300. The Relationship between LH Secretion Pattern and Ovulation Induced Effect of Clomiphene Citrate (CC) in Anovulatory Patients
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Anovulation
Clomifene
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ABSTRACT Clomiphene citrate, 100–200 mg/day for 6–9 days, stimulated the pituitary-Leydig cell axis in 14 normal men as evidenced by an increase in plasma LH and testosterone levels after 2 and 6 days, respectively. After 6 days of clomiphene, LH levels increased by 160% and testosterone levels 80 %. The elevation of plasma testosterone concentration was due to increased testosterone secretion rather than decreased clearance of this steroid from blood. Clomiphene had no effect upon the LH and testosterone levels of men in whom these hormones were suppressed with the synthetic androgen, fluoxymesterone. In men with hypopituitarism clomiphene did not increase plasma LH or stimulate testosterone secretion. Clomiphene stimulates the pituitary-Leydig cell axis in men by inducing LH release. Clomiphene may be useful clinically in the evaluation of the capacity of the anterior pituitary to secrete LH.
Hypothalamic–pituitary–gonadal axis
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Pulsatile flow
Clomifene
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Clomifene
Induced ovulation
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The influence of clomiphene, LH and LH-RH on vaginal cycle and ovarian function in mature rats, which had been exposed to continuous light in order to block the cyclic sexual centre, was examined by different doses. While ovulation was obtained by administration of LH and LH-RH, clomiphene showed no effect. It may be assumed that the central mode of action of the "ovulation inducing effect" of clomiphene is mediated by stimulation of the cyclic sexual centre in the anterior hypothalamus.
Clomifene
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Polycystic ovarian disease
Anovulation
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Abstract. A urinary luteinizing hormone test was utilized to predict ovulation in 99 spontaneous, 122 clomiphene citrate, and 82 human menopausal gonadotropin stimulated cycles. Tests were performed in early morning and evening specimens and follicular development was monitored by daily ultrasonography. A positive detection rate of 98, 97, and 94%, respectively, was obtained. Evidence of luteinized unruptured follicles was seen more frequently in stimulated cycles, concurring with negative test results. In 2 spontaneous, 1 clomiphene citrate and 5 hMG induced cycles two distinct LH surges were detected concomitant with a pattern of follicular atresia and subsequent new follicular development. Most ovulations occurred between 16 and 28 h after LH detection, signficantly earlier in spontaneous than in clomiphene citrate stimulated cycles (p<0.02), whereas pre-ovulatory follicles were larger in the clomiphene citrate group (p<0.001). The mean duration of the follicular and luteal phases, as calculated from the LH peak, was substantially shorter in the hMG cycles than in the other two groups (p<0.001).
Clomifene
Gonadotropin
Menotropins
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The differential diagnosis between hypogonadotropic hypogonadism and delayed puberty is facilitated by comparing the response of gonadotropins to LH-RH stimulation before and after administration of clomiphene citrate 200 mg daily during 7 days. Premedication of clomiphene citrate depresses peak values of LH and FSH on LH-RH in delayed puberty. In hypogonadotropic hypogonadism clomiphene citrate raises LH-RH induced peak LH while FSH does not change.
Delayed puberty
Menotropins
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A patient with anosmic hypogonadotrophism was treated with clomiphene citrate for 32 days. During the treatment period plasma follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were measured daily for 6 days and again at the end of 32 days. A definite increase in the concentration of plasma LH and FSH was shown at the end of the treatment period. This response was equivocal at the end of the first week of therapy. It appears that this patient is capable of synthesizing and releasing LH and FSH after treatment with clomiphene citrate. This response places the defect responsible for his hypogonadotrophic state above the level of the pituitary. It also suggests that long-term clomiphene citrate therapy may be capable of stimulating puberty in this patient as well as others with hypogonadotrophic states in whom clomiphene responsiveness is documented.
Hypogonadotrophic hypogonadism
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Objective To study the effect of clomiphene citrate on the estrogen and progesterone level in ovulation induction. Methods On the first day before ovulation and the 10th day after ovulation, the estrogen and progesterone of 16 infertility women with causes unexplained were measured,both in spontaneous and CC-induced cycles. Results On the first day before ovulation and the 10th day after ovulation,the estrogen and progesterone level in CC cycles were higher than those of the spontaneous cycles(P 0.05). Conclusion Clomiphene therapy can lead to the disorder of estrogen and progesterone level during the course of ovulation induction.
Induced ovulation
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