جستجوی مقالات مرتبط با کلیدواژه « کلومیفن » در نشریات گروه « پزشکی »

Infertility is one of the factors which have a significant effect on the sexual performance of couples, especially women. Infertility can affect sexual activity in infertile couples. On the other hand, ovulation stimulation therapies for infertility treatment can inhibit estrogen and thus reduce women's sexual function and satisfaction. Therefore, this study was performed with aim to determine and compare the sexual performance and satisfaction of women treated with two types of ovulation stimulant drugs: clomiphene and letrozole.

This two-group analytical study was performed on 80 infertile women referred to infertility centers in Isfahan province in 2019. The research tools were the questionnaires of Beck, sexual function and sexual satisfaction, which were completed twice before and after receiving clomiphene and letrozole. Data were analyzed by SPSS software (version 22) and Independent t-test, Mann-Whitney, Chi-square, Paired t-test, Wilcoxon and Friedman tests. P<0.05 was considered statistically significant.

In intra-group comparison, there was no statistically significant difference before and after drug administration in the variables of sexual satisfaction (p=0.053) and sexual function (p=0.057), but in inter-group comparison, there was a statistically significant difference in sexual function of the clomiphene group (P <0.001); lower sexual function was reported after clomiphene use than before its use, but in terms of sexual satisfaction in the clomiphene group, no significant difference was reported before and after receiving the drug (p>0.05). There was no significant difference in letrozole group before and after drug administration in both variables of sexual function and satisfaction (p=0.053).

The score of sexual performance decreased in the clomiphene group, but sexual satisfaction did not show any difference in any of the groups. In other words, women's sexual function is affected by many factors, one of which is the use of assisted reproductive drugs, including clomiphene. Clomiphene inhibits vaginal moisture by inhibiting estrogen, which can cause pain and reduce sexual arousal, orgasm, and libido in women. For this purpose, it is recommended that active people in the field of infertility pay attention to this issue.

Introduction & Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women. Chronic anovulation due to polycystic ovary syndrome predisposes women to endometrial changes. Stachys lavandulifolia is an aromatic plant belonging to the Labiatae family proven to have estrogenic properties. In this study, we evaluated the effects of Stachys lavandulifolia extract on endometrial histological parameters in a rat model of PCOS.
Thirty-six adult female Sprague-Dawley rats, weighing between 17-200 g were used in this experimental study. PCOS was induced by a single intramuscular injection of 4 mg Estradiol Valerate. The rats were divided into six groups; control group with no treatment, the PCOS group receiving solvent, three PCOS groups treated by multiple doses (225, 450, 900 mg/kg) of Stachys lvandulifolia extract, and PCOS group receiving clomiphene citrate (1.5 mg/kg). Extracts were injected intraperitoneally for a period of 4 estrous cycles (16 days). The endometrial biopsies were stained with Hematoxylin-Eosin and then the number of glands, endometrial glandular cell height, internal diameter of glands, height of epithelial cells and height of endometrium and pathological changes were examined.
The results showed that the height of surface epithelium and glandular epithelium increased and the endometrial thickness and internal diameter of glands insignificantly decreased in PCOS group compared to control (P>0.05) while the number of glands showed significant decrease (P=0.01). In addition, 40% of the rats in PCOS group showed endometrial hyperplasia. Treatment with clomiphen citrate and different concentrations of the Stachys lvandulifolia led height of glandular epithelium, internal diameter of glands, height of surface epithelium and endometrium and number of glands to become more similar tothe control group, although they were not significant(P>0.05). Treatment with clomiphen citrate and 900 mg/kg concentrations of the Stachys lvandulifolia reduced hyperplasia in 35% and 33.3% of rats respectively.
The results of this study showed that stachys lvandulifolia dose dependently causes changes in the endometrial histological parameters of PCOS rat model.

