Recurrent partial hydatidiform mole, with a first twin pregnancy, after treatment with clomiphene citrate.
We present a patient, treated for 3 months with clomiphen citrate after 5 years of infertility. This treatment resulted in a twin pregnancy, one degenerated into a partial hydatidiform mole and the other into a very early embryo death. The karyotype was a mosaic one: 63% of metaphases showed triploidy - 69 XXX and 37% diploidy - 46 XX. Despite all medical advice, she returned 8 months later with a new pregnancy, which proved to be a new partial hydatidiform mole, this time a single one. Karyotype was, also, a triploidy - 69 XXX. The genetic map of both genitors was performed, showing no aberrations. Unfortunately, the patient came back, once again, 5 months later, with a new positive pregnancy test. Ultrasonography revealed a new very early embryo death, the histopathological analysis establishing to be a single 'pure' stop in evolution of the pregnancy. As all the three pregnancies obtained after treatment with clomiphene were abnormal, two being partial hydatidiform moles and one being a premature miscarriage, without any genetic aberrations of the genitors, it seems very possible that clomiphene, apart from improving fertility, also increases the risk of abnormal ovum appearance.
Tica
Andrei Adrian
AA
Department of Pharmacology, University of Medicine and Pharmacy Craiova, Craiova, Dolj, Romania. ticaandrei2002@yahoo.com
Tica
Oana Sorina
OS
Georgescu
Claudia Valentina
CV
Mixich
Francisc
F
Tica
Vlad Justin
VJ
Berceanu
Sabina
S
Ebanca
Elena
E
Patrascu
Anca
A
Simionescu
Cristina
C
D000022:Abortion, Spontaneous / Q000139:chemically induced; D000328:Adult; D002996:Clomiphene / Q000009:adverse effects* / Q000627:therapeutic use; D020964:Embryo Loss / Q000139:chemically induced; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006828:Hydatidiform Mole / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D007247:Infertility, Female / Q000188:drug therapy; D007621:Karyotyping; D018311:Luteoma / Q000000981:diagnostic imaging; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012008:Recurrence; D014427:Twins; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000139:chemically induced* / Q000150:complications / Q000473:pathology
D005300:Fertility Agents, Female; D002996:Clomiphene