Use of clomiphene citrate in women

doi:10.1016/j.fertnstert.2006.08.023

Cited by 26 publications

(8 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, tamoxifen is the only SERM FDA-approved as adjuvant therapy for early-stage BC, and it is the only SERM approved for every BC stage, from the prophylactic through the metastaric settings. A fourth SERM, clomiphene (Clomid®) has long served as the standard-of-care fertility drug for inducing ovulation,154 and tamoxifen was used for this purpose before receiving approval as a BC treatment 155. Clomiphene sometimes leads to perceptible vision changes,156,157 especially when the dose is increased by a factor of up to four from the customary 50 mg / day starting dose, to achieve pregnancy 158.…”

Section: Adjuvant Endocrine Therapymentioning

confidence: 99%

Breast Cancer Medications and Vision: Effects of Treatments for Early-stage Disease

Eisner¹,

Luoh²

2011

Current Eye Research

View full text Add to dashboard Cite

This review concerns the effects on vision and the eye of medications prescribed at three phases of treatment for women with early-stage breast cancer (BC): (1) adjuvant cytotoxic chemotherapy, (2) adjuvant endocrine therapy, and (3) symptomatic relief. The most common side effects of cytotoxic chemotherapy are epiphora and ocular surface irritation, which can be caused by any of several different regimens. Most notably, the taxane docetaxel can lead to epiphora by inducing canalicular stenosis. The selective-estrogen-receptor-modulator (SERM) tamoxifen, long the gold-standard adjuvant-endocrine-therapy for women with hormone-receptor-positive BC, increases the risk of posterior subcapsular cataract. Tamoxifen also affects the optic nerve head more often than previously thought, apparently by causing subclinical swelling within the first 2 years of use for women older than ∼50 years. Tamoxifen retinopathy is rare, but it can cause foveal cystoid spaces that are revealed with spectral-domain optical coherence tomography (OCT) and that may increase the risk for macular holes. Tamoxifen often alters the perceived color of flashed lights detected via short-wavelength-sensitive (SWS) cone response isolated psychophysically; these altered perceptions may reflect a neural-response sluggishness that becomes evident at ∼2 years of use. The aromatase inhibitor (AI) anastrozole affects perception similarly, but in an age-dependent manner suggesting that the change of estrogen activity towards lower levels is more important than the low estrogen activity itself. Based on analysis of OCT retinal thickness data, it is likely that anastrozole increases the tractional force between the vitreous and retina. Consequently, AI users, myopic AI users particularly, might be at increased risk for traction-related vision loss. Because bisphosphonates are sometimes prescribed to redress AI-induced bone loss, clinicians should be aware of their potential to cause scleritis and uveitis occasionally. We conclude by suggesting some avenues for future research into the visual and ocular effects of AIs, particularly as relates to assessment of cognitive function.

show abstract

Section: Adjuvant Endocrine Therapymentioning

confidence: 99%

Breast Cancer Medications and Vision: Effects of Treatments for Early-stage Disease

Eisner¹,

Luoh²

2011

Current Eye Research

View full text Add to dashboard Cite

show abstract

“…Most of these women have irregular menstrual cycles but serum concentrations of follicle stimulating hormone (FSH) and estradiol (E 2 ) within the normal range, and are classified as World Health Organization (WHO) Group II anovulatory patients (World Health Organization, 1993). For these normogonadotrophic anovulatory infertile patients wishing to conceive, administration of the anti-estrogen clomiphene citrate (CC) to induce ovulation is the first-line pharmacological treatment, due to low costs and few complications (Practice Committee, ASRM, 2006; Thessaloniki ESHRE/ASRM-sponsored PCOS consensus workshop group, 2008). However, this treatment does not always lead to pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins

Andersen

Balen

Platteau³

et al. 2010

Human Reproduction

View full text Add to dashboard Cite

BACKGROUNDThe objective of this study was to identify baseline predictors of live birth in anovulatory patients undergoing ovulation induction, and based on these predictors, develop nomograms for estimation of the probability of live birth in a single cycle.METHODSUnivariate and multivariate logistic regression were used for retrospective analysis of clinical, sonographic and endocrinological parameters collected prior to the start of ovarian stimulation in a cohort of anovulatory World Health Organization (WHO) Group II patients (n = 335), who were resistant to clomiphene citrate (CC) and therefore stimulated with gonadotrophins using a low-dose step-up protocol.RESULTSThe univariate analysis identified age [OR = 0.91 (95% CI: 0.84–0.98), P = 0.015], duration of infertility [OR = 0.71 (95% CI: 0.56–0.91), P = 0.007], serum follicle stimulating hormone (FSH) concentration at the start of stimulation [OR = 0.83 (95% CI: 0.69–0.99), P = 0.034] and menstrual cycle pattern (P = 0.022) as significant predictors of live birth. Baseline concentrations of luteinizing hormone, androgens, glucose and insulin, as well as body mass index, were not predictors of live birth. In the multivariate analysis, duration of infertility, FSH and menstrual cycle pattern were independent predictors, and nomograms were designed with these three parameters for individual prediction of the probability of live birth.CONCLUSIONSThe chances of live birth in women with WHO Group II anovulatory infertility resistant to CC undergoing ovulation induction with gonadotrophins is highly influenced by the menstrual cycle pattern. Increases in duration of infertility and concentration of FSH (within the normal range) before the start of stimulation have negative influences on the likelihood of achieving a live birth.

show abstract

“…A recent publication has highlighted the time “lost” in successive cycles of attempted ovulation induction when the generally recognized approach is to administer progestin to induce endometrial shedding after each nonresponsive (anovulatory) cycle (5). Compared to historical controls (3, 4), that report suggested that utilization of a stair step protocol increasing the dose of CC reduced the time to ovulation by 32–53 days, and was associated with a three-fold higher overall rate of ovulation (64% at the 100 mg/d dosage) as compared to the progestin withdrawal group (where the ovulation rate was 22%). That report did not assess conception or live birth rates.…”

Section: Discussionmentioning

confidence: 95%

“…(1, 2) The American Society of Reproductive Medicine Practice Guidelines describes the use of progestin to induce a withdrawal bleed prior to initiation of CC administration in women with PCOS (3). However, there is scant literature on the value or possible detrimental effect of such a practice.…”

Section: Introductionmentioning

confidence: 99%

Endometrial Shedding Effect on Conception and Live Birth in Women With Polycystic Ovary Syndrome

Diamond

Krüger

Santoro

et al. 2012

Obstetrics & Gynecology

View full text Add to dashboard Cite

Objective To estimate whether progestin-induced endometrial shedding, prior to ovulation induction with clomiphene citrate, metformin, or a combination of both, affects ovulation, conception, and live birth rates in women with polycystic ovary syndrome (PCOS). Methods A secondary analysis of the data from 626 women with PCOS from the National Institutes of Child Health and Human Development Cooperative Reproductive Medicine Network trial was performed. Women had been randomized to up to six cycles of clomiphene citrate alone, metformin alone, or clomiphene citrate plus metformin. Women were assessed for occurrence of ovulation, conception, and live birth in relation to prior bleeding episodes (after either ovulation or exogenous progestin-induced withdrawal bleed). Results While ovulation rates were higher in cycles preceded by spontaneous endometrial shedding than after anovulatory cycles (with or without prior progestin withdrawal), both conception and live birth rates were significantly higher after anovulatory cycles without progestin-induced withdrawal bleeding (live birth per cycle: spontaneous menses 2.2%; anovulatory with progestin withdrawal 1.6%; anovulatory without progestin withdrawal 5.3%; p<0.001). The difference was more marked when rate was calculated per ovulation (live birth per ovulation: spontaneous menses 3.0%; anovulatory with progestin withdrawal 5.4%; anovulatory without progestin withdrawal 19.7%; p < .001). Conclusion Conception and live birth rates are lower in women with PCOS after a spontaneous menses or progestin-induced withdrawal bleeding as compared to anovulatory cycles without progestin withdrawal. The common clinical practice of inducing endometrial shedding with progestin prior to ovarian stimulation may have an adverse effect on rates of conception and live birth in anovulatory women with PCOS.

show abstract

Use of clomiphene citrate in women

Cited by 26 publications

References 71 publications

Breast Cancer Medications and Vision: Effects of Treatments for Early-stage Disease

Breast Cancer Medications and Vision: Effects of Treatments for Early-stage Disease

Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins

Endometrial Shedding Effect on Conception and Live Birth in Women With Polycystic Ovary Syndrome

Contact Info

Product

Resources

About