Sl. Young et al., Serum concentrations of enclomiphene and zuclomiphene across consecutive cycles of clomiphene citrate therapy in anovulatory infertile women, FERT STERIL, 71(4), 1999, pp. 639-644
Objective: To determine the serum concentrations of enclomiphene and zuclom
iphene across consecutive cycles of clomiphene citrate treatment in anovula
tory infertile women.
Design: Prospective cohort.
Setting: Tertiary institutional infertility clinic.
Patient(s): Fourteen consenting anovulatory infertile women receiving stand
ardized, cyclic, incremental treatment with clomiphene citrate for ovulatio
n induction.
Intervention(s): Clomiphene citrate treatment (50-150 mg/d, cycle days 5-9)
, titrated to the minimum effective ovulation-inducing dose, was administer
ed for three to six total cycles. Blood samples were obtained on cycle days
3 and 10 in each treatment cycle.
Main Outcome Measure(s): Serum concentrations of enclomiphene and zuclomiph
ene.
Result(s): Cycle day 3 zuclomiphene levels were below assay limits in all i
nitial cycles, increased progressively across three consecutive cycles, and
thereafter plateaued. Cycle day 3 enclomiphene concentrations were uniform
ly undetectable. Cycle day 10 enclomiphene levels increased with dose admin
istered, but these observations were not statistically significant.
Conclusion(s): Clomiphene citrate induction of ovulation results in an isom
er-specific systemic accumulation of zuclomiphene across consecutive cycles
of treatment. The combined maximum concentration of enclomiphene and zuclo
miphene attained in practice approximates 100 nmol/L and is generally well
below levels previously demonstrated to have adverse effects in vitro. (Fer
til Steril(R) 1999;71:639-44. (C)1999 by American Society for Reproductive
Medicine.).