A clomiphene citrate and tamoxifen citrate combination therapy: a novel therapy for ovulation induction.
OBJECTIVE
To assess the efficacy of a clomiphene citrate (CC) and tamoxifen citrate (CC/tamoxifen) combination therapy in ovulation induction by comparing with a CC alone therapy.


METHODS
A randomized cross-over study with CC alone and CC/tamoxifen combination therapies for 20 normoprolactinemic anovulatory women. Randomly selected 10 of the 20 women (group A) underwent a CC alone therapy (100 mg CC during cycle days 5 to 9) for the initial three consecutive treatment cycles and a CC/tamoxifen combination therapy (50 mg CC and 20 mg tamoxifen during cycle days 5 to 9) for the subsequent three consecutive treatment cycles. The remaining 10 (group B) were treated similarly but with the inverse sequence. Ovulation was documented when a high BBT phase persisted for 11 days or more, when midluteal serum P levels exceeded 7 ng/mL (22.3 nmol/L), or when pregnancy ensued.


RESULTS
The rates of ovulatory/treated, pregnant/treated, and pregnant/ovulatory cycles were 42 of 56 (75.0%), 3 of 47 (6.4%), and 3 of 35 (8.6%) for CC/tamoxifen, respectively. Those were 25 of 57 (43.9%), 1 of 48 (2.1%), and 1 of 21 (4.8%) for CC, respectively. Clomiphene citrate/tamoxifen was more effective in ovulation induction than CC. All the pregnancies were normal and single. None of the treatments was accompanied by any remarkable side effects.


CONCLUSIONS
Clomiphene citrate/tamoxifen is a novel treatment modality of ovulation induction with high efficacy.
Suginami
H
H
Department of Obstetrics and Gynecology, Ehime University School of Medicine, Japan.
Kitagawa
H
H
Nakahashi
N
N
Yano
K
K
Matsubara
K
K
D000328:Adult; D000728:Androgens / Q000097:blood; D000858:Anovulation / Q000097:blood / Q000188:drug therapy*; D002996:Clomiphene / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D010062:Ovulation Induction; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D013629:Tamoxifen / Q000627:therapeutic use*
D000728:Androgens; D004967:Estrogens; D013629:Tamoxifen; D002996:Clomiphene; D011374:Progesterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone