A CLOMIPHENE CITRATE AND TAMOXIFEN CITRATE COMBINATION THERAPY - A NOVEL THERAPY FOR OVULATION INDUCTION

Objective: To assess the efficacy of a clomiphene citrate (CC) and tam oxifen citrate (CC/tamoxifen) combination therapy in ovulation inducti on by comparing with a CC alone therapy. Design: A randomized cross-ov er study with CC alone and CC/tamoxifen combination therapies for 20 n ormoprolactinemic anovulatory women. Randomly selected 10 of the 20 wo men (group A) underwent a CC alone therapy (100 mg CC during cycle day s 5 to 9) for the initial three consecutive treatment cycles and a CC/ tamoxifen combination therapy (50 mg CC and 20 mg tamoxifen during cyc le days 5 to 9) for the subsequent three consecutive treatment cycles. The remaining 10 (group B) were treated similarly but with the invers e sequence. Ovulation was documented when a high BBT phase persisted f or 11 days or more, when midluteal serum P levels exceeded 7 ng/mL (22 .3 nmol/L), or when pregnancy ensued. Results: The rates of ovulatory/ treated, pregnant/treated, and pregnant/ovulatory cycles were 42 of 56 (75.0%), 3 of 47 (6.4%), and 3 of 35 (8.6%) for CC/tamoxifen, respect ively. Those were 25 of 57 (43.9%), 1 of 48 (2.1%), and 1 of 21 (4.8%) for CC, respectively. Clomiphene citrate/tamoxifen was more effective in ovulation induction than CC. All the pregnancies were normal and s ingle. None of the treatments was accompanied by any remarkable side e ffects. Conclusion: Clomiphene citrate/tamoxifen is a novel treatment modality of ovulation induction with high efficacy.