Effect of Initiation Day of Clomiphene Citrate Treatment On Endometrium and Cervical Mucus

Berna Seçkin; Hulusi Bülent Zeyneloğlu; Sertaç Batıoğlu; Oya Gökmen

Effect of Initiation Day of Clomiphene Citrate Treatment On Endometrium and Cervical Mucus

Year 2016, Issue: 1, 38 - 43, 01.03.2016

Berna Seçkin Hulusi Bülent Zeyneloğlu Sertaç Batıoğlu Oya Gökmen

Abstract

Objective: To compare the antiestrogenic effects of clomiphene citrate CC on reproductive end organs in patients where CC was started on different days of the cycle. Patients and Methods: A total of 95 patients who underwent ovulation induction with CC were initially included in this prospective randomized controlled study. Patients were divided into two treatment groups: in day 3 group n=52 , CC was given from day 3 to 7 of the cycle for five days, whereas in day 5 group n=43 , CC was given on days 5 to 9. The antiestrogenic effects of CC in terms of endometrial thickness and cervical mucus quality, cycle characteristics, and treatment outcomes were assessed. To observe possible differences in antiestrogenic effects, only data from ovulatory cycles were analyzed. Results: Fourty-four patients in the day 3 group and 34 patients in the day 5 group were analyzed. Endometrial thickness was similar in both groups on the day of human chorionic gonadotropin hCG . In the day 3 group, the mean cervical mucus score was lower 8.1±2.7 vs. 9.7±2.3, p=0.036 . There were no significant differences between the groups in the mean serum estradiol E2 , progesterone levels, and the number of leading follicles on the day of hCG, and ovulation and pregnancy rates per cycle. Conclusion: Endometrial thickness does not differ whether starting CC on day 3 or 5 of the cycle. Nevertheless, poor cervical mucus quality may be more common in the patients where CC was started on day 3 of the cycle compared to day 5.

