The effects of clomiphene citrate and cyclofenil on cervical mucus volume and receptivity over the periovulatory period

Thompson, Lisa; Barratt, Christopher L.R.; Thornton, Simon J.; Bolton, A.E.; Cooke, I. D.

doi:10.1016/s0015-0282(16)55627-1

Cited by 18 publications

(6 citation statements)

References 11 publications

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“…However, it has anti-estrogenic effect so it may be associated with poor cervical mucus and endometrial thinning due to prolonged estrogen-receptor depletion in the endometrium and possibly in the cervix; an effect that can explain the obvious discrepancy between the ovulation rate and the pregnancy rate achieved with CC. 3,4 Letrozole; an aromatase inhibitor, has been tried by many researchers as an alternative treatment to CC in different regimens. [12][13][14][15][16][17][18] The optimal dose of letrozole for ovulation induction in patients with PCOS has not been yet determined.…”

Section: Resultsmentioning

confidence: 99%

“…However, there is a marked discrepancy between ovulation rate and pregnancy rate achieved with CC which can be attributed to the negative effect on the cervical mucus and endometrium. 3,4 Letrozole is a type II a third-generation aromatase inhibitor that has been widely used in women with breast cancer. 5 It works through inhibiting the conversion of and rostenedione and testosterone to estrogen in the ovary which leads to estrogen depletion that creates negative feedback signals to hypothalamic-pituitary axis (HPA), therefore, follicle-stimulating hormone (FSH) secretion increases, stimulating the development of ovarian follicles.…”

Section: Introductionmentioning

confidence: 99%

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Optimized Letrozole Dose Versus Traditional Use of Clomiphene Citrate for Ovulation Induction in Patients With PCOS: A Prospective Randomized Controlled Trial

Elkhateeb¹,

Mahran²

2016

Gynecol Obstet Res Open J

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Citation : patients were randomly allocated into two groups; study group (100 patients) receiving gradually increased doses of letrozole starting with 2.5 mg on cycle day 3 with incremental increase of 2.5 mg daily till reaching a dose of 10 mg daily on cycle day 6 and a control group (100 patients) receiving CC at a dose of 100 mg daily for 5 days starting from cycle day 3. Patients were followed up for three treatment cycles. The primary outcome was clinical pregnancy rate and the secondary outcome was number of mature follicles, endometrial thickness, serum progesterone and time to reach a dominant follicle. Result(s):The two groups were similar in the demographic features and baseline hormonal milieu. There was no significant difference between the two groups as regards the number of mature follicles and the time to reach mature follicles. Endometrial thickness on HCG day was significantly higher in the letrozole group as compared with CC group (10.1±0.22 mm vs 8.2±0.69 mm, p=0.01)). Serum progesterone was higher in letrozole group than in CC group (19.3±3.1 vs 15.3±2.2, p<0.01). Ovulation was achieved in165/242 cycles (68.2 %) in the letrozole group and 169/249 cycles (67.9 %) in the CC group which was not statistically significant. Clinical pregnancy rate was significantly higher in letrozole group in comparison with CC group (14.8 % vs 10.4 %, p<0.01) Conclusion(s): Letrozole in gradually increased dose achieves higher clinical pregnancy rate as compared with the traditional dose of CC. Therefore, it can be used as a first-line treatment for ovulation induction in women with PCOS.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Optimized Letrozole Dose Versus Traditional Use of Clomiphene Citrate for Ovulation Induction in Patients With PCOS: A Prospective Randomized Controlled Trial

Elkhateeb¹,

Mahran²

2016

Gynecol Obstet Res Open J

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“…No changes in cervical mucus production, volume, or characteristics could be detected when clomiphene was given to normal women. 13 The same group also studied the endometrial effects of clomiphene in normally cycling women and could not determine any significant effects on luteal-phase endometrial morphology. 14 Although these studies would suggest that there is no significant impact of clomiphene in these areas, other investigators have suggested otherwise.…”

Section: Clomiphene Citratementioning

confidence: 99%

Ovulation Induction in the Estrogenized Anovulatory Patient

Kettel¹,

Hummel²

1996

Semin Reprod Med

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Ovulation induction is one of the greatest success stories in reproductive endocrinology. With appropriate therapy in properly f1p4cted patients, the conception and live birth-rates in treated patients are almost indistinguishable from normal. In the estrogenized woman there are many different techniques to reverse the condition of chronic anovulation. With clomiphene citrate, up to 80% of patients will ovulate, and approximately half will conceive. In women who fail clomiphene therapy, injectable gonadotropins are usually successful in inducing ovulation. New protocols for administering these powerful agents have minimized the risk of ovarian hyperstimulation and multiple pregnancy. When medical therapy fails to result in successful ovulatory cycles, surgical treatments can be considered. Laparoscopic ovarian ablation has been shown to be effective treatment. Whether this less invasive surgery results in fewer adhesions than conventional ovarian wedge resection remains to be proven. By carefully considering each patient and individualizing treatment based on a full knowledge of alternatives, ovulation induction remains one of the most challenging and rewarding treatments in reproductive endocrinology.

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“…The studies on the negative effect of CC on the cervical mucus did not evaluate whether abnormal cervical mucus was associated with lower pregnancy chances and the only prospective follow-up study on the relation between the result of the PCT and pregnancy rates describes the PCT outcome in some women, while the pregnancy rates are described in other women [4][5][6][7]. Therefore the association between outcome of the PCT and pregnancy chances cannot be determined from this study.…”

Section: Introductionmentioning

confidence: 97%

“…Though CC results in high pregnancy rates, several studies have shown that CC has a negative effect on the cervical mucus [4][5][6]. The Dutch guidelines and the National Institute for Health and Clinical Excellence guidelines are not specific on the necessity to perform a PCT to exclude or demonstrate a cervical factor in women ovulating after induction as evidence on the relation between cervical factor and pregnancy chances does not exist.…”

Section: Introductionmentioning

confidence: 99%

Does the postcoital test predict pregnancy in WHO II anovulatory women? A prospective cohort study

Nahuis

Weiss

Velde

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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The effects of clomiphene citrate and cyclofenil on cervical mucus volume and receptivity over the periovulatory period

Cited by 18 publications

References 11 publications

Optimized Letrozole Dose Versus Traditional Use of Clomiphene Citrate for Ovulation Induction in Patients With PCOS: A Prospective Randomized Controlled Trial

Optimized Letrozole Dose Versus Traditional Use of Clomiphene Citrate for Ovulation Induction in Patients With PCOS: A Prospective Randomized Controlled Trial

Ovulation Induction in the Estrogenized Anovulatory Patient

Does the postcoital test predict pregnancy in WHO II anovulatory women? A prospective cohort study

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