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 937 records · Page 52Linked to original sources

The inhibition of the estrogen receptor's positive cooperative [3H]estradiol binding by the antagonist, clomiphene.

The calf uterine estrogen receptor showed positive cooperativity of [3H]estradiol equilibrium binding; the Scatchard plot was convex and the Hill coefficient was 1.69 +/- 0.021 (n = 14). The effects of the estrogenic antagonists, zuclomiphene (cis-2-(p-[2-chloro-1,2-diphenylvinyl]phenoxy)triethylamine citrate) and enclomiphene (trans-23-(p-[2-chloro-1,2-diphenylvinyl]phenoxy)triethylamine citrate), on the positive cooperativity of [3H]estradiol binding were measured by titrating the receptor with a variable concentration of [3H]estradiol and antagonist while maintaining a constant excess in a specific ratio of the antagonist to the [3H]estradiol. With a 45- to 55-fold molar excess of zuclomiphene or an 820- to 900-fold molar excess of enclomiphene above the [3H]estradiol concentration, the receptor's positive cooperative [3H]estradiol binding was inhibited. A transition from a convex to a linear Scatchard plot and a decrease in the Hill coefficient from 1.69 to 1.10 +/- 0.02 (n = 6) were induced. The specifically bound [3H]estradiol was inhibited 43 to 50% by the zuclomiphene and enclomiphene. The addition of unlabeled estradiol in a 1- or 2.3-fold molar excess above that of the [3H]estradiol concentration produced a 50 to 75% competitive displacement of the specifically bound [3H]estradiol; nevertheless, the Scatchard plot remained convex and the Hill coefficient was 1.74 and 1.80, respectively. Thus, inhibition of the positive cooperativity of [3H]estradiol binding by the clomiphene isomers was not due to dilution of the specifically bound [3H]estradiol by the antagonist. These data demonstrate that there are two molecular mechanisms by which an estrogen antagonist interferes with the function of the receptor: as a competitor, thus blocking the estrogen receptor's binding site to an agonist, and second by inducing conformational changes that inhibit site:site interactions and receptor activation.

Animals↗

Polycystic ovarian syndrome; a retrospective study of the therapeutic effect of ovarian wedge resection after unsuccessful treatment with clomiphene citrate.

The therapeutic effect of ovarian wedge resection (OWR) was evaluated in a study of 92 patients with polycystic ovarian syndrome who did not conceive after clomiphene treatment. The frequency of ovulation was significantly higher after OWR than before (0.02 less than P less than 0.05). Postoperatively, 58 of the patients (63%) attained pregnancy one or more times, either spontaneously or after induction of ovulation. The beneficial effect of OWR on menstrual irregularities was significant (P less than 0.001).

Adult↗

Experience with clomiphene and bromocryptine in the treatment of infertility.

Eighty-nine patients with defective ovulation were treated either with clomiphene citrate, with or without human chorionic gonadotrophin, or bromocryptine. The pregnancy rate in the two groups was 33.3 and 28.6 percent, respectively. There were no major complications in this study; the merits of these regimens in a unit without facilities for endocrine study are discussed.

Adult↗

[The outlook and the quality of pregnancies resulting from treatment with clomiphene citrate and chorionic gonadotrophin. 53 consecutive cases (author's transl)].

The study of 53 pregnancies which were the result of induction of ovulation using a standard treatment with 100 mg of clomiphene citrate and 3 injections of 1,500 I.U. of H.C.G. showed no increase in the risk of fetal malformation. Before treatment this same group of women has a high risk of spontaneous abortion (43p. 100). After treatment in 53 conceptions 7 ended with an abortion which, is 13p. 100. The risks which follow this treatment are above all dominated by the definite increase in twin pregnancies and in prematurity which follows from this factor.

Abnormalities, Drug-Induced↗

[Follicular and endometrial growth profiles in stimulated cycles with clomiphene citrate].

