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PubMed2005

[Clinical observation on effect of Chinese herbs in adjusting hypoestrogenemia status by clomiphene to promote ovulation].

OBJECTIVE: To explore the effect of Yijing Huoxue Cuyun Decoction (YHCD) in adjusting hypoestrogenemic response induced by clomiphene. METHODS: Infertile patients caused by ovulation disturbance were randomly divided into 2 groups. The 60 patients in the observed group were treated with clomiphine plus YHCD, and the 58 patients in the control group were given clomiphine plus estradiol valerate. RESULTS: By scoring on the cervical relaxation and improvement of cervical mucus, 38 patients (63.3%) in the observed group had Insler score of more than 8 points, while that in the control group was only 25 (43.1%), comparison between the two groups showed significant difference (P < 0.05). The endometrium thickening in the observed group was 0.98 +/- 0.19 cm, significantly different to that in the control group (0.85 +/- 0.21 cm, P < 0.01). Twenty-five patients in the observed group (41.7%), and fourteen patients in the control group (24.1%), respectively got pregnancy, the pregnant rate in the former was obviously higher than that in the latter (P < 0.05). CONCLUSION: YHCD can ameliorate hypoestrinemia induced by clomiphene and increase the pregnant rate in patients.

Adult↗
PubMed1990

Luteinizing hormone and human chorionic gonadotropin receptors in human corpora lutea from clomiphene citrate-induced cycles.

Midluteal phase corpora lutea (CL) obtained from women induced with 50 mg (n = 5), 100 mg (n = 5), and 150 mg (n = 5) of clomiphene citrate (CC) were measured for luteinizing hormone/human chorionic gonadotropin (LH/hCG) concentrations and cytosol progesterone (P) and 17 alpha-hydroxyprogesterone (17-OHP) and compared with midluteal phase CL from eight normal women (controls). More CL (26) that were significantly heavier (2.0 +/- 0.3 g, [mean +/- SEM]) were obtained with CC than in controls (10). Clomiphene citrate treatment increased LH/hCG receptor concentrations and the dissociation constant significantly from 69 +/- 12 fmol/mg protein and 1.1 +/- 0.2 x 10(-10) M, respectively, in controls to 112 +/- 6 fmol/mg protein and 2.1 +/- 0.1 X 10(-10) M. Cytosol P and 17-OHP levels were not significantly increased. Cumulatively these cellular effects may be responsible for increasing serum P and responsiveness to hCG and for correcting luteal dysfunction.

17-alpha-Hydroxyprogesterone↗
PubMed1990

Clomiphene citrate stimulation as an adjunct in locating ovarian tissue in ovarian remnant syndrome.

Ovarian remnant syndrome results from residual ovarian tissue after bilateral oophorectomy. The syndrome is associated with chronic pelvic pain and is suspected when premenopausal levels of FSH and LH are present in a patient with documented bilateral oophorectomy. Histologic demonstration of ovarian tissue at operation confirms the diagnosis. We treated a patient with ovarian remnant syndrome with a 10-day course of clomiphene citrate, 100 mg daily, to stimulate the residual ovarian tissue and facilitate localization. Preoperative ultrasound revealed a 5.0 x 3.5 x 6.2-cm cystic mass in the right adnexal region. Exploratory laparotomy easily localized the mass, and it was removed intact. Histologic slides demonstrated normal ovarian tissue with multiple follicles in various stages of development and a corpus luteum cyst. Clomiphene citrate is capable of stimulating an ovarian remnant, producing an enlarged, cystic structure easily localized by ultrasound. The increased size and preoperative knowledge of the location facilitated surgical removal.

Adult↗
PubMed1990

Quantitative and qualitative tests for urinary luteinizing hormone. Comparison in spontaneous and clomiphene-citrate-treated cycles.

