Objective: The purpose of this study was to assess whether or not clomiphene citrate is associated with the risk of ovarian hyperstimulation syndrome (OHSS) in women with polycystic ovary syndrome (PCOS) treated with a first-line therapy (Clomid®) in a cohort of women with a normal menstrual cycle, who were excluded from the study. Methods: A cohort of patients with PCOS and age >30 years with or without anovulation, who were excluded from the study, was enrolled at the Nipig Health Research Hospital and at the National University of São Paulo (NUSP). Patients with HMG-CoA deficiency were excluded from the study. The study was conducted in the period from February 1st to May 1st, 2015. Patients were included if they met the following criteria: (1) HMG-CoA deficiency, (2) ovulation (cycle), (3) or other risk factors (hormone or growth factor) for ovarian hyperstimulation (OHSS) and (4) anovulation (cycle). All patients were randomly assigned to one of the study groups (clomiphene citrate or placebo) after the first week of treatment. The patients were followed up for periods between 2 and 6 weeks. The primary outcome of interest was the rate of OHSS in the period from February 1st to June 30th, 2015. Secondary outcomes included the percentage of women who had an ovulation, number of cycles, and live birth. The patients were divided into two groups: those who did not ovulate, those who did ovulate, and those who did ovulate. The primary end point of interest was the number of cycles, and secondary end points included the percentage of live birth, number of cycles, and number of live births. The study was approved by the Regional Consiliated Committee of the University of São Paulo (protocol number NUSP-1221-05). This study was registered in the Clinical Trials Registry (NCT05631144).
Citation:Sallis-Majdia S, Kaur P, Jain M, Thakrouth A, et al. (2021) The potential role of clomiphene citrate in ovarian hyperstimulation and ovulation in women with polycystic ovary syndrome (PCOS). PLoS ONE 18(12): e012896. https://doi.org/10.1371/journal.pone.012896
Editor:Geraldine S. S. Boccardo, University of Florence, Italy
Received:August 13, 2021;Accepted:September 17, 2021;Published:September 18, 2021
Copyright:© 2021 Sallis-Majdia et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability:All relevant data are within the paper and its Supporting Information files.
Funding:The authors received no specific funding for this work.
Competing interests:The authors have declared that no competing interests exist.
Polycystic ovary syndrome (PCOS) is a common female reproductive system in which women are unable to produce ovulation at all due to the absence of hormones (progesterone, estrogen, and estrogen-binding globulin). This condition is common among women with polycystic ovaries []. PCOS is also known to be a common female infertility disorder []. In fact, in 2015, the National Agency for the Prevention and Control of Cancer and Reproductive Diseases (NAPCD) published a national surveillance report on the prevalence and characteristics of PCOS in a community setting []. The report found that only 35.6% of women with PCOS have an ovulation []. It is estimated that around 20–30% of women with PCOS may be infertile, and approximately half of these women may be at risk of developing OHSS [,]. It is estimated that approximately one third of women with PCOS will have OHSS []. In addition, a meta-analysis conducted by the European Society of Urology (ESU) has revealed that approximately one in five women with PCOS will have OHSS [].
The term hyperstimulation refers to the rapid and continuous release of an estrogenic chemical from the hypothalamus [].
For more information about Clomid, including details on how to use it safely, and to decide if it’s the right choice for you, our team of fertility specialists, or a in-person physician, can get in touch at1-800-CILOMID-PHYSICAL-SERIOTYPHYS INTERACTIVE.
Clomid, also known as clomiphene citrate, is an oral medication that is primarily used to treat infertility in women who do not ovulate regularly or are experiencing infertility problems. It works by stimulating the pituitary gland to increase the production of gonadotropins, such as FSH and luteinizing hormone (LH).
Clomid is taken orally once daily, with or without food, about two to three times a day. It is important to follow your doctor’s instructions when taking clomiphene citrate to ensure its effectiveness and minimize the risk of side effects.
Clomid has been a staple in fertility treatment for decades, particularly for women who struggle to ovulate regularly due to polycystic ovary syndrome (PCOS), irregular menstrual cycles, or other hormonal imbalances. When taken correctly, clomiphene citrate can successfully restore ovulation to levels that are ovulating and improving fertility.
Clomid is a widely used medication that can help women who are struggling with infertility. It works by stimulating the pituitary gland to increase the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are essential for ovulation. FSH helps regulate ovulation, which can improve pregnancy rates and improve fertility.
Women who are trying to conceive should speak to their healthcare provider first before starting Clomid, as it can increase the likelihood of twins or even live- twins.
Like all medications, clomiphene citrate can cause side effects, although not everyone will experience them. Common side effects include hot flashes, nausea, and mood swings. More serious side effects may include irregular menstrual cycles or ovarian hyperstimulation syndrome (OHSS).
For more information on the risks and benefits of taking clomiphene citrate, including the table below, see the.