Keywords

clomiphene citrate, cervical mucus, endometrial thickness, initiation day

References

Adashi EY. Clomiphene citrate: mechanism(s) and site(s) of action--a hypothesis revisited. Fertil Steril. 1984;42:331-44.
Fritz M, Speroff L. Clinical Gyneocology endocrinology and infertility. 8th ed. PhiladelphiaL. Lippincott Williams & Wilkins. 2011:1296-1306.
Homburg R. Clomiphene citrate-end of an era? A mini-review. Hum Reprod. (Oxford, England) 2005;20:2043-51.
Nelson LM, Hershlag A, Kurl RS, Hall JL, Stillman RJ. Clomiphene citrate directly impairs endometrial receptivity in the Mouse. Fertil Steril. 1990;53:727-31.
Fritz MA, Holmes RT, Keenan EJ. Effect of clomiphene citrate treatment on endometrial estrogen and progesterone receptor induction in women. Am J Obstet Gynecol. 1991;165:177-85.
Randall JM, Templeton A. Cervical mucus score and in vitro sperm mucus interaction in spontaneous and clomiphene citrate cycles. Fertil Steril. 1991;56:465-8.
Tepper R, Lunenfeld B, Shalev J, Ovadia J, Blankstein J. The effect of clomiphene citrate and tamoxifen on the cervical mucus. Acta Obstet Gynecol Scand. 1988;67:311-4.
Triwitayakorn A, Suwajanakorn S, Triratanachat S, Sampatanukul P, Pruksananonda K, Sereepapong W. Effects of initiation day of clomiphene citrate on the endometrium of women with regular menstrual cycles. Fertil Steril. 2002;78:102-7.
Biljan MM, Mahutte NG, Tulandi T, Tan SL. Prospective randomized double-blind trial of the correlation between time of administration and antiestrogenic effects of clomiphene citrate on reproductive end organs. Fertil Steril. 1999;71:633-8.
Kelekçi S, Saygili-Yilmaz E, Inan I, Eminsoy G. A trial of a new regimen with clomiphene citrate administration to reduce the antiestrogenic effects on reproductive end organs. Eur J Obstet Gynecol Reprod Biol. 2004;116:54-7.
Wu CH, Winkel CA. The effect of therapy initiation day on clomiphene citrate therapy Fertil Steril. 1989;52:564-8.
Hosie MJ, Murphy CR. A scanning and light microscope study comparing the effects of clomiphene citrate, estradiol 17-beta and progesterone on the structure of uterine luminal epithelial cells. Eur J Morphol. 1995;33:39-50.
Takasaki A, Tamura H, Taketani T, Shimamura K, Morioka H, Sugino N. A pilot study to prevent a thin endometrium in patients undergoing clomiphene citrate treatment. J Ovarian Res. 2013 27;6:94.
Marrs RP, Vargyas JM, Shangold GM, Yee B. The effect of time of initiation of clomiphene citrate on multiple follicle development for human in vitro fertilization and embryo replacement procedures. Fertil Steril. 1984;41:682-5.
Insler V, Melmed H, Eichenbrenner I, Serr DM, Lunenfeld B. The cervical score. A simple semiquantitative method for monitoring of the menstruel cycle. Int J Gynaecol Obstet. 1972;10:223-8.
Mikkelson TJ, Kroboth PD, Cameron WJ, Dittert LW, Chungi V, Manberg PJ. Single-dose pharmacokinetics of clomiphene citrate in normal volunteers. Fertil Steril. 1986;46:392-6.
Bonhoff AJ, Naether OG, Johannisson E. Effects of clomiphene citrate stimulation on endometrial structure in infertile women. Hum Reprod. 1996;11:844-9.
Gelety TJ, Buyalos RP. The effect of clomiphene citrate and menopausal gonadotropins on cervical mucus in ovulatory cycles. Fertil Steril. 1993;60:471-6.
Asaad M, Abdulla U, Hipkin L, Diver M. The effect of clomiphene citrate treatment on cervical mucus and plasma estradiol and progesterone levels. Fertil Steril. 1993;59:539-43.
Bateman BG, Nunley WC Jr, Kolp LA. Exogenous estrogen therapy for treatment of clomiphene citrate-induced cervical mucus abnormalities: is it effective? Fertil Steril. 1990;54:577-9.

KLOMİFEN SİTRAT TEDAVİ BAŞLANGIÇ GÜNÜNÜN ENDOMETRİUM VE SERVİKAL MUKUSA ETKİSİ

Year 2016, Issue: 1, 38 - 43, 01.03.2016

Berna Seçkin Hulusi Bülent Zeyneloğlu Sertaç Batıoğlu Oya Gökmen

Abstract

Amaç: Siklusun farklı günlerinde klomifen sitrat CC tedavisi başlanan hastalarda, klomifen sitratın reprodüktif organlardaki antiöstrojenik etkisini kıyaslamak

