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 865 records · Page 48Linked to original sources
PubMed1988

Structural and ultrastructural patterns of the human preovulatory endometrium following clomiphene citrate treatment.

To investigate ultrastructural modifications in the endometrium of women receiving clomiphene citrate (CC) treatment, we performed endometrial biopsies in the preovulatory phase in 17 patients with anovulatory infertility and 16 normo-ovulating women with tubal or male sterility. Histology, scanning and transmission electron microscopy (SEM and TEM) revealed midproliferative phase aspects in 11.7% of the treated group and 6% of the controls, late proliferative aspects in 76.4% and 82%, and postovulation days 1-3 characteristics in 11.7% and 12% respectively. No significant differences were observed between the patients and controls; our data indicate that CC taken in a dose not exceeding 100 mg/day from day 3 of the cycle can induce endometrial maturation that is almost identical with that of a spontaneous preovulatory phase. This type of endometrium should therefore allow implantation of a fertilized egg and maintain unmodified the complex biohumoral relations with the embryo.

Clomiphene↗
PubMedDate not supplied

Adverse effect of clomiphene citrate on sperm morphology.

The beneficial effect of clomiphene citrate (CC) in treating male infertility is controversial. To evaluate the effects of CC on sperm morphology using strict criteria, the semen analyses of 74 men were evaluated at intervals ranging from 1 to 18 months of treatment. Seventy patients receiving no medication were used as control. The patients in each category were divided into three subgroups: A (1-3 months), B (4-6 months), and C (greater than 6 months). In the control group, there were no significant differences in percentages or total normal forms between baseline and repeat semen analysis at any interval. Treatment with CC for 1-3 months did not adversely affect percentages of normal forms. Treatment for greater than 3 months caused a highly significant decrease in percentage of normal forms. Three months of CC caused no change in the absolute number of morphologically normal sperm, but longer periods (greater than 6 months) were associated with a significant decrease. There was significant deterioration of sperm function as measured by percentage of normal forms in patients treated with CC for 4-18 months. The physiological clinical significance remains to be investigated.

Clomiphene↗
PubMedDate not supplied

Effect of clomiphene citrate therapy on postcoital tests in successive treatment cycles including response to supplemental estrogen therapy.

Debate continues as to whether clomiphene citrate (CC) has an adverse effect on cervical mucus. Some researchers conclude that adverse effects maybe related to hormonal abnormalities, e.g., premature luteinization or improper timing. This study evaluated the initial and accumulative effects of CC on postcoital testing (PCT) and attempted to determine if supplemental estrogen (E) improves PCT and/or inhibits follicular maturation. The majority of patients taking CC had poor PCT tests even on the first treatment cycle. Good initial PCTs tended to remain so in subsequent cycles or at least to respond to subsequent supplemental E. Poor PCTs responding to E tended to continue to respond to the combination. PCTs not responding to E therapy continued this pattern in subsequent cycles. Supplemental E did not suppress follicular maturation.

Animals↗
PubMed1988

Pituitary response during pulsatile luteinizing hormone-releasing hormone ovulation--induction in patients with clomiphene citrate-resistant polycystic ovary-like disease.

The pituitary response to pulsatile luteinizing hormone-releasing hormone (LRH) was studied in 6 women with clomiphene-resistant polycystic ovary-like disease (PCOD). PCOD was defined as oligomenorrhea, elevated luteinizing hormone (LH), normal follicle-stimulating hormone (FSH), and, in general, elevated androgens. LRH was administered in a pulsatile way, chronically, with a pulse dose of 20 micrograms and a pulse interval of 60, 90 and 120 minutes. Blood was drawn every 10 minutes for 6 hours, at the start of therapy (pulse study 1) and 9-15 days after the start of therapy (pulse study 2). Five patients ovulated within 10 days of therapy, which meant that pulse study 2 was performed during the luteal phase. One patient remained anovulatory. The follicular and luteal response during LRH therapy was comparable to that of normal cycles, although the pituitary response was enhanced in PCOD at the start of therapy, which might be related to the state in which the ovary finds itself with respect to follicular development. Desensitization for LH to LRH occurred only incidentally during pulse study 1. Desensitization for FSH to LRH already developed during pulse study 1 and continued to existed during therapy. The 60, 90 and 120 minute LRH pulse interval regimes resulted in LH nadir intervals with wide ranges, although the medians were 60, 90 and 120 minutes respectively.