Ovulation disorders are one of the most important causes of infertility in women. Clomiphene citrate is used commonly in such patients for the induction of ovulation. But some of the patients are resistant to this drug or even if they have successful ovulation, they may not become pregnant. Tamoxifen is a non steroidal compound like as clomiphene, that is used for ovulation induction, while it doesn’t have undesirable effect of clomiphene on endometrium. The purpose of this study, is comparison between these two drugs for ovulation induction and pregnancy. In this clinical trial, 144 women with infertility were placed in two groups in Block randomization form, who were referred to clinics since March 2006 till March 2008 and were diagnosed to have only ovulatory factor infertility by different tests. (The number of patients was determined according to the pilot study). The treatment of first group was 40mg/day by Tamoxifen and of second group was clomiphene150mg/day from days3 till 7 of menstrual cycle. Then, by using transvaginal sonography in 12-16 days of cycle, they were tested for follicular growth, endometrial thickness and pattern. Finally, the patients were followed up for pregnancy and side effects related to it. Afterwards, descriptive statistics and x2 and T-Test and SPSS software statistical analysis were carried out. (P<0.05) was considered as statistically significant). In each group, 72 patients were treated. The ovulation rate in group 2 was meaningfully higher than that in group 1 (P<0.05). The pregnancy rate in the patients who had ovulation in both groups was similar. But pregnancy rate in patients who received clomiphene citrate was higher. There was no significant difference between the 2 groups in terms of endometrial thickness, pattern and the side effect of treatment. The patients’ conditions in 2 groups were similar in terms of BMI, age, the duration of infertility and ovarian volume. The results of this study show that using TMX as the first treatment for ovulation induction is not effective and suitable.

Polycystic ovary syndrome (PCOS) is one of the most common hormonal problems among women in the age of fertility that causes infertility via stopping ovulation. Prescribing calcium with clomiphene may greatly impact induction ovulation and follicles growth. Thus، this study was conducted aimed on investigating the effect of Calcium-vitamin D in efficacy of induction ovulation in infertile women with PCOS.

This randomized controlled trial was conducted on 44 infertile women with PCOS in years 2010-2011. Patients were divided into two groups (22 Intervention and 22 controls) using block randomization method. Intervention group received a daily dose of 50 mg clomiphene tablet with 400 units of vitamin D3 and 1000 mg calcium and control group received a daily dose of 50 mg clomiphene tablet with placebo. In order to measure follicles size، patients underwent sonography during three menstruation cycles، each time at 13th day of menstruation. Data were analyzed using SPSS software version 11. 5 and Chi square، Fisher، Mann-Whitney and repeated measures ANOVA Tests. P less than 0. 05 was considered statistically significant.

No significant statistical different was observed in trend of changes in follicle size in two groups (p=0. 1). However، the median and mean of follicles size in intervention group was higher than control group in first، second and third months (p<0. 05). There was also no significant statistical difference between the first and second months regarding the size of follicles (p=0. 82); but the size of follicles in third month was significantly different from second month (p=0. 01).

Adding 400 units of vitamin D3 and 1000 mg calcium to normal clomiphene dosage may increase the size of follicles that its effect is especially more significant after the second post-treatment menstruation.

Letrozole has fewer side effects than clomiphene citrate; this drug may be a replacement for clomiphene citrate in induction of ovulation. The aim of this study was to investigate the efficacy of letrozole in ovarian stimulation in infertile women with ovulatory disorders infertility. Infertile women with ovulatory disorders hospitalized in Imam Khomeini Hospital in Sary were randomly and double-blind assigned in a 1:1---------------7db11f3a101c6 Content-Disposition: form-data; name="f_lastNameL[3]"

Clomiphen citrate is the first choice to induce ovulation in patients with infertility. In resistant cases, an alternative such as tamoxifen is administered. To investigate the effect of tamoxifen on endometrial thickness and ovulation rate of infertile women with poor response to clomiphen citrate. This was a clinical trial performed at Kosar hospital, affiliated to Qazvin University of Medical Sciences, in 2007. Thirty four infertile women who were treated by a maximum of 150mg clomiphen citrate for 5 days but still with endometrial thickness below 7mm or absence of dominant follicle, considered as resistant cases. The resistant patients were treated with tamoxifen citrate 10 mg for 5 days from 5th to 9th day of menstruation. In case of inadequate response, reflected through the absence of dominant follicle during next periods, the dose of drug was increased to 10-20 mg/day. At the 16th day of menstruation, vaginal sonography was applied to investigate the number and diameter of dominant follicle and endometrial thickness. Data were analyzed using chi-square test and T. test. Using clomiphen citrate, 6 patients with improper endometrial thickness showed a distinct improvement (5±1.8 mm to 12.1±1 mm, P<0.002). Using 30 mg of tamoxifen, 8 patients (23.4%) were found to have dominant follicle (P=0.008) and 2 cases became pregnant. Tamoxifen may be a good alternative for clomiphen resistant patients in whom it improves the endometrial thickness and in the meantime accelerates the development of dominant follicle before treatment with HMG or surgery.

