Authors: Shelby Howard, Elizabeth F Sutton, Briasha Jones, Neil Chappell.
Objective: To determine if Clomiphene Citrate (CC) is an effective option for inhibiting ovulation during controlled ovarian hyperstimulation for elective oocyte cryopreservation (OC). Design: We conducted a prospective, observational study in eight individuals undergoing ovarian stimulation wherein CC was used to prevent premature ovulation. The study was registered as a clinical trial (Reference ID: NCT05866068).
Subjects: Females (n=8) 18-42 years old and undergoing elective OC were eligible to participate. Individuals using tobacco or illicit drugs, with a history of infertility, undergoing cancer treatment, previous failed IVF, drug allergy to CC, hypertension, or history of migraines with aura were excluded.
Main Outcome Measures: The primary outcome was incidence of premature ovulation. Secondary outcomes include the number of oocytes retrieved, number of mature oocytes, and study-related adverse events.
Results: The average age was 35.75 ± 5.04 (range 26-41). Six participants were Caucasian, and two were Asian. The average body mass index (BMI) was 24.4 ± 4.5kg/m2 (range 20.1-31.3), and the average AMH was 3.78 ± 1.74 ng/ mL(range 1.78-6.58). CC was well tolerated with no evidence of early ovulation. The total gonadotropin dose ranged from 1775IU to 4950IU. The peak LH ranged from 7.64 mIU/mL to 28.4 mIU/mL, and the peak progesterone ranged from 0.71 ng/mL to 4.11 ng/mL. The number of oocytes retrieved ranged from 7 to 24 with an average maturity rate of 87%.
Conclusion: CC prohibits ovulation during OC; however, transient higher LH levels noted in a few of the cycles may predispose to premature luteinization, or even ovulation, resulting in a canceled cycle.
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