To study follicular and endometrial growth patterns in Clomiphene Citrate (CC) stimulated cycles, 50 CC cycles of 31 infertile women with patient Fallopian Tubes, were followed, 17 spontaneous conceptional cycles of fertile women were followed as controls. The pattern of follicular growth was similar in both groups until the day before ovulation in which CC cycles showed larger follicular diameters than spontaneous ones; 23.8 +/- 3.1 mm versus 21.6 +/- 2.9 mm (p = 0.013). Follicular rupture occurred on day 16.1 +/- 2.9 in CC cycles, and on day 15.1 +/- 1.85 on spontaneous conceptional ones. This suggests that the follicle, under the influence of CC, has to reach a larger critical mass to produce enough estradiol to revert the hypothalamic blockage produced by the drug, thus permitting the preovulatory LH surge. Endometrium under CC action, was always thinner than in natural cycles. On the day of follicular rupture, the CC cycle's endometrium measured 11.1 +/- 2.02 mm and the natural cycle's endometrium measured 10.6 +/- 1.8 mm (ns). This finding could be attributed to a antiestrogenic effect of CC on the endometrium. It is concluded that cycles under CC action have different follicular and endometrial growth patterns than spontaneous conceptional cycles.

Adult↗

[Use of an GnRH analogue for induction of gonadotrophin ovulatory surge in cycles stimulated with clomiphene citrate and menopausal gonadotropin in an in vitro fertilization program].

In 23 women treated for sterility by the in vitro fertilization method the gonadotropins ovulatory surge was stimulated by applying a GnRH analogue (Buserelin). The authors showed that a single injection of GnRH analogue in the cycles stimulated with clomiphene citrate and menopausal gonadotropin causes pituitary output of both LH and FSH which is sufficient for morphological and functional maturity of the oocytes. After such treatment two patients conceived and delivered healthy babies.

Adult↗

[Factors affecting the results of in vitro fertilization--IV. Importance of the stimulation protocols combining GnRH analogs and HMG in women with unsuccessful stimulation with combinations of clomiphene citrate-HMG].

Poor responders, whose cycles were cancelled after CC-hMG stimulation because of inadequate response, were stimulated with GnRH analogues (Suprefact nasal spray) and hMG in short protocol. In this highly negative selected group the cancellation rate was significantly lower (16.2%) than in the "normal" IVF population stimulated with clomiphene citrate and hMG (24.8%). All other parameters (number of oocytes and embryos, pregnancy rate) did not differ in the two groups. Embryos were frozen in 23.4% of cycles after GnRH-hMG stimulation and in 26.1% of cycles after CC-hMG stimulation. In GnRH-a cycles more ampoules (17.7) were injected per patient than after CC-hMG protocols (11.1 ampoules). Severe ovarian hyperstimulation syndrome developed in 4.0% CC-hMG cycles and in 2.8% cycles where GnRH analogues were used.

Buserelin↗

[Pro clomiphene].

Thanks to CC an important number of endocrine sterility has been cured. The antiestrogenic effect of CC has been accused to promote perturbations of cervical mucus secretion and endometrial receptivity. The different technics to assure correction of negative side effects while promoting optimal activity of clomiphene will be discussed in terms of modern evaluation methods.

Abnormalities, Drug-Induced↗

Progesterone immunosuppressive levels and luteal steroid profiles in the cycles induced with clomiphene citrate.