According to side effects of clomiphen citrate (cc), especially on thendometrium, it was replaced with letrozole, an aromatase inhibitor, for induction of ovulation. In this study, effects of these drugs on ovulation and fertility were compared in patients with polycystic ovarian (PCO) syndrome. In a randomized clinical trial, women with PCO and history of infertility referred to gynecology clinic of Rasoul Akram hospital and private office between 2007 and 2008 were studied. Subjects were randomly assigned to two groups of clomiphen citrate and letrozole. In CC group, subjects were received 100 milligram per day clomiphen citrate between 3rd and 7th day of each cycle for 3 cycles. In letrozole group, women treated with letrozole 2.5 mg daily between 3 and 7 day of each for 3 cycles. Number of follicles in days of 12-16 of cycle, diameter of the greatest one, pregnancy and outcome of pregnancy were compared in two groups. 40 patients in each group were studied. Numbers of follicles, mean diameter of the greatest one were not significantly different in two groups. Pregnancy was occurred in 15 patients (37.5%) of letrozole group Vs 13 patients (32.5%) of CC group. There was no abortion in letrozole group Vs 3 abortion in CC group. Preterm labor was significantly lower in letrozole treated patients (p= 0.04). This study showed that letrozole could be proper substitution of clomiphen citrate for induction of ovulation in patients with PCO and infertility.

Although clomiphene citrate is the first line in ovulation induction in anovulatory infertile women, but some of polycystic ovarian syndrome (PCOS) patients are clomiphene-resistant. This study was carried out to compare the combined effect of letrozole and clomiphene with gonadotropins on pregnancy rate in clomiphene-resistant PCOS patients. This clinical trial study was carried out on 120 clomiphene-resistant PCOS patients. The patients were randomly divided into two groups: group 1 received clomiphene (100 mg/day) and group 2 received letrozole (5 mg/day) on the 3–7 th days of menstrual cycle. Both groups received (150 IU/im) HMG on the 5–8 th days of menstrual cycle. On 10-11 th days of menstrual cycle, transvaginal sonography was performed to determine endometrial thickness, dominant follicle number and increase HMG dose, if required. HCG at a dose of 5000 IU was administered when at least one mature follicle was observed. β-HCG level was evaluated 2 weeks after HCG administration. The two groups were compared for mature follicles numbers, endometrial thickness, gonadotropin consumption and pregnancy rate. Chi–square, Kolomogrov–Smirnov, t-test, Levene, Mann-Whitney tests were used to analyze data. Although the pregnancy rate in letrozole group was higher than in the clomiphene one, the difference was not significant (36.7% vs 33.3%, P=0.702). The mean endometrial thickness in letrozole and clomiphene group was 7.47 mm and 7.49 mm, respectively (P=0.685). In letrozole and clomiphene group the mean of dominant follicles numbers was 2.18 and 2.83, respectively (P=0.087) while the gonadotropin level mean in both groups was 6.78 (p=0.941). In clomiphene resistant PCOS patients, similar to clomiphene, letrozole in combined regimens with gonadotropin can be effective for the induction of ovulation.

