Clomiphene citrate affects cervical mucus and endometrial morphology independently of the changes in plasma hormonal levels induced by multiple follicular recruitment

Details

Serval ID
serval:BIB_52B495A3ADFD
Type
Article: article from journal or magazin.
Collection
Publications
Title
Clomiphene citrate affects cervical mucus and endometrial morphology independently of the changes in plasma hormonal levels induced by multiple follicular recruitment
Journal
Fertility and Sterility
Author(s)
Massai  M. R., de Ziegler  D., Lesobre  V., Bergeron  C., Frydman  R., Bouchard  P.
ISSN
0015-0282
Publication state
Published
Issued date
06/1993
Peer-reviewed
Oui
Volume
59
Number
6
Pages
1179-86
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jun
Abstract
OBJECTIVE: To analyze the effects of clomiphene citrate (CC) on cervical mucus (CM) and endometrial morphology independently of hormonal changes encountered when CC is administered for ovulation induction. DESIGN: Volunteers whose ovarian functions were temporarily suppressed (n = 18) by a long-acting GnRH agonist and 6 women of similar age suffering from premature ovarian failure (POF) received E2 and P. Half of the women also received CC (50 mg/d, days 2 to 6). SETTING: Tertiary University Institution, Hopital A. Beclere. PATIENTS, PARTICIPANTS: Eighteen volunteers suffering from infertility not related to a uterine cause and 6 women of similar age suffering from POF. MAIN OUTCOME MEASURE: Plasma gonadotropins, E2, and P were measured at baseline to confirm that the ovaries were inactive and twice weekly during physiological E2 and P replacement. Cervical mucus was analyzed on day 14 and scored from 0 to 15. Endometrial biopsies were obtained on replacement days 20 and 24 for conventional histology and immunocytochemistry analysis of estrogen receptors and progesterone receptors (PR). Premature ovarian failure women whose results have been previously published served as controls for day 20 biopsies. RESULTS: Cervical mucus scored lower in women who received CC (5.5 +/- 3.2) than in controls (13.6 +/- 4.7, mean +/- SEM). On day 20, endometrial findings were similar in women treated with CC and in controls. On day 24, specimens showed a significant delay in endometrial maturation in women treated with CC. On day 24, only staining for PR selectively persisted in endometrial stroma, and no difference was observed between women who received CC and controls. CONCLUSION: Our results indicate that CC significantly alters CM quality and late luteal phase endometrial morphology despite physiological levels of plasma E2 and P. Hence, clinicians should monitor E2 levels when using CC, and caution should be exerted when supraphysiological levels of E2 are not present to counterbalance the effects of CC on the CM and the endometrium.
Keywords
Adult Biopsy Cervix Mucus/*drug effects Clomiphene/*pharmacology Endometrium/*drug effects/pathology Estradiol/*blood/pharmacology Female Gonadotropin-Releasing Hormone/analogs & derivatives/pharmacology Humans *Ovulation Induction Progesterone/*blood/pharmacology *Triptorelin/*analogs & derivatives
Pubmed
Web of science
Create date
28/02/2008 11:37
Last modification date
20/08/2019 14:08
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