Cycle abnormalities in infertile women with regular menstrual cycles: effects of clomiphene citrate treatment

D. A. Rodin, AENEAS M. FISHER, Richard N. Clayton
In: Fertility and Sterility · 1994 · vol. 62(1) , pp. 42–47 · doi:10.1016/s0015-0282(16)56813-7 · PMID:8005302 · W2409116264
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This study investigated cycle abnormalities in infertile women with regular menstrual cycles and the effects of clomiphene citrate treatment on these abnormalities.

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Abstract

ObjectiveTo investigate the incidence and nature of cycle abnormalities and the effect of clomiphene citrate (CC) treatment in women with apparently ovulatory cycles and unexplained infertility.DesignNonrandomized, open study of patients before and during treatment.SettingThe Reproductive Medicine Clinic of a District General Hospital.PatientsThirty-five women with regular, apparently ovulatory menstrual cycles and unexplained infertility.InterventionsDetailed ultrasound and hormonal cycle tracking was performed before and during treatment with CC.Main outcome measuresSerial ultrasound scans and measurements of serum LH, FSH, E2, and P.ResultsBefore treatment, 54% of cycles were uniovulatory, 40% were characterized by cyst formation, and 6% were characterized by poor follicular growth. Fifty-one percent of pretreatment cycles had normal hormone profiles, 31% had defective luteal phases, 14% had increased early follicular phase serum FSH levels, and 9% had increased early follicular phase serum LH levels. Treatment with CC reduced the incidence of cyst formation to 9% and the incidence of luteal phase defects to 3%. However, 28% of CC-treated cycles showed ultrasound features of overstimulation and 51% had high follicular phase E2 peaks so that only 34% of CC-treated cycles had normal hormone profiles.ConclusionsCycle abnormalities are common in unexplained infertility. The incidence of cyst formation and luteal phase defects, the most common abnormalities in this group, is reduced by CC treatment.

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