Clomiphene-Induced Portal Vein Thrombosis and Superior Mesenteric Venous Thrombosis

Clomiphene citrate is a selective estrogen receptor modulator commonly used off-label for male infertility despite being approved only for female infertility. Clomiphene is generally safe, and serious adverse effects such as venous thrombosis are rarely reported. This report presents the case of a 32-year-old man who developed portal vein thrombosis (PVT) and superior mesenteric venous thrombosis (SMVT) following three months of clomiphene therapy for infertility. The patient presented with severe abdominal pain and was found to have acute thrombosis on CT imaging. No other underlying hypercoagulable condition was present, and clomiphene was identified as a possible provoking factor for the thrombosis. The patient was successfully treated with anticoagulation therapy and was discharged on dabigatran for six months, with follow-up imaging planned. This is the first reported case linking clomiphene use to PVT and SMVT. Further studies are necessary to better understand the degree of risk and mechanisms underlying clomiphene-induced thrombosis.