Identification and management of clomiphene citrate responses

Clomiphene citrate (CC) is widely used for induction of ovulation; however, adequate time is rarely used to monitor patients on this form of therapy. Two hundred thirty-one infertility patients qualified for this study in 1155 cycles, during which basal body temperature charts were kept and the quality of cervical mucus was evaluated. Nine types of responses were classified: three ovulatory (O1, O2, O3), three anovulatory (A1, A2, A3), and three miscellaneous (M1, M2, M3). The overall, uncorrected pregnancy rate was 54.9%, and 79.2% showed ovulatory responses. The most common response was O1 (normal responses, 38.5%) with the highest pregnancy rates (92.1%). Poor estrogenic response with poor cervical mucus (CM) (O2) was fairly common (13.4%) and had poor pregnancy rates, even with the addition of estrogens (12.9%). It is suggested that this new classification of CC responses will help to identify and more efficiently manage patients undergoing this form of therapy.