Adult↗
PubMed1988

Effect of clomiphene citrate on prolactin and gonadotropin release during GnRH-analog treatment.

The capacity of the anterior pituitary to secrete prolactin (PRL) and gonadotropins was evaluated by TRH and GnRH stimulation, followed by metoclopramide (MC) administration 1 hour later, before and after clomiphene citrate (CC) priming in 8 endometriosis patients receiving GnRH agonist analog (Buserelin) therapy for 6 months. GnRH-analog treatment lowered the maximal PRL responses to TRH and MC stimulation in the luteal phase, compared to those of 8 normally menstruating control patients. The LH response to GnRH stimulation was also diminished, indicating pituitary desensitization, while the FSH response remained unchanged. Antiestrogen administration during GnRH-analog treatment further reduced the capacity of pituitary lactotropes to secrete PRL in TRH and MC tests, and it increased the LH response but not the FSH response to GnRH stimulation. These data suggest that CC affects the mechanisms controlling PRL and gonadotropin secretions in hypoestrogenic women after prolonged GnRH agonist analog treatment by different modes of action, the action on gonadotropes being stimulatory and that on lactotropes inhibitory.

Adult↗
PubMed1997

Comparison of a blocking vs. a flare-up protocol in poor responders with a normal and abnormal clomiphene citrate challenge test.

This study aimed to standardize the clomiphene citrate test (CC-t) in our laboratory while comparing two different protocols of controlled ovarian stimulation in poor responders. One hundred and forty-four patients scheduled for assisted reproductive techniques were submitted to the CC-t within 3 months before starting stimulation; 133 underwent controlled ovarian stimulation with a blocking protocol. Poor responders in the first cycle (n = 30) were subsequently treated with a flare-up protocol. Although it was not statistically significant, more patients reached oocyte retrieval with the flare-up protocol. In the completed cycles, more gonadotropin ampules (55 +/- 15 vs. 34 +/- 13; p < 0.001) and more stimulation days (12.6 +/- 1 vs. 11.6 +/- 1.2; p < 0.005) were needed in the blocking than in the flare-up protocol. No difference was observed in peak 17 beta-estradiol levels, preovulatory follicles, oocytes retrieved or pregnancy rate between the two protocols. According to the threshold values, established on CC-t of patients who obtained a clinical pregnancy (n = 44), the incidence of abnormal results was 10%. All but one patient with abnormal CC-t were poor responders during the first stimulation cycle. The flare-up protocol did not improve the ovarian response in these patients.

Adult↗
PubMed1999

Induction of ovulation with clomiphene citrate in combination with metoclopramide in patients with amenorrhea of hypothalamic origin.

Literature data have demonstrated that the chronic use of metoclopramide (MCP), a dopamine antagonist, causes increased gonadotropin secretion in patients with hypothalamic amenorrhea but without triggering ovulation. It has also been observed that women with hypothalamic amenorrhea respond poorly to ovulation induction with clomiphene citrate (CC). On this basis, the objective of the present study was to determine the effect of MCP on the response to CC in patients with hypothalamic amenorrhea in order to evaluate the validity of the simultaneous use of these drugs as ovulation inducers in this type of chronic anovulation. Twenty-two patients with amenorrhea of hypothalamic origin were submitted to a randomized double blind study in which one tablet of 5 mg MCP or placebo was administered every 8 hours for 2 months. After the 30th day of medication (MCP or placebo), CC, 100 mg orally, was additionally administered to both groups for 5 days. Blood samples were collected on days 1, 15 and 30 during the first month of the study and on days 7, 14 and 21 after the last CC tablet during the second month, for later measurement of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol and progesterone by radioimmunoassay. The group that received MCP showed a significant increase in LH and FSH during the first month of the study, as well as a slighter increase in estradiol. Prolactin increased only during the second stage of treatment. No significant increases in gonadotropins, prolactin or estradiol occurred in the placebo group. In the group treated with MCP, 40% of the patients ovulated after CC, with menstruation occurring in 60% of them. In the placebo group, 33.3% of the women ovulated after CC and 44.4% menstruated at the end of the study. We conclude that MCP increases the circulating levels of LH, FSH, estradiol and prolactin in patients with hypothalamic amenorrhea and low estrogen levels, supporting the hypothesis that an increase in hypothalamic dopaminergic tonus occurs in these patients. On the other hand, the combination of MCP and CC does not improve the rate of ovulation compared to placebo.

Adult↗
PubMed1984

The effect of clomiphene-citrate on broody turkey hens.

