Ovulation Induction With Clomiphene Citrate and Dexamethasone

Launched by SAN ANTONIO MILITARY MEDICAL CENTER · May 14, 2013

Keywords

ClinConnect Summary

For decades clomiphene citrate (CC) has been the first line therapy for ovulation induction in anovulatory or oligoovulatory women, and for superovulation in women with unexplained infertility or partners with mild sperm abnormalities. While approximately 80% of patients achieve ovulation with CC, less than half conceive. Pregnancy is achieved in approximately 10% of ovulatory cycles.

Addition of dexamethasone to CC has been shown to result in pregnancy rates of 21-40% in CC-resistant women (defined as patients failing to ovulate on CC alone). A subsequent randomized controlled trial demon...

Gender

FEMALE

Eligibility criteria

• Inclusion Criteria:
• • Active duty military members or dependents seeking infertility treatment at Brooke Army Medical Center
• • primary or secondary infertility
• • candidate for intrauterine insemination (IUI)
• Exclusion Criteria:
• • Severe male factor infertility (total motile sperm count \<10 million/mL)
• • Bilateral fallopian tube obstruction
• • Diminished ovarian reserve (baseline follicle stimulating hormone \> 20)
• • History of clomiphene resistance as determined by a Clomid challenge test or prior non-ovulatory cycles while taking clomiphene
• • Known or suspected hypopituitarism or hypothalamic amenorrhea
• • Six or more prior therapeutic CC cycles without a pregnancy
• • Diabetes
• • Renal impairment, hepatitis, hepatic cirrhosis, or myasthenia gravis
• • Osteoporosis
• • Cataracts or glaucoma
• • Congenital Adrenal Hyperplasia, Cushing's disease, or any condition requiring chronic corticosteroid use