EFFECTS OF CLOMIPHENE CITRATE ON THE ENDOMETRIAL THICKNESS AND ECHOGENIC PATTERN OF THE ENDOMETRIUM

Objective: To study the effects of clomiphene citrate (CC) on the endo metrium by ultrasound and to reveal the echogenic difference between t he control cycle and the CC cycle. Design: Retrospective study of pati ents before and during a CC treatment. Setting: Department of Obstetri cs and Gynecology, Yamaguchi University School of Medicine, Ube, Yamag uchi, Japan. Patient(s): Seventy-nine infertile women who had a sponta neous ovulation and a normal luteal function. Intervention(s): Patient s received 50 mg/d CC between days 5 and 9 of the menstrual cycle. Mai n Outcome Measure(s): Endometrial thickness, echogenic pattern of the endometrium, serum E(2) content, and E(2) and P receptor contents in t he endometrium. Result(s): Endometrial thickness was significantly thi nner during the CC cycle (7.6 +/- 1.4 mm, mean +/- SD, n = 79) than du ring the control cycle (8.5 +/- 1.7 mm, n = 79) on late proliferative days, but there was no significant difference on midsecretory days (10 .8 +/- 2.2 mm during the CC cycle, n = 79; 11.2 +/- 2.2 mm during the control cycle, n = 79). The echogenic patterns, however, were differen t between the two cycles on midsecretory days. Moreover, the incidence in which patients showed a grade 3 endometrium on midsecretory days w as significantly higher during the conceived CC cycle compared with th e not-conceived CC cycle. Serum E(2) levels were significantly higher, but E(2) receptor contents in the endometrium were significantly lowe r during the CC cycle (67 +/- 46 fmol/mg, n = 13) compared with the co ntrol cycle (123 +/- 89 fmol/mg, n = 15) on late proliferative days. C onclusion(s): Clomiphene citrate affected the echogenic pattern of the endometrium, and most of the Endometrium showed a grade 3 pattern on midsecretory days during the conceived CC cycle. Under the CC treatmen t, the comfortable endometrium for embryos might be different from the control cycle.