Clomiphen failure and Clomiphen resistance

·          What is the difference between CC Resistance & CC failure:-

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·         By CC failure we mean that there is documented ovulation as evidenced 1) by serial follicular monitoring, or 2) home testing by LH kit or 3) by estimating  day 23 serum progesterone.

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·           By contrast CC resistance means there is no ovulation inspite of timely ingestion  of CC/Letrozole  The common causes of CC resistance are difficult to establish but mostly growth factor or genetic . Subtle endocrine disorders or environmental pollutants or endocrine disruptors may affect the gbgrowth of follicles or timely rupture in  response to harmonized release of FSH.
By CC failure, therefore we mean the choice of the drug to induce ovulation was appropite.A.  But due to some other  factor/ factors  conception didn’t occur. Such cases are common are  1) Tubal block & tubal diseases 2) Peel adhesive disease with altered tubo peritoneal relations 3)  Minimal endometriosis, 4) genital Koch’s hitherto undiagnosed and untreated. 5) Abnormal sperm morphology.

·         Uncommon causes of CC failure are 6) failure to comply with of timed intercourse as advised) Erectile disorders/ absence of husband due  to unavoidable circumstances)  7) Defective oogenesis –difficult to diag. This occurs for variety of causes but notably IGF disorders, Insulin resistance, Poor endometrial receptivity, Synechiae, polyps, cong abnormalities of uterus, & due possibly abnormal ovarian androgen biosynthesis e) PRL, disorder.

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