Induction of ovulation with an estrogen antagonist, tamoxifen.
Tamoxifen (Norvadex), synthesized by the Imperial Chemical Industries Ltd., is a triphenylethylene derivative having a clomiphene-like structure and displays anti-estrogenic activities. In this study we used tamoxifen for the treatment of anovulatory infertility and investigated the clinical results. Induction rate of ovulation recorded 100% in the patients with sporadic anovulatory cycle, 83.3% in those with persistent anovulatory cycle, 70% in those with the first grade amenorrhea type I and 66.7% in those with the first grade amenorrhea type II. However, tamoxifen was absolutely ineffective against the second grade amenorrhea. The patients with sporadic or persistent anovulatory cycle responded to 40 mg-daily tamoxifen-treatment, recording 100% of ovulatory induction rate. The patients with the first grade amenorrhea also responded to 60 mg-daily treatment, indicating 70% of ovulatory induction rate. The rate of pregnancy established in the women desiring pregnancy marked 15.4%, and 2 out of 4 women with successful pregnancy experienced spontaneous abortion. Out of 4 patients who did not respond to the previous clomiphene treatment, 3 women accomplished ovulatory induction with tamoxifen. The endocrinological dynamics in the tamoxifen treatment were similar to those in the clomiphene treatment.
D000568:Amenorrhea / Q000188:drug therapy; D000858:Anovulation / Q000188:drug therapy; D002582:Cervix Mucus / Q000187:drug effects; D002996:Clomiphene / Q000627:therapeutic use; D003338:Corpus Luteum / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008183:Luteal Phase; D007986:Luteinizing Hormone / Q000097:blood; D010062:Ovulation Induction; D011247:Pregnancy; D013629:Tamoxifen / Q000627:therapeutic use*; D013997:Time Factors
D013629:Tamoxifen; D002996:Clomiphene; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone