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Clomiphene-induced quintuplets with a failed attempt at delayed-interval delivery
C Rosa1, J P Fontenot, F E Harlass
1Department of Obstetrics and Gynecology, William Beaumont Army Medical Center, El Paso, TX 79920-5001, USA.
Military Medicine
|December 1, 1995
Summary
Clomiphene citrate can induce ovulation but rarely results in high-order multiple gestations. This case details a rare instance of quintuplets conceived using clomiphene citrate alone.
Area of Science:
- Reproductive Endocrinology
- Obstetrics and Gynecology
Background:
- Clomiphene citrate is a common medication for ovulation induction in women with ovulatory dysfunction.
- While generally safe, it carries a known risk of multiple gestation, typically twins or triplets.
Observation:
- A 27-year-old woman with secondary infertility and oligo-ovulation conceived on clomiphene citrate.
- Early ultrasound revealed five fetuses. The patient experienced preterm premature rupture of membranes at 19 weeks.
- An attempted delayed-interval delivery resulted in all five fetuses being born over 15 days without maternal complications.
Findings:
- This case represents the seventh reported instance of quintuplets resulting from clomiphene citrate use.
- It is potentially the first such case where no other fertility-enhancing medications were used concurrently.
- Delayed-interval delivery was unsuccessful in this high-order multiple pregnancy.
Implications:
- This case highlights the rare but significant risk of high-order multiple pregnancies with clomiphene citrate monotherapy.
- It underscores the importance of careful patient counseling regarding the risks of multiple gestation.
- Further research may be needed to understand the mechanisms leading to such extreme outcomes with clomiphene citrate.