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Reproductive Physiology, Endocrinology, and Infertility

Question
45 out of 56
 

What is true about clomiphene? (AIIMS May 2010)



A Enclomiphene is an estrogenic

B Pregnancy rate is 3 times of placebo

C Causes increase in sperm formation in RCT of oligospermia men

D 5 – 6% increase in twin pregnancy

Ans. A

Enclomiphene is an estrogenic

1. Clomiphene citrate is made up of

a. Trans enclomiphene 62%

b. Cis zuclomiphene citrate 38%

This Primarily acts at the receptor in Hypothalamus rather than the Ovarian and Pituitary axis. Blockade increases the stimulus to the pituitary to produce more FSH.

i. It elicits Hot flushes

ii. Antagonizes the beneficial actions of estrogens on hot flushes in PM women

iii. 6-12% increase in twins

iv. Oligospermia relief is not the best benefit of clomiphene citrate. Statistically speaking, because roughly 10-15% only are benefited with this in their oligospermia reversal.

2. Extra Edge Points about Clomiphene Citrate

i. Clomiphene can lead to multiple ovulation, hence increasing the chance of twins (10% of births instead of the normal ~1%).

ii. In comparison to treatment with purified FSH, the rate of ovarian hyperstimulation syndrome is low.

iii. There may be an increased risk of ovarian cancer and weight gain.

iv. Some patients may experience vivid and/or disturbing dreams

Reproductive Physiology, Endocrinology, and Infertility Flashcard List

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