Effectiveness of clomid: Arrighi’s data on the low efficacy of clomiphene in patients with an inferior luteal phase confirm the good results we have obtained in the treatment of this pathology with synthetic progestins. So, according to Townsend, clomiphene will give effect only with a daily excretion of estrogens of at least 10 mcg /day. According to other authors, ovulation stimulation with clomiphene is possible only in patients with estrogen excretion of at least 20 mcg per day.
There are indications of low efficacy of clomiphene in patients with initial high gonadotropin secretion. Obviously, this applies to patients whose ovarian tissue is unable to respond to stimulation with gonadotropins and clomiphene.
A summary analysis of the data on the use of clomiphene in 6714 patients with anovulation, conducted by Macgregor, showed that ovulation appears in 70%, and pregnancy occurs only in 32.7% of women. Such a discrepancy between the frequency of ovulation and the onset of pregnancy is usually explained by the appearance of cyclic secretion of LH at an inappropriate time, resulting in premature luteinization of follicles without full ovulation.
Purpose and effectiveness of clomid
The administration of clomiphene in patients with impaired gonadotropin secretion revealed its low effectiveness compared to gonadotropins. In addition, it should be noted that every 5th woman with the onset of pregnancy after the use of clomiphene has an interruption in the second trimester (18.5%).
Our own experience of using clomiphene in 51 patients (in the presence of anovulation in 22 and an incomplete luteal phase in 29) showed that ovulation occurred in almost all women, and pregnancy occurred only in 18 of 51, i.e. in every third patient.
At the same time, the best effect was achieved in patients with anovulation. Ovulation was confirmed by an increase in the excretion of total estrogens by 2-3 times, and pregnanediol by 3 times. In most patients, 10-12 days after the end of taking clomiphene, the excretion of estrogens increases to 50-70 mcg / day and ovulation occurs, followed by an increase in basal temperature and the excretion of pregnanediol. If pregnancy has not occurred, then a menstrual-like reaction occurs 10-12 days after the basal temperature rises.
The effectiveness of clomid (treatment with clomiphene) in patients with estrogen excretion below 10 mcg / day was insignificant. Only 1 out of 8 patients with prolonged amenorrhea became pregnant. The relatively low effectiveness of treatment with clomiphene in patients with an inferior luteal phase was also noted.