Common Side Effects | Typical Benefits | Cost | |
|---|---|---|---|
| Hot Flashes | Nausea, Diarrhea, Insomnia | $0.25 per day | $2.50 per day |
| Mood Swings | Irregular or Light Mood swings, Headaches, Vomiting | $4.00 per day | |
| Irregular Menstrual Cycles | Infrequent or Short-term Irregular Pregnancy | $0.5 per day | $7.50 per day |
| Ovulatory Defenses | Elevated or Abnormal Uterine Bleeding | $10.00 per day | |
| Vomiting | Abnormal or Severe Indigestion, Nausea, and Abdominal Pain | $1.00 per day | |
| Weight Gain | Abnormal Weight Gain | $0.50 per day | |
| Headaches | Headaches, Nose/ Nasal Congestion, Dizziness | $1.50 per day | $4.50 per day |
Less serious side effects can include irregular menstrual cycles or OHSS, which can affect the menstrual flow and cause pain, bleeding, and irregular heartbeat. It is important to monitor your hormone levels and discuss any concerns with your healthcare provider before starting Clomid.
Understanding the significance of Post Cycle Therapy (PCT) and its importance in female fertility is essential for men and women facing fertility challenges. By investing in PCT, men and women can maintain and enhance their natural reproductive processes, leading to improved fertility.
PCT not only enhances natural fertility but also plays a crucial role in managing and addressing female infertility, making conception a priority.
PCT plays a crucial role in managing female fertility by:
By regularly monitoring and adjusting hormonal levels, men and women can significantly enhance their PCT journey while addressing fertility challenges.
Post Cycle Therapy (PCT) operates primarily through the production and subsequent metabolism of hormones. This process involves the stimulation of aromatase enzyme, which converts androgens into estrogen. By doing so, estrogen can effectively stimulate the testes to produce more testosterone, leading to improved fertility.
In women, PCT enhances natural testosterone production by:
Estrogen hormones, such as testosterone, are essential for maintaining reproductive health. By reducing estrogen levels, PCT helps to:
In rare cases, PCT can significantly enhance fertility outcomes in women undergoing fertility treatment:
In women undergoing PCT, hormonal imbalances can disrupt hormonal balance, leading to impaired ovulation or reduced egg production. By replenishing declining estrogen levels, PCT helps to:
Enhance hormonal levels to ensure ovulation is effectively achieved, ensuring that conception is a reality for the individual.
Post Cycle Therapy (PCT) is essential for maintaining hormonal balance throughout the menstrual cycle. It’s characterized by the stimulation of the aromatase enzyme, which converts androgens into estrogen. By doing so, estrogen levels can be replenished, enhancing reproductive health.
The primary mechanism through which PCT enhances fertility outcomes is through the activation of estrogen receptors in the body. This stimulates the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones promote the ovaries to produce eggs.
In men, PCT works by stimulating the production of testosterone, leading to improved follicular development and a more favorable testosterone ratio post cycle.
The correct dosage of PCT for men and women is crucial for optimal hormonal balance. Typically, PCT is initiated at a low dose, typically 5 mg per day. This ensures optimal hormonal stimulation, ensuring that conception occurs effectively.
For women, the typical starting dose is 50-100 mg daily, but this can vary based on individual needs and medical history. Always monitor your healthcare provider’s recommendations throughout your PCT regimen.
It’s crucial to adhere strictly to the prescribed dosage to achieve the best results.
For men and women undergoing PCT, PCT is primarily indicated for:
Clomid is a fertility drug used to stimulate ovulation in women with polycystic ovary syndrome (PCOS). It works by stimulating the pituitary gland to produce more follicles and eggs than the normal woman does. Clomid can be prescribed to women with PCOS or as an intrauterine device (IUD).
It is generally used in the treatment of unexplained infertility. However, it is important to note that Clomid should only be taken under the guidance of a doctor. It should only be used by women who are trying to get pregnant due to the following reasons:
Clomid is not recommended for use in women who have not been diagnosed with PCOS due to the following reasons:
It is essential to inform your doctor of any other medications or medical conditions you are currently taking before starting Clomid. They will consider whether Clomid is suitable for you based on your medical history and the potential risks and benefits. It is important to discuss all the medications you are currently taking with your doctor before starting Clomid to make sure it is safe for you to take.
This is not a complete list of all medications that may be used for infertility in women. Always check with your doctor or pharmacist before stopping any medication, especially any drugs that are already in your body. They can provide you with the right information about the potential risks and benefits and can help you make informed decisions about your treatment.
Clomid is a fertility drug used to stimulate ovulation in women with PCOS. It works by increasing the number of follicles that develop and the number of eggs released.
It is important to note that Clomid should only be used by women who are trying to get pregnant due to the following reasons:
Clomid is not recommended for use in women who have unexplained infertility because of the following reasons:
This is not a comprehensive list of all medications that may be used for infertility in women.
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