Clomiphene Citrate has been one of the effective medications in the treatment of infertility but it has undesirable side effects, such as flushing, decreased cervical mucus production, impaired postcoital test (PCT) and multiple pregnancies. Letrozole is a newer drug and it improves cervical mucus production, increases endometrial thickness and reduces the risk for multiple pregnancies. Comparing the efficacy of clomiphene citrate versus letrozole for ovulation induction in patients with Polycystic Ovarian Disease (PCOD) was the objective of this study. This clinical trial study was done on 100 infertile, 20-35 year-old women with PCOD attending Vali-e-Asr Infertility Clinic from April 2003 to April 2007. The cases were candidates for intrauterine insemination (IUI) and signed a consent form to participate in the study. The cases were assigned to two groups through simple random sampling, the first group receiving clomiphen citrate plus HMG and the second one Letrozole plus HMG. Endometrial thickness, number of mature follicles, pregnancy rates, history of abortion and multiple pregnancies were recorded and compared in the two groups. Comparing the two groups, the number of mature follicles (p=0.000), the risk for ovarian hyperstimulation (40% versus 14%, p=0.003) and abortions rates (37.5% versus 11.11%, p=0.048) were significantly higher in the clomiphene group. Differences in endometrial thickness and pregnancy rates (eight subjects in the clomiphene versus nine in the letrozole group) were of no statistical significance in the two groups. It seems that letrozole is a good substitute for clomiphene citrate, especially in patients at risk of abortion or ovarian hyperstimulation syndrome (OHSS), or in those who cannot tolerate clomiphene citrate. Further studies are needed to be done to fully suggest letrozole as the first line treatment for controlled ovarian hyperstimulation syndrome.

Clomiphene is an effective and cheap drug in induction of ovulation or super ovulation in infertile women. Although it induced ovulation in 80-90% of cases, pregnancy rate is 30-40% due to anti Estrogenic effect on endometrial and mucosal cervix. The goal of this research is to evaluate the inhibition of antiestrogenic effect of clomiphene citrate by using of ethinyl estradiol. A double blind clinical trial was performed in 62 infertile patients. They were 20-35 years old and 3 months before treatment they didn’t used any drugs for their infertility. They had BMI < 30 and in normal range of FSH, LH, TSH, PRL and testosterone on the third days of menstrual cycle. They were randomly divided into two groups A and B. Group A received 100 mg/day clomiphene citrate in the 5th day of menstrual cycle for 5 days and 0.05 mg/day ethinyl estradiol for 5 days from 8th day of menstrual cycle. Group B received only clomiphene citrate 100 mg/day in the 5th day of menstrual cycle for 5 days. Patients whom have follicles growth of greater than 18 mm have prescribed 10,000 HCG and 36 hours later IUI was performed for all patients. Our results show that pregnancy rate in patients who received clomiphene citrate plus ethinyl estradiol was higher than patients who received only clomiphene citrate, 14.3% versus 9.7%, respectively. This difference is not significant. Mean size of dominant follicles in groups A was less than group B (p=0.0001) and cancellation rate was higher in group A (p=0.005). Endometrial thickness and appearance in two groups was similar. Although ethinyl estradiol could not either increased endometrial thickness or improved endometrial appearance. It could not also decrease follicular growth rate that to our best knowledge was not reported previously. But it could increase pregnancy rate from 9.7% to 14.3%. Although this differences is not significant (p=69%) it is important from clinical point. This difference may be due to differences in etiology of infertility between two groups or other causes. More studies are needed in future.

Background and Clomiphene is the most common drug for the male idiopathic infertility treatment with different results and no valuable factor ha been suggested for prediction of treatment. Therefore the present study was designed to investigate the relationship between early morning total Serum Testosterone Level (STL) before treatment and post-clomiphene changes in the spermogram. Methods and Materials: This clinical trial study was conducted on 172 idiopathic infertile men from 2001 to 2006 in Mashad Iran. Demographic and spermogram data were recorded via questionnaires and patients were divided into 6 groups by their pre-treatment STL. Spermogram parameter changes before and after clomiphene therapy were analysed with SPSS software using t-test ANOVA and Fisher’s test. Mean age of patients was 31 years; and mean Serum Testosterone Level was 361.3ng/dl. After prescribing clomiphene recovery was observed in the spermogram of in 125 patients (72.7%) with Total Serum Testosterone Level of 200-500ng/dl (P£0.031). Early morning Serum Testosterone Level can be used as a criterion for predicting the efficacy of clomiphene in male idiopathic infertility.

