Sequential clomiphene citrate-menotropin therapy for induction or enhancement of ovulation

Fertility and Sterility
E Kemmann, J R Jones

Abstract

Either to induce ovulation in anovulatory infertility patients or to enhance ovulation in patients with mild endometriosis or luteal phase inadequacy, we utilized a sequential regimen of low-dose clomiphene citrate (CC) followed by human menopausal gonadotropin (hMG) injections on alternate days; duration and dosage of menotropin therapy was individualized by using serum estradiol levels for monitoring until the time of administration of human chorionic gonadotropins. Previous therapeutic efforts without menotropins had been unsuccessful in all patients. One third of 70 treated patients conceived during 156 treatment cycles. The pregnancy rate was 44% in anovulatory patients (n = 34), and 26% in patients with ovulation dysfunction (n = 23). Pregnancy rates declined with patient's age. Four of the 23 patients that conceived had a spontaneous abortion (17%). The multiple gestation rate was 10.5%. A relative inhibition of cervical mucus development was noted and shown to be caused by CC. Hyperstimulation occurred in three patients. The discussed CC-hMG regimen approaches the effectiveness of standard hMG therapy; but compared with standard hMG therapy, it has significant economic advantages and seems to have a markedly lower rate ...Continue Reading

Citations

Jun 1, 1986·Asia-Oceania Journal of Obstetrics and Gynaecology·M YasudaO Tanizawa
Jan 1, 1985·Annals of the New York Academy of Sciences·A BirkenfeldH M Beier
Feb 1, 1997·The Journal of Obstetrics and Gynaecology Research·S M ZiadehA Abu-Hieja
Aug 13, 2010·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·A BadawyM Totongy
Jan 11, 2000·Clinical Obstetrics and Gynecology·L J Wolf
Sep 8, 2004·Journal of the Society for Gynecologic Investigation·Mohamed F M Mitwally, Robert F Casper
Apr 6, 2006·Fertility and Sterility·Hananel HolzerTogas Tulandi
Sep 1, 1988·Baillière's Clinical Obstetrics and Gynaecology·K M McKenna, R J Pepperell

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