Clomiphene Citrate-Initiated Ovulation: A Clinical Update

Adashi, Eli Y.

doi:10.1055/s-2007-1022505

Cited by 45 publications

(11 citation statements)

References 132 publications

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“…If women with PCOS become pregnant after ovulation induction, they may develop luteal phase defect (LPD) resulting in pregnancy loss (4). The pregnancy rate among PCOS women is only 40-50% even when other factors are excluded and ovulation induction is successful (5). The deficiency of luteal phase progesterone synthesis and/or action is the leading cause of infertility or spontaneous abortion in cases of LPD (6).…”

Section: Introductionmentioning

confidence: 99%

Effects of metformin treatment on luteal phase progesterone concentration in polycystic ovary syndrome

Meenakumari

Agarwal

Krishna

et al. 2004

Braz J Med Biol Res

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The causes of luteal phase progesterone deficiency in polycystic ovary syndrome (PCOS) are not known. To determine the possible involvement of hyperinsulinemia in luteal phase progesterone deficiency in women with PCOS, we examined the relationship between progesterone, luteinizing hormone (LH) and insulin during the luteal phase and studied the effect of metformin on luteal progesterone levels in PCOS. Patients with PCOS (19 women aged 18-35 years) were treated with metformin (500 mg three times daily) for 4 weeks prior to the test cycle and throughout the study period, and submitted to ovulation induction with clomiphene citrate. Blood samples were collected from control (N = 5, same age range as PCOS women) and PCOS women during the late follicular (one sample) and luteal (3 samples) phases and LH, insulin and progesterone concentrations were determined. Results were analyzed by one-way analysis of variance (ANOVA), Duncan's test and Karl Pearson's coefficient of correlation (r). The endocrine study showed low progesterone level (4.9 ng/ml) during luteal phase in the PCOS women as compared with control (21.6 ng/ml). A significant negative correlation was observed between insulin and progesterone (r = -0.60; P < 0.01) and between progesterone and LH (r = -0.56; P < 0.05) concentrations, and a positive correlation (r = 0.83; P < 0.001) was observed between LH and insulin. The study further demonstrated a significant enhancement in luteal progesterone concentration (16.97 ng/ml) in PCOS women treated with metformin. The results suggest that hyperinsulinemia/insulin resistance may be responsible for low progesterone levels during the luteal phase in PCOS. The luteal progesterone level may be enhanced in PCOS by decreasing insulin secretion with metformin.

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Section: Introductionmentioning

confidence: 99%

Effects of metformin treatment on luteal phase progesterone concentration in polycystic ovary syndrome

Meenakumari

Agarwal

Krishna

et al. 2004

Braz J Med Biol Res

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“…Acting as an antiestrogen, CC is believed to displace endogenous estrogen from hypothalamic estrogen receptors, thereby removing the negative feedback effect exerted by endogenous estrogens. The change in pulsatile LH-releasing hormone release is thought to normalize the release of pituitary FSH and LH and initiates ovulation (8).…”

Section: Discussionmentioning

confidence: 99%

Clomiphene citrate–induced severe hypertriglyceridemia

Yaşar

Ertuğrul

2009

Fertility and Sterility

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“…Pregnancy rates are about 15% to 20 % per cycle. No adverse perinatal outcome following aromatase inhibitor use has yet been reported in the published, peer-reviewed literature, although the authors of a study presented during the American Society for Reproductive Medicine meeting in 2005 reported a higher rate of congenital anomalies with 5 mg anastrozole (24,25,26). Notably, letrozole has warned clinicians against prescribing drugs for ovulation induction on the basis of reports of birth defects and spontaneous miscarriages in its safety database (27).…”

Section: Ovulation Induction Controlled Ovarian Hyperstimulationmentioning

confidence: 99%