Polycystic ovary syndrome is one of the most common endocrine disorders which can cause oligoovulation and anovulation in infertile women. Treatment of PCOS at first step is medical and in resistant cases surgery by laparoscope and electro-cauterization of the ovaries will be considered. The aim of this study was to evaluate the effect of laparoscopic cauterization of ovaries on ovulation, pregnancy, ovarian response to induction of ovulation and menstrual regulation. In a semi-experimental- (before and after study), cauterization of the ovaries by laparoscope was done in 44 PCOS patients who were resistant to medical treatment. Ovulation, pregnancy and menstrual regulation were evaluated in these patients in a period of 3 months. Then pregnancy rate, ovulation and regularity of menses were evaluated before and after cauterization. Sampling method was census and data were analyzed by paired T-test, Wilcoxon, and Fischer`s exact test using SPSS soft ware. 44 patients aged from 18 to 36 with unsuccessful medical induction of ovulation and irregular menses were selected for the study. After cauterization of the ovaries, ovulation was evident in 32 (%72) and 15 (%34.09) of them became pregnant, with twin pregnancy in 3 cases. Ovarian hyperstimulation syndrome was not occurred in the patients. In spite of different results of different studies, our study revealed that the response of ovaries to medical treatment and also pregnancy outcome would be better after laparoscopic cauterization of the ovaries and this effect is better when combination of HMG and clomiphen citrate is used. Pregnancy and regulation of menses after cauterization had no relation to age and cause of infertility.

Background and Çhronic annovulation is a common cause of infertility in women and polycystic ovarian syndrome (PÇÔS) is the most common cause of anovulation. Ôvulation induction with clomiphene is the first line of therapy in pcos. 20-22% of the patients may be resistant to clomiphene. The objective of this study was to assess the ovulation and pregnancy rates with tamoxifen in clomiphene resistant PÇÔS patients. This is a descriptive study on 100 patients with PÇÔS and resistance to clomiphene reffered to infertility clinic of Ïmam Hospital in Sari, Ïran. patients were given tamoxifen 40 mg/d from the third to seventh day of the cycle. Treatment was monitored by serial vaginal sonography. hÇG was administered 10/000 unit ÏM when 1-3 follicles were >18mm. Ôvulation rate based on (midluteal progesteron level>3ng/ml) and clinical pregnancy rate were assessd. The ovulation rate was 27%. gestational sac was seen in 18 patients (18%). The study showed that endometrial thickness was 10.72 mm in pregnant versus 8/16 mm in nonpregnant subjeots with significant differences (p<0/05). The number of dominant follicles >16mm were 3/4 in pregnant versus 2.7 in nonpregnant (p<0/05) with significant differences. Çonclusion: This study showed that tamoxifen is usefull in inducting ovulation and pregnancy in clomiphene-resistant PÇÔS patients by increasing the endometrial thickness and dominant follicle due to estrogen agonist effect.

There are many methods for treatment of patients with unexplained infertility. The easiest method is induction of ovulation and the most commonly used drug for induction of ovulation is Clomiphen Citrate.

This study was carried out to compare the efficacy of different methods of Clomiphen Citrate administration for induction of ovulation.

This is a randomized clinical trial performed on 60 cases with unexplained infertility in Mirzakoochakkhan Hospital of Tehran from September 23, 2001 to March 20, 2003. Patients were divided into three groups with 20 cases in each group. All three groups were treated with Clomiphen Citrate 100 mg/d. In group A, 100 mg of Clomiphen Citrate was given for the first 5 days of the cycle and in group B on days 3-7 and in group C on days 5-9.

The results showed no significant differences in age, parity, duration of infertility, weight or endometrial pattern in the three groups. The mean follicles number in group A was 2± 0.85, in group B 2.25± 0.9 and in group C 1.1± 0.8. There was signiticant difference between three groups. We observed 2 pregnancy cases in group A, 4 pregnancies in group B and 1 pregnancy in group C. No differences in the mean serum progestrone levels in mid – luteal phase were detected between the three groups.

Considering the results obtained, it appears that administration of Clomiphen Citrate on days 3-7 exert the best impact on the folicle number and pregnancy rate.