Several studies have focused their attention on the possible interferences of the endocrine with the immunity system; these interrelations have been summoned to explain some aspects of the implantation. It has already been demonstrated that progesterone could play an immunosuppressive role, allowing the implantation of allotransplantation. However, the individual plasmatic levels of the substance needed to produce that effect still unknown. With the aim of determining the certain immunosuppressive progesterone levels in women with normal ovulatory function, and in order to determine if the other principal steroids might also have immunosuppressive effects, in 47 women affected by sine causa infertility, treated with 100 mg. die of Clomiphene Citrate (from day 3 to day 7) we evaluated the plasma levels of progesterone, 17-OH-Progesterone and 17 beta-Estradiol. The assays were made on the 7th, 11th and 14th post-ovulation days both in women who conceived (immunosuppressive effect present) and in women who did not achieve pregnancy (immunosuppressive effect absent). The results achieved showed a significant difference only in the progesterone values, while those of the other steroids were not significantly different, indicating thus that progesterone is the main element responsible for the immunosuppressive phenomenon and that the seriated evaluation in the luteal phase of this steroid could be used as a marker of achieved implantation.

17-alpha-Hydroxyprogesterone↗

A prospective randomized trial of artificial insemination versus intercourse in cycles stimulated with human menopausal gonadotropin or clomiphene citrate.

OBJECTIVE: To determine the relative efficacy of intrauterine insemination (IUI), direct intraperitoneal insemination, and intercourse in cycles stimulated with clomiphene citrate (CC) or human menopausal gonadotropins (hMG). DESIGN: A prospective randomized trial with a 2(3) factorial design with eight different treatment alternatives. Only one cycle per couple was performed. SETTINGS: The Departments of Obstetrics and Gynecology, Central Hospital, Västerås and Akademiska Hospital, Uppsala University, Uppsala, Sweden. PATIENTS: Of 157 randomized couples with unexplained infertility including 51 cases with minimal or mild endometriosis, 148 were selected for comparison. MAIN OUTCOME MEASURE: Pregnancy rate (PR). RESULTS: Follicular stimulation with hMG gave a higher PR than with CC in the insemination cycles, 19% (10/52) and 4% (2/49), respectively, but the PRs in intercourse cycles were not significantly different for hMG and CC, 13% (3/24) and 17% (4/23), respectively. Insemination cycles and intercourse cycles had a similar overall PR, 12% (12/101) and 13% (7/47), respectively. Furthermore, IUI and direct intraperitoneal insemination did not differ in efficacy. CONCLUSION: Follicular stimulation with hMG is more effective than CC in insemination cycles, but insemination as such seems to have no beneficial effect on the PR in stimulated cycles for treatment of unexplained infertility.

Adult↗

Serum insulin in clomiphene responders and nonresponders with polycystic ovarian disease.

OBJECTIVE: To investigate insulin levels in women with polycystic ovarian disease (PCOD) who are responders or nonresponders to clomiphene citrate (CC). DESIGN: Open and prospective study. SETTING: Outpatient infertility clinic of a third level medical institution. PATIENTS: Ten healthy women (group 1) and 35 PCOD women classified as responders (group 2 n = 10) or nonresponders (group 3 n = 25) on the basis of serum progesterone > or = 19 nmol/L in response to CC repeatedly administered in doses up to 250 mg/day for five days; they were further subdivided if body mass index (BMI) was below (N) or above (H) mean + 3 SD of group 1. INTERVENTIONS: Blood samples were obtained in a 100-g, 2-hours oral glucose tolerance test (OGTT). MAIN OUTCOME MEASURES: Serum glucose, insulin, free testosterone (free-T), dehydroepiandrosterone sulphate (DHEA-S), and androstenedione (A) were determined in the samples OGTT and the areas under the curve (AUC) were calculated. RESULTS: Group 3 had higher BMI, basal LH, and insulin and AUC insulin than groups 1 and 2; free-T was higher in groups 2 and 3 than in group 1, and basal PRL was higher in group 2 compared to groups 1 and 3. When BMI < or = 25.4 kg/m2 (mean + 1 SD of group 1) 77% of the PCOD cases responded (10 out of 13) whereas none with BMI > 25.4 responded to CC (n = 22) irrespectively of basal insulin concentration or AUC insulin. CONCLUSION: Moderate to excessive overweight seems more frequently and closely associated to a negative CC response in women with PCOD than hyperinsulinemia.