The effect of clomiphene-citrate (CC) on broody turkey hens was examined in three experiments. Turkey hens were categorized as broody if found in the laying nest during 6 successive checks per day, if they were reluctant to leave the nest for a period of 24 hr or more, if they had ruffled feathers, and if their cloacal orifices were contracted so as to prevent vaginal exposure by abdominal massage during artificial insemination. In each experiment, 20 hens, selected as broody from commercial breeding flocks, were treated; half were treated with CC at a dosage of 6 mg/kg body weight/day (per os) for 5 consecutive days, and the rest (control) received parallel treatment with a placebo (CaCO3). In all experiments, the CC administration alleviated brooding behavior and increased egg production.

Animals↗
PubMed1987

Clomiphene-citrate does not reduce broodiness of turkey hens.

Broody turkey hens were treated by giving them clomiphene-citrate (6 mg/kg body weight), an antiestrogen compound, orally for 5 consecutive days in conjunction with the standard practice of moving them into a different pen and exposing them to continuous high intensity light (greater than 215 lx). This treatment did not reduce broody behavior or have any beneficial effect on egg production.

Animals↗
PubMed1989

Responses of luteinizing hormone and prolactin plasma concentrations to oral administrations of clomiphene citrate in broody turkey hens.

Plasma levels in luteinizing hormone (LH) and prolactin were measured after oral administration of clomiphene-citrate (CC) at doses of 6 and 12 mg/kg BW/day for 5 consecutive days to broody turkey hens. No significant changes in prolactin levels were measured following treatment. The LH concentrations were significantly decreased (P less than .05) following administration of the 12-mg/kg dose. These results were interpreted as an indication of oestrogenic-like, rather than antioestrogenic-like, activity of CC when administrated to turkey hens at this particular physiological stage.

Administration, Oral↗
PubMed1999

Outcome of stimulated in vitro fertilisation (SIVF) using clomiphene citrate and human menopausal gonadotropin in different infertility groups.

A prospective study was undertaken to evaluate the efficacy of stimulated in vitro fertilization (SIVF) using Clomiphene Citrate and hMG in different infertilities. The analysis was applied to the first 81 cycles over a period of 9 months in the years 1994-1996 in Sheffield Fertility Centre (SFC). The female patients included in this study were under 40 years of age, and their FSH and LH values were < 10IU/L. Mild and moderate male factor infertilities were included. For tubal factor infertility 16 cases were included with an implantation rate of 0%. The unexplained factor infertility included 33 cases with an implantation rate per embryo transfer (ET) of 41%. For male factor infertility there were 18 cases with an implantation rate per ET of 42%. Out of 3 cases in the ovulatory factor group none reached ET with 0% implantation. For multiple factor infertility 11 cases were included with a 0% implantation rate. The overall implantation per embryo transfer was 27%, while the implantation per cycle started was 15%. We conclude that there are certain infertility factors, i.e. unexplained infertility and mild male factor, which can have good results in IVF using CC/hMG only.

Adult↗
PubMed1999

[Treatment of polycystic ovary syndrome and related infertility with clomiphene resistance by compound cyproterone acetate].

OBJECTIVE: To assess the efficacy and safety of compound cyproterone acetate (CPA Co, or Diane-35) in the treatment of polycystic ovary syndrome (PCOS) and to explore its potential role in improving the outcome of ovulation induction in clomiphene (CC) resistant cases. METHODS: Twenty-nine proven PCOS patients were enrolled. Seventeen out of them, including 16 who were resistant to CC, had anovulatory infertility. CPA Co was given for 4-6 cycles. Serum luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E2), testosterone(T), androstenedione(A), dehydroepiandrosterone (Ds), sex hormone binding globvlin (SHBG), insulin concentrations, total cholesterol, triglycerides(TG), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol (LDL-C), apolipoprotein A, apolipoprotein B and transvaginal pelvic ultrasonography were determined before, 2-3 cycles and 4-6 cycles after treatment. After stopping the drug, CC or human menopausal gonadotropin were re-administered in 12 patients (22 cycles) and 5 cases (6 cycles) respectively for induction of ovulation. RESULTS: All patients had regular uterine bleeding during CPA Co therapy. Acne improved in 8 cases. Hirsute score didn't decrease significantly. Serum LH, FSH, E2, A, T, Ds concentrations decreased significantly (P < 0.05-0.01), while SHBG levels increased by 5.1 times after treatment. Meanwhile, bilateral ovarian volumes shrunk and follicle numbers decreased significantly (P < 0.05-0.01). Serum insulin levels did not change significantly. As to the lipid profile, the most striking change was 55.1% increase of HDL-C and 23.0% decrease of LDL-C, although TG also increased by 36.2%. 58.6% of patients had mild and transient adverse effects. Serum alanine transaminase increased in 3 cases. After stopping treatment, CC induced 5.3% (by cases) or 45.4% (by cycles) ovulation rate and 2 pregnancies achieved in 12 CC resistant patients. CONCLUSION: CPA Co has antiandrogenic effects on PCOS patients clinically, biochemically and in ovarian morphology. Pretreatment of CPA Co may play a role in improving the outcome of ovulation induction in CC resistant cases.

