Hormonal changes in consecutive clomiphene citrate stimulation cycles and their effect on pregnancy rates

Evrim Ebru Kovalak; Eser Şefik Özyürek; Özlem Karabay Akgül; Tolga Karacan

doi:10.4274/tjod.galenos.2022.40607

Hormonal changes in consecutive clomiphene citrate stimulation cycles and their effect on pregnancy rates

Turk J Obstet Gynecol. 2022 Sep 23;19(3):221-228. doi: 10.4274/tjod.galenos.2022.40607.

Authors

Evrim Ebru Kovalak¹, Eser Şefik Özyürek², Özlem Karabay Akgül¹, Tolga Karacan¹

Affiliations

¹ University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
² University of Health Sciences Turkey, Zeynep Kamil Women's and Children's Disease Training and Research Hospital, Clinic of Gynecologic Oncology, İstanbul, Turkey.

Abstract

Objective: To determine the relationship between the cumulative effect of sequential clomiphene citrate (CC) treatments in unexplained infertile women with intercycle and intracycle serum hormone changes.

Materials and methods: Patients who received CC 50 mg in the first cycle (group I, n=34) as ovulation induction and those who received CC 50 mg in the second consecutive cycle (group II, n=18) were compared. Basal (cycle days 2-5) and trigger day (the day that recombinant human chorionic gonadotropin is given) levels of gonadotropin and steroid hormones were measured.

Results: The 17OHP increase on trigger day was found to be statistically significantly higher in group II compared to the basal day (p=0.083). The testosterone (T) response on the trigger day of the patients in group II was found to be statistically significantly higher than that in group I (p=0.023). The number of selected follicles was negatively correlated with a follicle-stimulating hormone decrease and positively correlated with an estradiol increase. Endometrial thickness was positively correlated with a luteinizing hormone increase, and cycle cancelation was positively correlated with decreased estradiol.

Conclusion: Based on this study, it was concluded that the reason for the increased efficiency rate in successive cycles of CC may be the cumulative increase in T and 17OHP levels. However, this result was found not to affect the clinical pregnancy rate.

Keywords: Clomiphene; ovulation induction; steroids.