Adult↗

[Morphometric studies of effects of clomiphene citrate on histological characteristics of proliferative endometrium].

OBJECTIVES: To analyse quantitatively the effects of clomiphene citrate (CC) on histological characteristics of proliferative endometrium. METHODS: Endometrium biopsies were performed on day 12th of both natural and CC cycles in 14 infertile patients. Nuclear size, shapes and DNA contents of epithelial and glandular epithelial cells, stromal cells were measured or calculated after HE and Feulgeu staining by computerized image analysis technique. Results were compared before and after CC treatment. RESULTS: The average area, girth and maximal diameter of the nucler of glandular and epithelial cells in CC cycles were significantly smaller than those of natural cycles (P < 0.05), while the shape factor of stromal nuclea in CC cycles was larger than the natural ones (P < 0.05). DNA contents of glandular, epithelial and stromal nuclea in CC cycles were also smaller than those of natural cycles (P < 0.02). The difference of nuclear DNA content between the 2 cycles was positively correlated with the difference of nuclear area of glandular and epithelial cells (P < 0.01). CONCLUSIONS: CC treatment inhibited the endometrial mitosis and proliferation. This effects may begin at the stage of DNA synthesis, therfore DNA contents of endometrial glandular and stromal nuclea also decreased. The action of CC may be related to estrogen receptor synthesis.

Adult↗

Induction of multifollicular growth in patients non responding to clomiphene citrate and gonadotropins or gonadotropins only.

OBJECTIVE: We aimed at inducing multifollicular recruitment in patients with chronic anovulation-resistant to Clomiphene Citrate (CC) and/or exogenous gonadotropins. DESIGN: At the II Department of Obstetrics and Gynecology we treated our patients with exogenous gonadotropins and concomitant endogenous gonadotropin suppression obtained by the use of a GnRH analog (Buserelin). PATIENTS: We studied 14 patients with chronic anovulation due to either hypothalamic dysfunction or polycystic ovarian syndrome. MEASUREMENTS: We monitored the follicular growth ultrasonographically from the eighth day of the menstrual cycle, and assessed E2 and LH daily dosage from the tenth day. RESULTS: With this protocol we obtained 2 or 3 mature follicles, and reached an ovulatory rate of 80.7% and a pregnancy rate of 71.4%. Premature luteinization never occurred, and progesterone increase took place only after human chorionic gonadotropins administration.

Adult↗

Characteristics of gonadotropin response, follicular development, and endometrial growth and maturation across consecutive cycles of clomiphene citrate treatment.

OBJECTIVE: To examine the patterns of gonadotropin response, follicular development, and endometrial growth and maturation across consecutive cycles of clomiphene citrate (CC) treatment. DESIGN: Prospective analysis of cycle characteristics. SETTING: Academic tertiary medical center. PATIENTS: Nineteen consenting anovulatory infertile women receiving standardized, cyclic, incremental treatment with CC (50 to 150 mg/d, cycle days 5 to 9) for ovulation induction. INTERVENTIONS: In each of up to six consecutive treatment cycles, urinary LH was monitored twice daily from cycle day 10 until detection of the LH surge or day 21; blood samples and transvaginal ultrasound (US) examination were obtained on cycle days 3, 10, and every 1 to 3 days thereafter until collapse of the dominant follicle. Endometrial biopsy was performed 11 to 13 days after the LH surge in the first, third, and sixth ovulatory cycle. RESULTS: Follicular phase duration, peak follicular diameter, the number of preovulatory follicles, and peak endometrial thickness and echo pattern remained consistent across consecutive ovulatory (n = 55) and anovulatory (n = 23) treatment cycles. Endometrial dating was > or = 3 days out of phase in 2 of 31 (6%) cycles sampled. Peak serum E2 and P concentrations did not vary with cycle number or correlate with endometrial thickness or echo pattern. Cycle day 10 FSH levels were significantly higher in ovulatory subjects than in anovulatory subjects. CONCLUSIONS: Patterns of gonadotropin response, follicular development, and endometrial growth and maturation remain consistent across consecutive cycles of CC treatment.