A study was performed to evaluate conditions in which false-positive and -negative predictions of ovulation occur with qualitative urinary luteinizing hormone (LH) tests. Three urine specimens and a serum sample were collected daily for LH determination from five anovulatory women treated with clomiphene citrate and from six spontaneously cycling women. The urinary LH was determined with one quantitative and three qualitative tests, and the serum LH was determined with a quantitative assay. Ovulation was determined with transvaginal ultrasound and a serum progesterone level on day 22 of the menstrual cycle. There were six ovulatory and five anovulatory cycles. In those 11 cycles the qualitative urinary LH tests were falsely positive twice and falsely negative thrice. All the false-positive and -negative tests except for one occurred when the quantitative urinary LH was 24-28 mIU/mL. Two false-positive tests occurred one to two days after clomiphene administration. Two false-negative tests occurred in a cycle in which follicular development appeared suboptimal, and one occurred in a cycle with a brief urinary LH surge.

Clomiphene↗
PubMed1990

[Clomiphene citrate ointment in the local treatment of condylomata acuminata].

The hypothesis underlying local treatment of Condylomata acuminata with clomiphene citrate is based on the assumption that susceptibility to this disease in women depends on the relative amount of oestrogen receptors in the affected, as opposed to the unaffected areas. We postulate blockade of these skin receptors after local application of clomiphene citrate ointment. A pilot study was conducted in 15 patients aged 20-33 with Condylomata acuminata. After only 2 months a complete remission was recorded in 12 patients (= 80%).

Administration, Topical↗
PubMed1989

[Clomiphene as an inducer of multiple follicular growth].

In our IVF + ET & GIFT programs we gave 100 mg of clomiphene from cycle days 2 to 6 in 35 cycles of 32 infertile patients. Serum estradiol curves were made establishing 3 types of curves: 1. climbing curve which was subdivided in curve A (6 cycles) with more than 600 pg/mL of estradiol, more than 4 follicles of a mean size of 35 mm; curve B (13 cycles) with an estradiol range from 300 to 600 pg/mL, 2.9 follicles of 24 mm and curve C with less than 300 pg/mL of estradiol, 0.8 follicles of 22 mm. 2. Flat curve with minimum estradiol level and follicle size and 3. Irregular curve with atypic variations that probably reflect oocyte atresia and cyst formation. The progesterone level in the luteal phase was parallel to the estradiol. There was evidence of multiple follicular growth in 20 cycles (57%). Nine laparoscopies for ovum capture were made, collecting a mean of 1.2 oocytes per laparoscopy; they were fertilized in vitro and later transferred 4 embryos and 4 oocytes were transferred to the fallopian tubes. There was at most one mature oocyte per laparoscopy. No pregnancies were achieved. The clomiphene as a single agent, for its wide availability, might be choice for some women that show a good response, which might depend on several factors, but it cannot be considered the ideal single agent for programs that include ovum pick ups.

Adult↗
PubMed1989

[Treatment of anovulation in polycystic ovary syndrome with clomiphene citrate in 10-day cycles].

The efficacy of a new schedule for the use of Clomiphene citrate (50 mg daily, during the first ten days of the cycle) is reported, in relation to ovulation induction and fertility. We treated 41 patients with the syndrome of polycystic ovary, who were anovulant and desired fertility. Ovulation was successfully induced in 35 of them (85.4%). Pregnancy was achieved in 28 patients (68.3%). In 87.5% of those becoming pregnant, gestations was achieved with less than 6 months of treatment. Our results are equally good or better than those reported in the literature with conventional treatment. Pregnancies obtained were normal. No congenital malformations were observed. There were only two abortions, spontaneous. No patient presented ovarian hyperstimulation syndrome. This new schedule is recommended because it is effective and it may give less complications. Also, it is not necessary to increase progressively the dose of clomiphene citrate.

Adult↗
PubMedDate not supplied

Daily or alternate-day FSH therapy in patients with polycystic ovarian disease resistant to clomiphene citrate treatment.

The effectiveness of intramuscular follicle stimulating hormone (FSH) administered as daily or alternate-day injections to patients with polycystic ovarian disease (PCOD) who previously failed to ovulate on clomiphene citrate was compared. The study comprised 20 treatment cycles of daily FSH and 19 of alternate-day FSH in 12 patients. The overall ovulation rate per cycle was 78% and was similar for both groups. Nine out of 12 patients achieved a pregnancy, with twice as many occurring in the alternate-day group. It is concluded that alternate-day FSH therapy is as effective as daily FSH in achieving ovulation and pregnancies in patients with PCOD resistant to treatment with clomiphene citrate.

