Critical Review of 160 Clomiphene-Related Pregnancies

Goldfarb, Alvin F.; Morales, Antonio; Rakoff, A. E.; Protos, Peter

doi:10.1097/00006254-196809000-00022

Cited by 7 publications

(8 citation statements)

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“…Moreover, there is a higher than expected incidence of miscarriage in conception cycles following clomiphene citrate treatment [255]. Such discrepancy is believed to be due to the peripheral antiestrogenic effect of clomiphene citrate, particularly at the level of the cervical mucus [256,257] and endometrium, [258,259].…”

Section: Part Onementioning

confidence: 99%

“…In spite of the high ovulation rate associated with the use of clomiphene citrate, the pregnancy rate is much lower than anticipated. This is particularly true when considering pregnancy rate per cycle after three cycles of CC treatment [421], with higher than expected incidence of miscarriage in conception cycles [255]. Such discrepancy is believed, as explained earlier, to be due to the peripheral antiestrogenic effect of clomiphene citrate particularly at the level of the cervical mucus and endometrium, and which manifest themselves even in the presence of gonadotropin treatment superovulation.…”

Section: Part Twomentioning

confidence: 99%

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The role of aromatase inhibitors in ameliorating deleterious effects of ovarian stimulation on outcome of infertility treatment

Mitwally

Casper

Diamond

2005

Reprod Biol Endocrinol

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Clinical utilization of ovulation stimulation to facilitate the ability of a couple to conceive has not only provided a valuable therapeutic approach, but has also yielded extensive information on the physiology of ovarian follicular recruitment, endometrial receptivity and early embryo competency. One of the consequences of the use of fertility enhancing agents for ovarian stimulation has been the creation of a hyperestrogenic state, which may influence each of these parameters. Use of aromatase inhibitors reduces hyperestrogenism inevitably attained during ovarian stimulation. In addition, the adjunct use of aromatase inhibitors during ovarian stimulation reduces amount of gonadotropins required for optimum stimulation. The unique approach of reducing hyperestrogenism, as well as lowering amount of gonadotropins without affecting the number of mature ovarian follicles is an exciting strategy that could result in improvement in the treatment outcome by ameliorating the deleterious effects of the ovarian stimulation on follicular development, endometrial receptivity, as well as oocyte and embryo quality. PART ONE IntroductionCurrent epidemiological evidence suggests that 15% of couples will experience infertility. Background prevalence rates now appear to be reasonably stable, but there is evidence of an increase in the rate of referrals for medical help [1,2]. Farley and Belsey, 1988 [3], have reported estimates of the prevalence (percentage) of primary infertility by region and country.

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Section: Part Onementioning

confidence: 99%

Section: Part Twomentioning

confidence: 99%

The role of aromatase inhibitors in ameliorating deleterious effects of ovarian stimulation on outcome of infertility treatment

Mitwally

Casper

Diamond

2005

Reprod Biol Endocrinol

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“…Despite good ovulation induction with the use of CC, the pregnancy rate is much lower (13)(14)(15). Moreover, a higher than expected incidence of miscarriage in conception cycles after CC treatment has been reported (16). The discrepancy has been observed consistently between ovulation and pregnancy rates in women treated with CC, and it may be a result of the antiestrogenic effects of CC at the level of ovary, ovum, and uterus (17)(18)(19).…”

mentioning

confidence: 99%

Clomiphene citrate inhibits gonadotropin-induced ovulation by reducing cyclic adenosine 3′,5′-cyclic monophosphate and prostaglandin E2 levels in rat ovary

Chaube

Prasad

Tripathi

et al. 2006

Fertility and Sterility

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“…[98][99][100][101][102] Moreover, there may be a higher than expected incidence of miscarriage in conception cycles following CC treatment. 103 Such discrepancy is believed to be due to the peripheral antiestrogenic effect of CC, particularly at the level of the cervical mucus [104][105][106] and endometrium. [107][108][109] The accumulation in the body of the zu-isomer of CC due to its long half-life ( $ 2 weeks) adds to the persistence of the abnormal estrogenic effect.…”

Section: Induction and Augmentation Of Ovulation After Clomiphene Citmentioning

confidence: 99%

Aromatase Inhibitors in Ovulation Induction

Mitwally

Casper²

2004

Semin Reprod Med

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The new third generation aromatase inhibitors are extremely potent and specific oral inhibitors of estrogen production. We reported the success of using aromatase inhibitors for induction of ovulation in World Health Organization (WHO) type II anovulatory patients. Promising pregnancy rates were associated with the use of aromatase inhibitors for induction of ovulation in these women. In addition, the use of aromatase inhibition in conjunction with gonadotropin injection was associated with a significant reduction in the gonadotropin dose required for optimum controlled ovarian hyperstimulation. We believe that these oral agents are efficient and safe and have many advantages compared with clomiphene citrate (CC). We propose that aromatase inhibitors will replace CC in the future as the new primary treatment for ovulation induction. In this review, we present an update on the use of aromatase inhibitors for induction of ovulation and we discuss several new areas of potential interest regarding the use of aromatase inhibitors, either alone or together with recombinant follicle-stimulating hormone (FSH) for infertility treatment. Further research in these areas may demonstrate an expanded role in assisted reproductive technologies.

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Critical Review of 160 Clomiphene-Related Pregnancies

Cited by 7 publications

References 0 publications

The role of aromatase inhibitors in ameliorating deleterious effects of ovarian stimulation on outcome of infertility treatment

The role of aromatase inhibitors in ameliorating deleterious effects of ovarian stimulation on outcome of infertility treatment

Clomiphene citrate inhibits gonadotropin-induced ovulation by reducing cyclic adenosine 3′,5′-cyclic monophosphate and prostaglandin E2 levels in rat ovary

Aromatase Inhibitors in Ovulation Induction

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