on cycle days 7 and 9, whereas the pulse amplitude (P less than 0.025) and the pulse area (P less than 0.01) were higher in the CC/FSH-treated patients. The increase in overall mean LH level during the hormone therapy was not significant. In the CC/FSH-treated women, a decreased number of FSH pulses (P less than 0.01) with increased amplitude (P less than 0.001) and pulse area (P less than 0.01) was found. Clomiphene citrate treatment increased the mean FSH level (control versus cycle day 7, P less than 0.05) which was further increased (cycle day 7 versus cycle day 9, P less than 0.05) by FSH administration on cycle days 7 to 8. Otherwise pure FSH was found to be unable to modify endogenous LH or FSH secretory patterns under these conditions. CONCLUSIONS: Clomiphene citrate increases the amplitudes of both LH and FSH pulses in the midfollicular phase of a stimulated cycle, an effect which is not influenced by pure FSH administration.

Adult↗
PubMed1993

A clomiphene citrate and tamoxifen citrate combination therapy: a novel therapy for ovulation induction.

OBJECTIVE: To assess the efficacy of a clomiphene citrate (CC) and tamoxifen citrate (CC/tamoxifen) combination therapy in ovulation induction by comparing with a CC alone therapy. DESIGN: A randomized cross-over study with CC alone and CC/tamoxifen combination therapies for 20 normoprolactinemic anovulatory women. Randomly selected 10 of the 20 women (group A) underwent a CC alone therapy (100 mg CC during cycle days 5 to 9) for the initial three consecutive treatment cycles and a CC/tamoxifen combination therapy (50 mg CC and 20 mg tamoxifen during cycle days 5 to 9) for the subsequent three consecutive treatment cycles. The remaining 10 (group B) were treated similarly but with the inverse sequence. Ovulation was documented when a high BBT phase persisted for 11 days or more, when midluteal serum P levels exceeded 7 ng/mL (22.3 nmol/L), or when pregnancy ensued. RESULTS: The rates of ovulatory/treated, pregnant/treated, and pregnant/ovulatory cycles were 42 of 56 (75.0%), 3 of 47 (6.4%), and 3 of 35 (8.6%) for CC/tamoxifen, respectively. Those were 25 of 57 (43.9%), 1 of 48 (2.1%), and 1 of 21 (4.8%) for CC, respectively. Clomiphene citrate/tamoxifen was more effective in ovulation induction than CC. All the pregnancies were normal and single. None of the treatments was accompanied by any remarkable side effects. CONCLUSION: Clomiphene citrate/tamoxifen is a novel treatment modality of ovulation induction with high efficacy.

Adult↗
PubMed2000

Effects of clomiphene citrate on the endometrium of regularly cycling women.

OBJECTIVE: To study the effects of clomiphene citrate (CC) on the endometrium of regularly cycling women. DESIGN: Prospective, controlled study. SETTING: Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. PATIENT(S): Thirty healthy, regularly cycling, female volunteers. INTERVENTION(S): All volunteers were studied for two consecutive cycles, one control cycle and one CC-treated cycle. Clomiphene citrate (100 mg/d) was given on days 3-7 of the CC-treated cycles. Ultrasonography was performed daily to assess ovulation. Ultrasonography and endometrial biopsy were performed, and blood samples were obtained for determination of E2 and progesterone levels 7 days after ovulation in both the control and CC-treated cycles. MAIN OUTCOME MEASURE(S): Histologic dating, morphometric analysis, and ultrasonographic appearance and thickness of the endometrium. RESULT(S): Histologic dating and ultrasonographic appearance and thickness of the endometrium were similar in the control and CC-treated cycles, but morphometric parameters were different. The number of glands per square millimeter and the mean diameter of the glands were lower in the CC-treated cycles than in the control cycles, but the number of vacuolated cells per 1,000 glandular cells was higher. CONCLUSION(S): Clomiphene citrate has effects on the endometrium of regularly cycling women, as demonstrated by a reduction in glandular density and an increase in the number of vacuolated cells.

Adult↗
PubMed1979

Cortisone acetate versus clomiphene citrate in per-germinal idiopathic oligospermia.

Long-term, low dose clomiphene citrate (25 mg./day for 25-day cycles with 5-day rest periods) and long-term, low dose cortisone acetate (5 mg. twice daily) were compared in equivalent populations of men with idiopathic oligospermia. Clomiphene citrate seemed to be more effective than cortisone acetate in enhancing spermatozoal number and the likelihood of pregnancy. In addition, clomiphene citrate increased serum testosterone levels and provided an indicator of hypothalamic-pituitary-testicular axis responsiveness.

Clomiphene↗
PubMed1988

Second pregnancy with spontaneous ovulation following clomiphene- or gonadotropin-induced pregnancy.

