title: Repeated intracyclic clomiphene citrate therapy can be more effective than hMG therapy in inducing ovulation: case report.
abstract: OBJECTIVE
  When clomiphene citrate is ineffective in the treatment of anovulation, hMG administration is typically selected. However, high-dose hMG therapy is associated with a variety of adverse events. We describe the use of a modified clomiphene citrate regimen that was successful in increasing the effectiveness of ovulation induction.
  
  
  METHODS
  A patient who did not initially respond to clomiphene citrate therapy required a total dose of 2400 IU hMG to prodeuce mature follicles. However, because of the physical and emotional burdens on the patient, and the possibility of multiple pregnancy and ovarian hyperstimulation syndrome, re-treatment with clomiphene citrate was then selected. Two courses of clomiphene citrate administered at a fixed interval during the same cycle safely induced ovulation. After initial induction of ovulation, her ovulatory failure improved and natural ovulation occurred.
  
  
  CONCLUSIONS
  Repeated intracycle clomiphene cirate therapy may be more effective than hMG therapy in inducing ovulation in some patients.
authors.affiliation: Department of Obstetrics and Gynecology, Kohseichuo General Hospital, Tokyo, Japan. mkawamura@kohseichuo.jp
authors.forename: M
authors.initials: M
authors.lastname: Kawamura
authors.forename: Y
authors.initials: Y
authors.lastname: Aoki
authors.forename: R
authors.initials: R
authors.lastname: Kanda
authors.forename: H
authors.initials: H
authors.lastname: Nakagomi
authors.forename: Y
authors.initials: Y
authors.lastname: Tsukahara
authors.forename: N
authors.initials: N
authors.lastname: Hashimura
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000150:complications; D000858:Anovulation / Q000150:complications / Q000628:therapy*; D002996:Clomiphene / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D006801:Humans; D008596:Menotropins / Q000008:administration & dosage; D010062:Ovulation Induction / Q000379:methods*
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D008596:Menotropins