Keywords

klomifen sitrat, servikal mukus, endometrial kalınlık, başlangıç günü

References

Adashi EY. Clomiphene citrate: mechanism(s) and site(s) of action--a hypothesis revisited. Fertil Steril. 1984;42:331-44.
Fritz M, Speroff L. Clinical Gyneocology endocrinology and infertility. 8th ed. PhiladelphiaL. Lippincott Williams & Wilkins. 2011:1296-1306.
Homburg R. Clomiphene citrate-end of an era? A mini-review. Hum Reprod. (Oxford, England) 2005;20:2043-51.
Nelson LM, Hershlag A, Kurl RS, Hall JL, Stillman RJ. Clomiphene citrate directly impairs endometrial receptivity in the Mouse. Fertil Steril. 1990;53:727-31.
Fritz MA, Holmes RT, Keenan EJ. Effect of clomiphene citrate treatment on endometrial estrogen and progesterone receptor induction in women. Am J Obstet Gynecol. 1991;165:177-85.
Randall JM, Templeton A. Cervical mucus score and in vitro sperm mucus interaction in spontaneous and clomiphene citrate cycles. Fertil Steril. 1991;56:465-8.
Tepper R, Lunenfeld B, Shalev J, Ovadia J, Blankstein J. The effect of clomiphene citrate and tamoxifen on the cervical mucus. Acta Obstet Gynecol Scand. 1988;67:311-4.
Triwitayakorn A, Suwajanakorn S, Triratanachat S, Sampatanukul P, Pruksananonda K, Sereepapong W. Effects of initiation day of clomiphene citrate on the endometrium of women with regular menstrual cycles. Fertil Steril. 2002;78:102-7.
Biljan MM, Mahutte NG, Tulandi T, Tan SL. Prospective randomized double-blind trial of the correlation between time of administration and antiestrogenic effects of clomiphene citrate on reproductive end organs. Fertil Steril. 1999;71:633-8.
Kelekçi S, Saygili-Yilmaz E, Inan I, Eminsoy G. A trial of a new regimen with clomiphene citrate administration to reduce the antiestrogenic effects on reproductive end organs. Eur J Obstet Gynecol Reprod Biol. 2004;116:54-7.
Wu CH, Winkel CA. The effect of therapy initiation day on clomiphene citrate therapy Fertil Steril. 1989;52:564-8.
Hosie MJ, Murphy CR. A scanning and light microscope study comparing the effects of clomiphene citrate, estradiol 17-beta and progesterone on the structure of uterine luminal epithelial cells. Eur J Morphol. 1995;33:39-50.
Takasaki A, Tamura H, Taketani T, Shimamura K, Morioka H, Sugino N. A pilot study to prevent a thin endometrium in patients undergoing clomiphene citrate treatment. J Ovarian Res. 2013 27;6:94.
Marrs RP, Vargyas JM, Shangold GM, Yee B. The effect of time of initiation of clomiphene citrate on multiple follicle development for human in vitro fertilization and embryo replacement procedures. Fertil Steril. 1984;41:682-5.
Insler V, Melmed H, Eichenbrenner I, Serr DM, Lunenfeld B. The cervical score. A simple semiquantitative method for monitoring of the menstruel cycle. Int J Gynaecol Obstet. 1972;10:223-8.
Mikkelson TJ, Kroboth PD, Cameron WJ, Dittert LW, Chungi V, Manberg PJ. Single-dose pharmacokinetics of clomiphene citrate in normal volunteers. Fertil Steril. 1986;46:392-6.
Bonhoff AJ, Naether OG, Johannisson E. Effects of clomiphene citrate stimulation on endometrial structure in infertile women. Hum Reprod. 1996;11:844-9.
Gelety TJ, Buyalos RP. The effect of clomiphene citrate and menopausal gonadotropins on cervical mucus in ovulatory cycles. Fertil Steril. 1993;60:471-6.
Asaad M, Abdulla U, Hipkin L, Diver M. The effect of clomiphene citrate treatment on cervical mucus and plasma estradiol and progesterone levels. Fertil Steril. 1993;59:539-43.
Bateman BG, Nunley WC Jr, Kolp LA. Exogenous estrogen therapy for treatment of clomiphene citrate-induced cervical mucus abnormalities: is it effective? Fertil Steril. 1990;54:577-9.

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Details

Primary Language	English
Journal Section	Research Article
Authors	Berna Seçkin Hulusi Bülent Zeyneloğlu Sertaç Batıoğlu Oya Gökmen
Publication Date	March 1, 2016
Published in Issue	Year 2016Issue: 1

Cite

EndNote	Seçkin B, Zeyneloğlu HB, Batıoğlu S, Gökmen O (March 1, 2016) Effect of Initiation Day of Clomiphene Citrate Treatment On Endometrium and Cervical Mucus. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 1 38–43.