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Roy Homburg, Clomiphene citrate—end of an era? CC has been the first line therapy for these cases for the last 40 years. Non-response to CC and the gap between ovulation and pregnancy rates have variously been attributed to its anti-estrogen purchasings clomiphene, and high LH and androgen concentrations. For CC, it may not yet be the end of an era but it may be the beginning of the end. Later to become known as clomiphene citrate CC this compound has had a remarkably sustained career as the first-line treatment for women with absent or irregular ovulation due to hypothalamic—pituitary dysfunction associated with normal basal levels of endogenous estradiol WHO group II. Until the introduction of CC the only plausible treatment for these patients who wished to conceive was bilateral wedge resection of the ovaries. Despite the use of CC in controlled ovarian stimulation, its original indication of ovulation induction for WHO group II classification of oligo- or anovulation, particularly when associated with PCOS, remains its most frequent and most successfully treated indication.

 

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Other drugs for induction of purchasing clomiphene, including letrozole, are discussed elsewhere. En-clomiphene is cleared rapidly, while zu-clomiphene has a long half-life 1. The two clomiphene isomers have mixed estrogenic and antiestrogenic effects that vary among species. En-clomiphene is the more potent isomer with greater antiestrogenic activity and the one primarily responsible for inducing follicular development 2. Clomiphene is cleared through the liver and excreted in feces. Over 50 percent of an oral dose of 14C-labeled clomiphene citrate is excreted after five days, but traces of radioactivity from the labeled clomiphene appear in the feces up to six weeks after administration.

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