Related Experiment Videos
Intrauterine exposure to clomiphene and neonatal persistent hyperplastic primary vitreous
1Motherrisk Program, Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, University of Toronto, Toronto, Ontario M5G 1X8, Canada.
Insights
Clomiphene, used to treat infertility, may be linked to persistent hyperplastic primary vitreous (PHPV) in newborns. This rare congenital eye condition warrants consideration in infants exposed to clomiphene during pregnancy.
Area of Science:
- Ophthalmology
- Teratology
- Reproductive Medicine
Background:
- Persistent hyperplastic primary vitreous (PHPV) is a congenital condition affecting eye development.
- Clomiphene is a widely used medication for ovulation induction in women with infertility.
- Ocular side effects of clomiphene in mothers include visual disturbances and retinal changes.
Observation:
- A case report details a child diagnosed with PHPV shortly after birth.
- The mother used clomiphene 100 mg daily for approximately four weeks during early pregnancy.
- The potential teratogenic effects of clomiphene have been studied in animal models, with some showing cataract formation.
Findings:
- While animal studies showed mixed results, human cases of congenital retinal aplasia have been reported with clomiphene exposure.
- This case suggests a possible association between maternal clomiphene use and congenital PHPV.
- The risk may be higher with prolonged, high-dose clomiphene exposure during gestation.
Implications:
- Clinicians should consider clomiphene exposure when evaluating congenital eye abnormalities like PHPV.
- Further research is needed to establish a definitive causal link and understand the risk factors.
- This highlights the importance of counseling patients on potential fetal risks associated with fertility treatments.
Abstract:
A 4-year-and-10-month-old girl was diagnosed shortly after birth with persistent hyperplastic primary vitreous (PHPV). Her mother took clomiphene 100 mg daily for approximately 4 weeks and discontinued the drug once she had a positive pregnancy test. The exact time of gestation was not clear. Clomiphene is an estrogen antagonist effective in the treatment of anovulation. Various ocular side effects have been described in women taking the drug, including decreased vision, mydriasis, flashing lights, central scotoma, photophobia, diplopia, allergic reactions, retinal vasospasms, detachment posterior vitreous, and possibly posterior subcapsular cataracts. These occur in 1.5-10% of patients taking clomiphene. The potential effects of clomiphene on the fetus have been investigated in five animal studies. Cataracts were observed in fetal mice and rats, but not in monkeys. In humans, a case of congenital retinal aplasia was described. The possibility of clomiphene-induced congenital PHPV should be considered, especially in pregnant women who are taking a high and prolonged dose.