For investigation of the rates of spontaneous pregnancy following termination of pregnancy induced by treatment with clomiphene or human menopausal gonadotropin-human chorionic gonadotropin (hMG-hCG) and of spontaneous abortion in the second pregnancy, 119 women (58 with an anovulatory cycle and 141 with amenorrhea) who desired another pregnancy were studied. The rate of spontaneous pregnancy following pregnancy induced by clomiphene was 46.6%, which was significantly (p less than 0.001) higher than that following pregnancy induced by hMG (14.9%). The mean (+/- SEM) period between the termination of the first induced-ovulation pregnancy and the second spontaneous pregnancy was 16.6 +/- 1.4 months. The spontaneous abortion rates in the second pregnancies after pregnancies induced by clomiphene and hMG were 7.5% and 9.8%, respectively, which were significantly (p less than 0.001, p less than 0.05) lower than those in the first pregnancy (25.7%, 33.0%). There was no difference between the spontaneous abortion rates following a first pregnancy which terminated in abortion and those following a pregnancy which ended in birth. These data suggest that a first pregnancy in anovulatory women may restore the ovulatory cycle and have a beneficial effect on the rates of spontaneous abortion in the second pregnancy.

Clomiphene↗
PubMed1987

Teratogenic effects of clomiphene, tamoxifen, and diethylstilbestrol on the developing human female genital tract.

The potential estrogenicity and teratogenicity of triphenylethylene antiestrogens were examined in 54 genital tracts isolated from 4- to 19-week-old human female fetuses and grown for 1 to 2 months in untreated athymic nude mice or host mice treated by subcutaneous pellet with the antiestrogens clomiphene and tamoxifen or the synthetic estrogen diethylstilbestrol (DES). In specimens grown to a gestational age equivalent of 15 weeks or less, the vagina and urogenital sinus were lined by an immature squamous epithelium, which were similar in both drug-treated and untreated specimens. Proliferation and maturation of the squamous vaginal epithelium were observed in specimens treated with clomiphene, tamoxifen, or DES only when grown to a gestational age equivalent of 16 weeks or more. Formation of endometrial and cervical glands proceeded in 87 per cent (13 of 15) of control specimens grown to a gestational age equivalent of 13 weeks or more in untreated hosts. By contrast, age-matched drug-treated specimens contained glands in only 44 per cent (12 of 27) of specimens. In the developing uterine corpus of untreated controls, the uterine mesenchyme segregated into inner (endometrial stroma) and outer (myometrial) layers; whereas in drug-treated specimens, condensation and segregation of the mesenchyme were greatly impaired. The fallopian tube was also affected by clomiphene and tamoxifen (and to a lesser extent by DES) in that its epithelium was hyperplastic and disorganized. The complex mucosal plications characteristic of the fallopian tube were also distorted in drug-treated specimens. These results emphasize the heretofore unrecognized estrogenicity and potential teratogenicity of triphenylethylene antiestrogens on the developing human genital tract and emphasize the need for caution to prevent inadvertent exposure of the developing fetus to these compounds.

Abnormalities, Drug-Induced↗
PubMed2001

Laparoscopic ovarian drilling in clomiphene citrate-resistant women with polycystic ovary syndrome.

STUDY OBJECTIVE: To analyze the efficacy of laparoscopic ovarian drilling using monopolar diathermy in women with anovulatory infertility with clomiphene-resistant polycystic ovary syndrome (PCOS), and to determine factors influencing pregnancy rate and pregnancy outcomes. DESIGN: Prospective study (Canadian Task Force classification II-2). SETTING: Infertility clinic in a tertiary referral teaching hospital. PATIENTS: Seventy women with clomiphene-resistant PCOS. INTERVENTION: Laparoscopic ovarian drilling, with follow-up for 4.5 years. MEASUREMENTS AND MAIN RESULTS: Follow-up data, which were available for 66 patients, showed a spontaneous ovulation rate of 81.8%, cumulative ovulation rate of 93.9%, and pregnancy rate of 54.5%. Successful pregnancies were commonly complicated by gestational diabetes mellitus and pregnancy-induced hypertension. Pregnancy rates (23.5%) were low in women with tuboperitoneal disease and those whose partners had subfertile male factors. Statistical evaluation using a proportion test (Z test) and multivariable logistical regression analysis showed that elevated luteinizing hormone levels (>10 IU/L), short duration of infertility (<3 yrs), and absence of preexisting tubal disease were associated with better outcomes. CONCLUSION: Laparoscopic ovarian drilling is an effective surgical procedure in women with clomiphene-resistant PCOS.

Adult↗
PubMed2003

Effects of neonatal clomiphene citrate on fertility and sexual behavior in male rats.

In order to investigate the participation of estrogen during the period of brain sexual differentiation, male rats were treated with clomiphene citrate in the neonatal phase. Fertility and sexual behavior were assessed during adult life. Sexual maturation, body weight, and wet weight of the testes were unchanged. Although the adult male rats treated with clomiphene in the neonatal phase presented a significant reduction in the frequency of mounts, 90% of these rats were able to mate with normal females, which became pregnant. However, these females exhibited a significantly increased number of pre- and post-implantation losses. When these adult male rats were castrated and received estrogen, 60% presented female sexual behavior (receptive behavior and acceptance of mount). Thus, treatment of pups with clomiphene immediately after birth has a long-term effect on the reproductive physiology and sexual behavior of male rats.

Animals↗