Factors associated with pregnancy or miscarriage after clomiphene therapy in WHO group II anovulatory women.
OBJECTIVE
The present study was designed to determine whether clinical and endocrine characteristics assessed on initial screening of normogonadotropic oligo/amenorrhoeic infertile patients could predict ovulation and then conception and successful live birth or miscarriage.


METHODS
Retrospective cohort study


METHODS
Outpatient clinic.


METHODS
Eighty-two consecutive women receiving clomiphene citrate (CC) therapy from 1993 to 1998.


RESULTS
A cumulative conception rate of 67% was reached after six or more CC-induced cycles. Patients with failure of ovulation after a full course of CC had more severe oligomenorrhoea (p < 0.001) and greater BMI (p < 0.05) at initial screening. There was no relationship with levels of LH or androgens. In contrast, among women who ovulated in response to CC, conception was associated with less frequent periods, and higher basal levels of LH, free testosterone and androstenedione. Conceptions with subsequent miscarriage were associated with intermediate levels of LH and numbers of spontaneous periods between non-conception and live births.


CONCLUSIONS
These observations are consistent with the hypothesis that failure of ovulation after CC is related to different factors (overweight and severe oligomenorrhoea) from those that predispose to non-conception (low basal LH and androgen levels and mild oligomenorrhoea).
Milsom
Stella R
SR
Department of Reproductive Medicine, National Women's Hospital, University of Auckland, New Zealand.
Gibson
Gillian
G
Buckingham
Karen
K
Gunn
Alistair J
AJ
D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D000568:Amenorrhea / Q000188:drug therapy / Q000503:physiopathology; D000858:Anovulation / Q000188:drug therapy* / Q000503:physiopathology; D016009:Chi-Square Distribution; D002996:Clomiphene / Q000008:administration & dosage* / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000188:drug therapy; D009520:New Zealand; D009839:Oligomenorrhea / Q000188:drug therapy; D010062:Ovulation Induction / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D005300:Fertility Agents, Female; D002996:Clomiphene