Factors associated with pregnancy or miscarriage after clomiphene therapy in WHO Group II anovulatory women: a study conducted at Fertility Plus, National Women's Hospital, Auckland

Authors


  • Stella R Milsom MB ChB FRACP Endocrinologist, Gillian Gibson MB ChB FRANZCOG Obstetrician, Karen Buckingham MB ChB FRANZCOG Resident in Obstetrics and Gynaecology, Alistair J Gunn MB ChB FRACP PhD Endocrinologist

Address for correspondence
Dr Stella R Milsom
Department of Reproductive Medicine
National Women's Hospital
Private Bag 92 189
Greenlane
Auckland New Zealand

Abstract

ABSTRACT

Objectives

The present study was designed to determine whether clinical and endocrine characteristics assessed on initial screening of normogonadotropic oligo/amenorrhoeic infertile patients could predict ovulation and then conception and successful live birth or miscarriage.

Study design

Retrospective cohort study.

Setting

Outpatient clinic.

Population

Eighty-two consecutive women receiving clomiphene citrate (CC) therapy from 1993 to 1998.

Results

A cumulative conception rate of 67% was reached after six or more CC-induced cycles. Patients with failure of ovulation after a full course of CC had more severe oligomenorrhoea (p < 0.001) and greater BMI (p < 0.05) at initial screening. There was no relationship with levels of LH or androgens. In contrast, among women who ovulated in response to CC, conception was associated with less frequent periods, and higher basal levels of LH, free testosterone and androstenedione. Conceptions with subsequent miscarriage were associated with intermediate levels of LH and numbers of spontaneous periods between non-conception and live births.

Conclusions

These observations are consistent with the hypothesis that failure of ovulation after CC is related to different factors (overweight and severe oligomenorrhoea) from those that predispose to non-conception (low basal LH and androgen levels and mild oligomenorrhoea).

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