CLOMIPHENE TREATMENT FOR WOMEN WITH UNEXPLAINED INFERTILITY - PLACEBO-CONTROLLED STUDY OF HORMONAL RESPONSES AND CONCEPTION RATES

被引：49

作者：

GLAZENER, CMA

COULSON, C

LAMBERT, PA

WATT, EM

HINTON, RA

KELLY, NG

HULL, MGR

机构：

[1] University of Bristol, Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Bristol Maternity Hospital, Bristol

[2] Reproductive Medicine Clinic, Bristol General Hospital, Bristol

来源：

GYNECOLOGICAL ENDOCRINOLOGY | 1990年 / 4卷 / 02期

关键词：

D O I：

10.3109/09513599009012324

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

One hundred and eighteen patients with unexplained infertility were treated with clomiphene (Clomid, Merrell) in a randomized placebo-controlled cross-over study lasting up to 3 months with each preparation. Compared with placebo, clomiphene led overall to a 66% increase in mid-luteal serum progesterone levels (from mean 43 nmol/1 to 71 nmol/1, p < 0.001) and a 53% rise in the 3-month cumulative conception rate (from 14.6% to 22.33% p < 0.05). The greatest relative increase in conception rates with clomiphene was in women with infertility lasting more than 3 years (3-month rates from 2.9% to 14.4% p<0.05). Differences in conception rates were not related to the rises in progesterone, and there was no carryover effect of clomiphene into the following placebo cycles in terms of progesterone levels or conceptions. The findings suggest that couples with unexplained infertility of less than 3 years duration are essentially normal, but with more than 3 years duration there is often a subtle disorder of ovulation that is corrected by clomiphene therapy. © 1990 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

引用

页码：75 / 83

页数：9

共 19 条

[1] Hull M.G.R., Glazener C.M.A., Kelly N.J., Conway D.I., Foster P.A., Hinton R.A., Coulson C., Lambert P.A., Watt E.M., Desai K.M., Population study of causes, treatment and outcome of infertility, Br. Med. J., 291, pp. 1693-1697, (1985)
[2] Hull M.G.R., Joyce D.N., McLeod F.N., Ray B.D., McDermott A., Human in-vitro fertilisation, in-vivo sperm penetration of cervical mucus and unexplained infertility, Lancet, 2, pp. 245-246, (1984)
[3] Mahadevan M.M., Trounson A.O., Leeton J.F., The relationship of tubal blockage, infertility of unknown cause, suspected male infertility and endometriosis to success of in-vitro fertilisation and embryo transfer, Fertil. Steril., 40, pp. 755-762, (1983)
[4] Wardle P.G., Mitchell J.D., McLaughlin E.A., Ray B.D., McDermott A., Hull M.G.R., Endometriosis and ovulatory disorder: reduced fertilisation in-vitro compared with tubal and unexplained infertility, Lancet, 2, (1985)
[5] Lenton E.A., Sobowale O.S., Cooke I.D., Prolactin concentrations in ovulatory but infertile women
[6] treatment with bromocriptine, Br. Med. J., 2, pp. 1179-1181, (1987)
[7] Wright C.S., Steele S.J., Jacobs H.S., Value of bromocriptine in unexplained primary infertility: a double-blind controlled trial, Br. Med. J., 1, pp. 1037-1039, (1979)
[8] Testart Castanier J.M., Feinstein M.C., Frydman R., Pituitary and steroid hormones in the preovulatory human follicle during spontaneous or stimulated cycles, Follicular Maturation and Ovulation, pp. 193-201, (1982)
[9] Glazener C.M.A., Kelly N.J., Hull M.G.R., Luteal deficiency not a persistent cause of infertility, Hum. Reprod., 3, pp. 213-217, (1988)
[10] Hull M.G.R., Savage P.E., Bromham D.R., The prognostic value of the post-coital test

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