Adult↗
PubMed2000

[Chronic low dose follicle stimulating hormone step-up regimen in the treatment of polycystic ovary syndrome related anovulatory infertility with clomiphene resistance].

OBJECTIVE: To assess the efficacy and safety of chronic low-dose follicle stimulating hormone (FSH) step-up regimen in ovulation induction of polycystic ovary syndrome(PCOS) related infertile patients with clomiphene (CC) resistance. METHODS: Nine PCOS related infertile patients with CC resistance were enrolled for ovulation induction by chronic low-dose FSH step-up regimen, using urinary FSH (Metrodin) or recombinant human FSH (Gonal-F) 5 cycles respectively. Follicular development was monitored by transvaginal ultrasonography and serum estradiol (E2) measurements. RESULTS: Nine out of ten cycles ovulated, among them 5 had monofollicle development, one achieved single pregnancy. No ovarian hyperstimulation syndrome(OHSS), local or systemic side effect was seen. CONCLUSION: Chronic low-dose FSH step-up regimen is an effective and safe choice in inducing ovulation for CC-resistant PCOS infertile cases. Transvaginal ultrasonography and serum E2 measurement are equally important for appropriate dose adjustment and avoidance of cancellation or OHSS.

Anovulation↗
PubMed2000

[Treatment options of clomiphene-resistant polycystic ovary syndrome related infertility].

OBJECTIVE: To investigate the treatment options of clomiphene(CC)-resistant polycystic ovary syndrome (PCOS) related infertility. METHODS: Fifty-nine PCOS patients with CC resistant-anovulation were accepted and treated by the following three protcols: (1) follicle-stimulating hormone (FSH) group, 49 cycles; (2) FSH + pulsatile gonadotropin-releasing hormone(GnRH) group, 13 cycles; (3) conventional in vitro fertilization (IVF)-embryo transfer (ET) group, 19 cycles. Suppressive treatment on serum luteinising hormone (LH) and testosterone (T) levels was given in the first and second groups in advance. Serum estradiol level; pregnancy rate; miscarriage rate, ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy rate were compared among the three groups. RESULTS: The pregnancy rate in FSH group, FSH + GnRH group and IVF-ET group were 37%, 54% and 22% respectively. The highest rate and multiple pregnancy rate was found in IVF-ET group. CONCLUSION: The rationale treatment options for CC-resistant PCOS related infertility was the addition pre-suppressive treatment, low-dose FSH stimulated regimen subsequent pulsatile GnRH infusion. IVF were only accepted after failure with gonadotropin therapy.

Adult↗
PubMed2000

Quadruplet pregnancy following a single course of clomiphene citrate. An expensive success.

Prescribing clomiphene citrate for infertility patients has been taken very lightly. High order pregnancy can happen with this treatment. In addition to high perinatal mortality and morbidity of multiple pregnancy, the economic and social strains on the national health system and the family is great. The case presented showed that although the outcome of pregnancy was successful but the cost to the national health was tremendous. It is therefore recommended that measures should be taken to avoid high order births. Moreover, delaying the delivery, if possible, will be cost effective.

Adult↗
PubMed2001

Abnormal pattern of integrin expression at the implantation window in endometrium from fertile women treated with clomiphene citrate and users of intrauterine device.

