Volume 2, Issue 2 (7-2004)                   IJRM 2004, 2(2): 74-77 | Back to browse issues page

XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ghafourzadeh M, Karimi M, Karimazadeh M A, Bokai M. Comparison between Two Methods of Ovulation Induction: Clomiphene alone and Clomiphene +Tamoxifen in PCOS Patients. IJRM 2004; 2 (2) :74-77
URL: http://ijrm.ir/article-1-19-en.html
Abstract:   (3490 Views)
Background: Infertility affects about 10-15% of reproductive-age couples. About half the causes of infertility are female related and approximately 40% of the cases are caused by anovulation, mostly in PCO women. Objective: This study was conducted to determine and compare the effects of two drug treatment regimens: higher dose of clomiphene and a combination of lower dose of clomiphene and tamoxifen in treating infertile women with PCO. Materials and Methods: The study was a randomized clinical trial conducted on 100 infertile patients who referred to Yazd-Iran Infertility Clinic between the years 2001-2003. The patients were selected who had received at least 3 periods of clomiphene, but no pregnancy had occurred. They were randomly divided into two groups. In the first group, clomiphene was increased to 100 mg and the second group 20 mg of tamoxifen was added to 50 mg of clomiphene from day 5-9 of menstruation cycle. Infertility duration, duration of medicine used, PCT score, endometrial thickness, ovulation, and pregnancy rate were studied in both groups. Results: Ovulation rate in clomiphene group was 54.9%; Tamoxifen + clomiphene group was 73.5% without significant differences in both groups. (PV = 0.053). Positive pregnancy rate in clomiphene group was 39.2%; clomiphene + tamoxifen group was 61.2% (P value < 0.05), which could be concluded that pregnancy rate was higher in clomiphene/tamoxifen group than in the clomiphene group. The presence of a dominant follicle in the two treatment groups in women between 18-24 was not significant, but in women between 25-39 years was significant (PV= 0.049) (Table III). Conclusion: The recommendation is to add Tamoxifen to Clomiphene in 35-39 women with 20? BMI ?26.99 before the use of gonadotropins treatment in PCOS with or without IUI, because these options have higher risk of multiple pregnancy and ovarian hyperstimulation syndrome. Article
Full-Text [PDF 140 kb]   (572 Downloads) |   |   Full-Text (HTML)  (402 Views)  
Type of Study: Original Article |

References
1. Borenstein R., Shoham Z., Yemini M., Barosh A., Fienstein M., Rozenman D. (2001) Tamoxifen treatment in women with failure of clomiphene citrate therapy. Aus N Z J Obstet Gynecol, 29(2): 173-5. [DOI:10.1111/j.1479-828X.1989.tb01711.x] [PMID]
2. Buckley M.M., and Goo K.L. (2000) Tamoxifen, Areappraisel of its Pharmacodynamic and pharmacokinetic propertics, and therapeutic use. Drugs 37(4): 451-9. [DOI:10.2165/00003495-198937040-00004] [PMID]
3. Buvat J., Buvat - Herbout M., Marcolin G. (2001) Ardaens Boulierk. Antiestrogens as treatment of female and male infertilities. Horm Res 28(2-4) : 219-29. [DOI:10.1159/000180947] [PMID]
4. ESHRE. (1999) Female infertility: Treatment options for complicated cases. The ESHRE capri workshop. Hum Reprod 12: 1191-6. [DOI:10.1093/humrep/12.6.1191] [PMID]
5. Fox R., Corrigan E., Thomas P.A., Hull M.G.R. (2000) the diagnosis of polycystic ovarian in women with menstrual disorder. Fertil Steril 66: 761-4.
6. Franks S. (2001) Medical progress article: Polycytic ovary syndrome. N Eng J Med 333: 853-61. [DOI:10.1056/NEJM199509283331307] [PMID]
7. Fukushima J., Tajimue C., Fuknma K., Maejama M. (2001) Tamoxifen in the treatment of infertility associated with luteal phase deficiency. Fertile Steril 37(6) 755-61. [DOI:10.1016/S0015-0282(16)46334-X]
8. Goldziehev J.W., Axelrod L.R. (1998) Clinical and biochemical features of polycystic ovarian disease. Fertil Steril 14: 631-53. [DOI:10.1016/S0015-0282(16)35047-6]
9. Hamilton - Fairley D., Kiddy D., Watson H., Paterson C., Franks S. (1999) Association of moderate obesity with poor pregnancy outcome in women with polycystic ovary syndrome. Br J Obstet Gynaecol 99 : 128 -31. [DOI:10.1111/j.1471-0528.1992.tb14470.x] [PMID]
10. Hull M.G.R. (1999) Epidemiology of infertility and polycystic ovarian disease: Endocrinological and demographic studies. Gynecol Endocrinol 235: 45.
11. Hull M.G.R. (1999) Epidemiology of infertility and polycystic ovarian disease: Endocrinological and demographic studies. Gynecol Endocrinol 1: 235: 45. [DOI:10.3109/09513598709023610] [PMID]
12. Jonathan S. (2002) Berek. Novak's textbook of gynecology. Williams & Wilkins 25: 840-852.
13. Jonicke F., Estofen D., Boos H., Bottger I. (2000) Endocrine fertility - restricting factors in clomiphene therapy. Ceburtshilf franenhalked 46(4) : 228-33.
14. Leon Speroff. (1999) Clinical Gyneacologic Endocrinology and Infertility. Lippinicon Williams & Wilkins12: 490.
15. Messini I.E., Nillius S.J. (1998) Compersion between tamoxifen and clomiphene for induction ovulation . Acta obstet Gynecol Scand 61(4): 377-9.
16. Nicholas S., Macklon. (2000) Optimizing protocols for ovulation induction.Female infertility therapy. MARTIN DUNITZ 7:76.
17. Robert Boostnfar M.D., John K. Jain M.D. (2001) A prospective randomized trial comparing clomiphen citrate with Tamoxifen Citrate for ovulation induction. Fertility and Sterility 75:(5) 1024-1026. [DOI:10.1016/S0015-0282(01)01749-6]
18. Shoham Z., Borenstein R., Lunenfeld B., Pariente C. (1999) Hormonal profiles following clomiphene citrate therapy in conception and nonconception cycles. Clin Endocrinol 33: 271-8. [DOI:10.1111/j.1365-2265.1990.tb00491.x] [PMID]
19. Tajima C. (1996) Endocrine profile in tamoxifen , Induced conception cycle. Fertil Steril 42(4): 548-53. [DOI:10.1016/S0015-0282(16)48137-9]
20. Tajima C. (1997) Tamoxifen in the treatment of infertile patiants associated with in adequate luteal phase. Fertile Steril 41(3): 470-72. [DOI:10.1016/S0015-0282(16)47730-7]
21. Tsuiki A., Uchara S., Kyono K., Satio A., Hoshi K. (1998) Induction of ovulation with an estrogen antagonist Tamoxifen. Tohoku J Exp Med 144(1): 21-23. [DOI:10.1620/tjem.144.21] [PMID]
22. WU.C.H. (1997) Less Miscarriage in pregnancy following tamoxifen treatment of infertile patients with luteal phase dysfunction as compared to clomiphene treatment. Early pregnancy 3(4): 301-5.

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb