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Related Concept Videos

Ovarian Cycle01:27

Ovarian Cycle

The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle length...
In Vitro Fertilization01:24

In Vitro Fertilization

In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
Oogenesis02:07

Oogenesis

In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
Oogenesis01:22

Oogenesis

Oogenesis,  the process of developing egg cells (female gametes), occurs within the ovaries and is fundamental to female fertility. This sequence begins during fetal development when diploid oogonia in the developing ovaries undergo mitotic divisions to produce primary oocytes. By birth, these primary oocytes enter prophase I of meiosis but become arrested in this stage, remaining suspended until puberty.
Each primary oocyte is surrounded by a layer of pre-granulosa cells, forming what is known...
Infertility in Females01:28

Infertility in Females

Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
Endometriosis, a condition characterized by abnormal growth of endometrial...
Hormonal Control of the Ovarian Cycle01:30

Hormonal Control of the Ovarian Cycle

The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle.  At puberty, GnRH secretion increases in both frequency and...

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Related Experiment Video

Updated: May 10, 2026

The Immediate Partial Removal of Cumulus-Oocyte Complexes: A Refined Approach for Rapid Observation of In Vitro Fertilization
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The Immediate Partial Removal of Cumulus-Oocyte Complexes: A Refined Approach for Rapid Observation of In Vitro Fertilization

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Clomiphene ovulation induction and higher-order multiple pregnancy.

Simon McDowell1, Ben Kroon, Anusch Yazdani

  • 1Queensland Fertility Group Research Foundation, University of Queensland, Brisbane, Queensland, Australia. simon.mcdowell@hotmail.co.uk

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|July 9, 2013
PubMed
Summary

Clomiphene citrate is a common infertility treatment, but it increases the risk of multiple pregnancies. Factors like dosage and cumulative use contribute to this risk, with limited evidence for ultrasound monitoring to reduce higher-order multiples.

Keywords:
clomiphenehigher-order multiple pregnancymultiple pregnancyovulation inductionovulatory dysfunction

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Last Updated: May 10, 2026

The Immediate Partial Removal of Cumulus-Oocyte Complexes: A Refined Approach for Rapid Observation of In Vitro Fertilization
08:06

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OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery
05:31

OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery

Published on: May 9, 2021

Area of Science:

  • Reproductive Endocrinology
  • Pharmacology

Background:

  • Clomiphene citrate is a first-line ovulation induction agent for ovulatory dysfunction.
  • A significant adverse effect of clomiphene citrate is an elevated risk of multiple and higher-order multiple gestations.
  • Potential contributing factors include variations in dosage, use of adjuvant therapies, weight loss prior to treatment, and the cumulative impact of multiple treatment cycles.

Purpose of the Study:

  • To review the mechanisms contributing to multiple pregnancies associated with clomiphene citrate.
  • To evaluate the potential role of ultrasound monitoring in mitigating the risk of higher-order multiple pregnancies.

Main Methods:

  • Literature review and synthesis of existing research on clomiphene citrate's effects on ovulation and pregnancy outcomes.
  • Analysis of factors influencing multiple pregnancy rates in clomiphene citrate treatment protocols.

Main Results:

  • Multiple pregnancy, including higher-order multiples, is a primary concern with clomiphene citrate therapy.
  • Identified mechanisms include dosing inconsistencies, adjuvant treatments, pretreatment weight loss, and cumulative exposure.
  • Evidence supporting ultrasound monitoring for reducing higher-order multiples remains limited.

Conclusions:

  • Understanding the multifactorial causes of multiple pregnancies is crucial for optimizing clomiphene citrate use.
  • Further research is needed to validate the efficacy of ultrasound monitoring in reducing higher-order multiple births.
  • Careful patient selection and monitoring may help mitigate risks associated with clomiphene citrate treatment.