Adult↗
PubMedDate not supplied

Resistant cases of polycystic ovarian disease successfully treated with a combination of corticosteroids, clomiphene, and bromocriptine.

Eight successively examined anovulatory women with polycystic ovarian disease (PCOD) who had remained resistant to treatment with clomiphene and dexamethasone (DEX) (and some to hMG/hCG) and had mildly elevated prolactin levels were treated with a combination of clomiphene, DEX, and bromocriptine. There was a decrease in the LH:FSH ratio and androgen and prolactin levels to normal values; within five to eleven treatment cycles, all were pregnant. These results were probably achieved because of the inhibition of prolactin secretion by the dopamine agonist, but may also be due to repletion of a suggested possible functional depletion of dopamine within hypothalamic nuclei in PCOD. This combination treatment is therefore highly recommended before resorting to hMG/hCG therapy or surgery, both of which have intrinsic disadvantages.

Adult↗
PubMed1986

Influence of the neonatal (clomiphene) inhibition of estradiol imprinting on gonadal development and gonadal and thyroid hormone production later in life.

Treatment of newborn rats with clomiphene citrate during the first 5 days of life gave rise to a marked decrease in body mass and to a still greater decrease in gonadal mass. A decrease was also observed in the testicular diameter of the males. The females showed a 43% increase in their estradiol levels over the control and an increase in the sensitivity to gonadotropins. Thyroxine level, which was also determined in view of the known gonadotropin-thyrotropin overlap, showed no change 6 weeks after pretreatment with clomiphene, while the thyroid gland responded to gonadotropin in the same manner as to thyrotropin.

Animals↗
PubMed1985

Hormone responses to clomiphene citrate in young chimpanzees.

The responses of gonadotropin and gonadal steroids to the administration of clomiphene citrate were studied in male and female chimpanzees, aged 3.6 to 9.9 years. Follicle-stimulating hormone (FSH) was significantly reduced after treatment in the prepubertal females (n = 4) and in early pubertal males (n = 2) but not in prepubertal males (n = 5). FSH was unchanged or increased in early pubertal females (n = 2) and late pubertal males (n = 2). There was no consistent response to treatment with clomiphene citrate by luteinizing hormone (LH) in either males or females, nor by 17 beta-estradiol in the females. Testosterone levels were reduced in the early pubertal males only. These results support the hypothesis that negative feedback by gonadal steroids is operative in prepubertal chimpanzees and that puberty is accompanied by a reduction in the sensitivity to such feedback.

Animals↗
PubMed1979

The gonadotropin releasing hormone stimulation and the clomiphene tests in female patients with anorexia nervosa.

In 9 female patients suffering from acute anorexia nervosa (a.n.) and in two patients in whom this disease had reached the remission phase, the response of the gonadotropin-producing cells in the adenohypophysis was checked by administration of Gn-RH and the degree to which the hypothalamic-hypophyseal axis could be stimulated was checked by administration of clomiphene (5 x 100 mg). Hormonal screening examinations (cervical score after Insler and hormonal vaginal cytology) were used to assay the basal estrogen production. LH and FSH concentrations in the serum were determined radioimmunologically using the principles of the double antibody technique. The gonadotropin-producing cells did not respond to Gn-RH administration in 8 of the 9 patients with acute a.n. The response was disturbed in one of these patients. The response to Gn-RH stimulation was normal in the two patients in the remission phase. Clomiphene had no stimulatory effect on the hypothalamic-hypophyseal axis during either the acute or remission phase. Hormonal treatment during the acute phase of a.n. is not indicated since, after recovery of a normal body weight, the symptoms recede and the cycle normalises spontaneously.

Adolescent↗
PubMed1985

[Effects of iontophoretically-applied LHRH, TRH, estrogen and clomiphene on thermo-sensitive neurons in the rat hypothalamus].

