Optimization of determination of ovulation after clomiphene therapy.

A total of 131 cycles of 71 sterility patients, who suffered from anovulatory cycles at least previous 6 months, were monitored daily by a rapid radioimmunoassay for LH and by gynecological examinations before we attempted to induce ovulations with Clomiphene. The width of the cervix, spinnbarkeit, transparency of the cervical mucus and karyopycnotic and acidophilic index of the vagina were recorded daily. 18 subjects exhibited hypoplasia of the uterus and 32 husbands of the 71 patients suffered from severe to medium oligospermia. Homologous inseminations were performed in 15 patients. Different patterns of LH serum levels were observed during and after Clomiphene treatment. The response of LH to Clomiphene and preovulatory LH rise was recorded in 73 cycles. No Clomiphene response with preovulatory LH peak was observed in 31 cycles. 11 patients out of 71 subjects failed to ovulate. 12 patients (30.7%) out of 39 subjects with normospermatic husbands became pregnant. 6 patients (18.7%) of 32 subjects whose husbands suffered from oligospermia became pregnant. A total pregnancy rate of 30% calculated, when the 11 patients with negative responses are excluded. The conclusion is reached that sterility patients benefit most, when both gynecological as well as rapid LH estimations by radioimmunoassay are used to time imminent ovulations in Clomiphene treated subjects.