Clomiphene Citrate Capsules

Clomiphene is a nonsteroidal fertility agent used to induce ovulation in infrequently ovulating or anovulatory women, including patients with polycystic ovary syndrome (PCOS). The drug is effective at producing ovulation in patients with an intact hypothalamic-pituitary-ovarian axis and with ovaries that are capable of functioning normally. Clomiphene is often the first-line agent for these patients due to the relative ease of use and low economic expense. Clomiphene will induce ovulation in 80% of appropriately-chosen patients; roughly 40% will become pregnant within 6 cycles of treatment. Clomiphene is not effective at increasing pregnancy rates in women who spontaneously ovulate on a regular cycle. Clomiphene therapy is associated with only slightly increased rates of multiple births (3—5%) compared to the general population (1%). Multiple gestation, if it occurs, is usually twins. Less than 1% deliver triplets or more. The rate of multiparity with clomiphene as a single-agent is much lower than that which occurs with other fertility agents (e.g., menotropins or FSH). Clomiphene is sometimes used as a diagnostic tool to assess ovarian reserve. It is also administered to regulate the timing of ovulation in those patients receiving donor insemination. Interestingly, clomiphene has been used to increase sperm counts in male patients with idiopathic oligospermia. The FDA first approved clomiphene in 1967.