Clomiphene citarte

Q 1:_Indications and usage of clomiphene citrate

Clomiphene citrate is indicated for the treatment of anovulation  but more probably in ovulatory dysfunction in women desiring pregnancy. Q. 1A:Can it be prescribed in males?? There are no adequate or well-controlled studies that demonstrate the effectiveness of in the Clomiphene citrate treatment of male infertility. In addition, testicular tumors and Gynaecomastia have been reported in males using clomiphene. The cause and effect relationship between reports of

testicular tumors and the administration of Clomiphene citrate is not known

Q,.2: What tests should ideally precede prior to prescribing CC ??  Ans; Other impediments to achieving pregnancy must be excluded or adequately treated before beginning CC   therapy.

Q3 . Who are most likely to respond?? Ans: Those patients most likely to achieve success with clomiphene therapy include patients with polycystic ovary syndrome like  WHO class II anovulatory disorders. It is also Oligo ovulation (patients with demonstrated ovulatory dysfunction)-

Q4: Who may not respond well but no harm in trying 1-2 cycle of CC as trial basis?? Ans: 1) who had hyperstimulation with gonadotrophins, 2) amenorrhea-galactorrhea syndrome, 3) psychogenic amenorrhea, 4) post-oral-contraceptive

amenorrhea, and 5) certain cases of secondary amenorrhea of undetermined etiology. 6) reduced estrogen levels,(Low ET on basal SCAN)  while less favorable, do not preclude successful therapy,

Q 6: What Lab tets must preceede prior to commencing CC??  Ans:-a) LFT, b) Pelvic scan to exclude myoma, Ov cyst, Ovarian cysts c) TSH. PRL ,Besides other genital tract impediments(gross PID)  or systemic diseases like (renal, hepatic, DM, Hypothyroid etc)  to achieving pregnancy must be excluded or adequately treated before beginning Clomiphene citrate therapy.

 Q.7: What may go wrong during CC ? What may be side effects??  Ans:-There are some rare risks  which are : 1)Ovarian Hyperstimulation Syndrome 2) very rarely reversible eye changes ,like  eclampsia

 Q. 8 What spl advice to offer to couple ?? Properly timed coitus in relationship to ovulation is important. An urinary LH kit may be of help so that the patient and her physician realizes that drug has responded by causing ovulation .Once ovulation has been established, each course Clomiphene citrate of should be started on or about the 2 -3rd day of the cycle so that the ill effects of CC on Endometrium is lessened by the time Et is supposed to be ready for implantation (window of implantation).