Studies were performed on the correlation between the hypothalamic temperature-sensitive neurons and hypothalamic neurons sensitive to LHRH, TRH, conjugated estrogen and clomiphene in 103 castrated matured female rats by the technique of microiontophoresis using a multi-barrel glass microelectrode. Out of 348 neurons in the hypothalamus, 24 neurons were found to be LHRH-sensitive, 20 TRH-sensitive, 41 estrogen-sensitive, and 18 clomiphene-sensitive. There were 19(28.8%) warm-sensitive and 11(16.7%) cold-sensitive neurons located in the preoptic area. From among the 19 warm-sensitive neurons, 14 neurons showed excitation by estrogen and 4 showed suppression by LHRH. Out of the 11 cold-sensitive neurons, estrogen, LHRH, and TRH excited 4, 3, and 3 neurons, respectively. It is suggested from these studies that LHRH mainly exhibits its thermo-regulatory functions by exciting warm-sensitive neurons and it is for this reason that exogenous estrogens are effective in alleviating hot flushes in natural as well as post-operative menopause which are thought to be caused by LHRH.

Action Potentials↗
PubMed1979

[Management of functional sterility using clomiphene. A clinical experience report].

121 patients are reported who underwent Clomiphen treatment for functional sterility in the Frauenklinik des Bezirkskrankenhauses Karl-Marx-Stadt from 1. 1. 1974 to 31. 12. 1977. Monophasic cycles (66 patients), corpus luteum insufficiency (41 patients) and secondary amenorrhoea (14 patients) were the indications for the Clomiphen therapy. 54 pregnancies (44,6%) were the result; in 18,5% gravidity was terminated by abortion or initiated interruption (1,9%). The clinical data are stated.

Amenorrhea↗
PubMed1979

[Serial determination of hormones in pregnancies following induction of ovulation with clomiphene and gonadotropins (author's transl)].

The HCG, HPL, progesterone and oestriol levels in the serum were determined in 33 pregnancies following induction of ovulation with clomiphene and in 7 pregnancies following induction of ovulation with gonadotropins. During these pregnancies bleeding, premature labour and toxaemia occurred more often in women who became pregnant after induction of ovulation with clomiphene. The progesterone and oestriol levels were increased up to the 12th week of gestation, whereas the HCG and HPL levels remained normal. After induction of ovulation with gonadotropins the progesterone levels remained elevated until the 19th week of gestation whereas the levels of HCG and HPL and oestriol remained normal. The course of the pregnancy in a patient who had Meigs-syndrome after treatment with gonadotropins was presented. Our results show that the hormonal evaluation of pregnancies after induction of ovulation is best accomplished during the first three months by HCG and HPL titres and during the second half of the pregnancy according to the same criteria as in other pregnancies.

Adult↗
PubMed1979

Clomiphene citrate therapy and associated ovarian endometrial cysts.

Four cases are presented of ovarian endometrial cyst formation associated with the use of clomiphene citrate therapy for oligo-ovulation and infertility. All required surgical intervention. Clomiphene citrate should be used with caution in patients with pelvic endometriosis and ovulatory dysfunction.

Adult↗
PubMedDate not supplied

[Improved pregnancy rates with ovulation stimulation using clomiphene and the effect of conjugated estrogens on the cervix].

From a larger group of women treated which clomiphene 25 patients were selected who failed to conceive in spite of an indirect evidence of the ovulatory response and adequate luteal phase. Seventeen of them, who showed a distinct suppression of preovulatory reaction according to a modified cervical score, were treated with combined clomiphene and conjugated estrogens. The cervical score, the cycle pattern and the pregnancy rate were compared with the results of the previous treatment. The improvement of the cervical score was noted in 74.4% of patients, 6 women became pregnant, and the pregnancy rate related to the number of ovulatory cycles was 13.9%. Criteria for the treatment presented are discussed.

Cervix Uteri↗
PubMed1981

The effect of clomiphene and conjugated oestrogens on cervical mucus.

The analysis of 157 menstrual in 50 patients on ovulation-inducing regimens showed that in restoring ovulation clomiphene citrate inhibited cervical mucus production and caused hypersecretion of oestradiol. The inhibitory effect was inversely proportional to serum oestradiol levels, and the addition of conjugated oestrogens did not rectify the inhibitory effect, increase plasma oestradiol levels or increase cycle length. Doubling the clomiphene dosage made no significant difference to any of the parameters examined. The mechanism of this inhibitory effect is still obscure.

Cervix Mucus↗