Adult↗

Use of endometrial measurement as an exclusion criterion for in vitro fertilization using clomiphene citrate.

OBJECTIVE: Previous reports have indicated an association between endometrial development and pregnancy outcome for patients treated with clomiphene citrate (CC) in conjunction with intrauterine insemination or intercourse. We expanded the use of CC for ovulation induction in association with in vitro fertilization (IVF). This study was designed to determine if endometrial thickness should be used as an inclusion or exclusion criterion for CC-IVF. STUDY DESIGN: One hundred twenty-eight patients were enrolled in an ovulation-induction regimen using CC for expected IVF-ET between January 1992 and December 1992. A total of 81 patients met inclusion criteria for CC-IVF and had endometrial measurement performed prior to human chorionic gonadotropin administration. Patients were categorized on the basis of endometrial measurement as follows: (A) > 4 - < 7 mm, (B) > or = 7 - < or = 10 mm, and (C) > 10 mm. Standard IVF was performed, and pregnancy rates for each category were evaluated. RESULTS: A total of 23 pregnancies (28% per retrieval) were established. Pregnancy rates were not different by category (P > .10, Fisher's Exact Test): (A) 3/15 (20%), (B) 13/41 (32%), and (C) 7/25 (28%). CONCLUSION: These data suggest that for CC-IVF. endometrial measurement should not be used as an exclusion criterion since pregnancies occurred at comparable frequencies in all the groups.

Adult↗

Clomiphene citrate therapy and unexplained subfertility.

Oestrogen receptor (ER) and progesterone receptor (PR) binding site levels were determined using an assay system based upon that of King et al. Endometrial samples were obtained from 49 subfertility patients on clomiphene citrate (Clomid) therapy admitted to hospital for dye laparoscopy. An assay system based on that of Kato and Seto using synthetic androgen R1881 was used to measure androgen receptor (AR) binding sites in endometrial tissue obtained in the above patients. It is concluded that a cyclic variation was observed in ER and PR binding sites in women on Clomid therapy. No cyclic variation was observed in AR binding sites of women on Clomid therapy.

Binding Sites↗

[Assessment of genetic toxicity of the exposure to clomiphene citrate, with various bacterial test systems].

Clomiphene citrate (CC) induces framshift mutations on the Salmonella typhimurium Ames strains TA1538, TA97 and TA100 employing in vitro metabolic activation with S9 aerochlor 1254 induced rat livers, but not base pair substitution mutations with neither the standard or the preincubation method. CC induced genolethal DNA damages on the Escherichia coli PolA-/PolA+ with S9 on the preincubation method or without S9 on the disk diffusion one. The severe primary DNA damages produced b CC was verified by the SOS induction on the lysogenic lambda phage induction with De Marini (1988) method and the induction of colicin E1 plasmid on E. coli. These results are suggestive that CC may be an adduct forming compound which is able to inhibit replication if the cell lacks DNA polymerase, or it may produce framshift mutations after replications. CC induced damages could be large lesions conducing to unicatenary DNA strains, that are able to induce the lexA regulated genes. So, the use of this ovulation inductor is a risk of genotoxic damage and it is advisable to do a risk-benefit evaluation in any particular case before its prescription.

Clomiphene↗

[Clinical experience in the treatment of functional sterility using clomiphene].

Report on further experience in the treatment of functional sterility in 102 patients with clomiphene. Changes compatible with ovulation were present in 71,6%. Pregnancy was obtained in 34,0%. The best results were obtained in patients with secondary amenorrhoea and luteal corpus insufficiency. Adding HCG on 10th and 12th day of treatment had no substantial effect on increasing either the ovulatory rate or the pregnancy rate.

Chorionic Gonadotropin↗