Clomiphene citrate: nuances of clinical application.

The results of administration of clomiphene citrate to 507 patients in 578 pregnancy attempts were evaluated with respect to pregnancy rate, outcome, sex ratio, and life table analysis. The effect of dose and concomitant administration of human chorionic gonadotrophin (hCG) was also assessed. The overall pregnancy rate was 38% by individual patient and 43% by patient attempt. A pregnancy rate of 61% was recorded for couples in which anovulation was the only reproductive problem. The abortion rate was 23% in a population screened by serum beta subunit hCG determination within a week of the missed expected menses. Many patients had multiple adverse fertility factors and fully 29% had been treated unsuccessfully with clomiphene citrate prior to entry into the program. The discussion includes results from the literature over the past two decades.