UNLABELLED: Determine quantitative expression of endometrial integrins that reflect receptivity during implantation window in fertile women treated with clomiphene citrate (CC), and in intrauterine device users (IUD) as compared to fertile controls. Comparative study of the quantitative expression of a1, a4, av and b3 integrins in epithelial and stromal cells in mid-secretory endometrium of CC treated fertile women, IUD users and controls. All subjects included in this study had regular and ovulatory menstrual cycles. SUBJECTS: Ten women treated with a daily dose of 50 mg of CC. Six women T-Cu device users and nine fertile controls. Age ranges for all groups were similar, 29-41 years old (mean 36.3). Tissue samples were taken at the mid-secretory phase or implantation window. A histological dating of the endometrial biopsies was assessed according to Noyes criteria. Ovulation was assessed by repeated transvaginal ultrasonography. The expression of a1, a4, aV and b3 integrins in dispersions of epithelial (EEC) and stromal (ESC) cells isolated from endometrial biopsies was quantitatively determined by flow cytometry using specific monoclonal antibodies. Immunohistochemistry was also used to detect integrin expression. Biopsies from CC-treated women had a high incidence of out-of-phase endometria. Interestingly, CC-treated women over-expressed a1, aV and b3-ESC integrins and under-expressed b3-EEC subunit (P<0.05). IUD users over-expressed the a1-EEC and under-expressed a4-ESC (P<0.05) at the time of the implantation window. CC treatment in fertile women provokes a high frequency of out-of-phase endometrium and desynchronises the expression of endometrial integrins at the implantation window. The epithelial b3 integrin was under-expressed in all CC-treated patients. The T-Cu intrauterine device alters endometrial receptivity by a different mechanism independent of the expression of the epithelial b3 integrin. However, both CC and IUD use alter the expression of some epithelial and stromal integrins during the implantation window.

Adult↗
PubMedDate not supplied

[Proceedings: Prolactin adenoma revealed by gemellary? pregnancy after clomiphen therapy. Hypophysectomy during 5 th month of pregnancy (author's transl)].

A 25 year old woman had galactorrhea and secondary amenorrhea since her first pregnancy at 20 years. After several treatments with Clomiphene, menses reappeared for 2 months and she became pregnant. At admission, she was in her 4th pregnancy month and had headaches and bitemporal hemianopsia. Hypophysectomy was performed during 5th pregnancy month. Prolactin adenoma with hemorragic lesions was found. Parturition of normal twins occurred 8th month. Partial hypophyseal recovery took place for the following 2 years, but hyperprolactinemia reappeared too.

Adenoma↗
PubMed2002

[Effects of metformin on the plasminogen activator system, endocrine, metabolic profiles in patients with polycystic ovary syndrome and clomiphene resistant cases].

OBJECTIVE: To assess the therapeutic effects of metformin in patients with polycystic ovary syndrome (PCOS) and clomiphene (CC) resistant cases. METHODS: Thirty one patients with PCOS, including 8 CC resistant cases were studied. Serum tissue-type plasminogen activator (tPA), plasminogen activator inhibitor type 1 (PAI-1), menstrual and reproductive hormone patterns, lipid and glucose metabolic parameters, bilateral ovarian volume, side effects were determined before and after oral administration of metformin 375 mg three times daily for 12 - 16 weeks. Metformin and CC were co-administered in CC resistant cases who had not restored their menstrual cycle after the treatment with metformin alone for investigating ovulation rate. In the remaining non-CC resistant metformin failure cases the dosage of metformin was incrersed to 500 mg three times daily for investigating menstrual cycle. RESULTS: After administration of metformin for 12 - 16 weeks, serum PAI-1, luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio, androstenedione, testosterone, low density liproprotein-cholesterol, total cholesterol, fasting insulin concentration and response to oral glucose tolerant test (OGTT), diastolic blood pressure decreased significantly, while FSH and estradiol levels increased, bilateral ovarian volume shrunk significantly (P < 0.05 - 0.01). Body mass index, waist hip ratio, LH, tPA, systolic blood pressure, prolactin, fasting glucose concentration and response to OGTT, high density liproprotein-cholesterol, apoliprotein A, apoliprotein B, triglycerides levels did not change significantly (P > 0.05). Nineteen out of thirty one cases (61%) had restoration of menstrual cycle, 2 became pregnant. In 6 CC resistant cases who had not restoration of menstrual cycle after the treatment with metformin, CC induced ovulation in 12/18 cycles or 5/6 cases and 2 pregnancies achieved. In others 6 metformin failure cases the dosage of metformin was increased to 500 mg three times daily, one restored menstrual cycle and became pregnant. CONCLUSIONS: Metformin may ameliorate the PAI-1, endocrine, metabolic profiles and menstrual abnormalities and improve the ovarian response to CC in CC resistant cases. Metformin provides a safe and effective approach to the treatment of PCOS.

Adult↗