title: Recurrent partial hydatidiform mole, with a first twin pregnancy, after treatment with clomiphene citrate.
abstract: 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.
authors.affiliation: Department of Pharmacology, University of Medicine and Pharmacy Craiova, Craiova, Dolj, Romania. ticaandrei2002@yahoo.com
authors.forename: Andrei Adrian
authors.initials: AA
authors.lastname: Tica
authors.forename: Oana Sorina
authors.initials: OS
authors.lastname: Tica
authors.forename: Claudia Valentina
authors.initials: CV
authors.lastname: Georgescu
authors.forename: Francisc
authors.initials: F
authors.lastname: Mixich
authors.forename: Vlad Justin
authors.initials: VJ
authors.lastname: Tica
authors.forename: Sabina
authors.initials: S
authors.lastname: Berceanu
authors.forename: Elena
authors.initials: E
authors.lastname: Ebanca
authors.forename: Anca
authors.initials: A
authors.lastname: Patrascu
authors.forename: Cristina
authors.initials: C
authors.lastname: Simionescu
mesh_terms: 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
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene