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Human Reproduction, Vol. 11, No. 12, pp. 2623-2628, 1996
© 1996 European Society of Human Reproduction and Embryology

research-article

Infertility: Incidence of spontaneous abortion in clomiphene pregnancies

Richard P. Dickey1,2,3, Steven N. Taylor1,2, David N. Curole1,2, Phillip H. Rye1,2 and Roman Pyrzak1,2

1Fertility Institute of New Orleans New Orleans, Louisiana, USA 2Department of Obstetrics and Gynecology, Louisiana State University School of Medicine and Tulane University School of Medicine New Orleans, Louisiana, USA

Correspondence: 3To whom correspondence should be addressed at Fertility Institute of New Orleans, 6020 Bullard Avenue, New Orleans, Louisiana 70128, USA

The purpose of this study was to determine whether the use of clomiphene results in a higher incidence of spontaneous abortion than occurs naturally in subfertile patients. Reproductive outcomes of 1744 clomiphene pregnancies were compared to outcomes of 3245 spontaneous pregnancies in a prospective study. Abortion was classified as clinical if a sac was seen on ultrasound or if it occurred after 6 gestational weeks, and as preclinical if a quantitative human chorionic gonadotrophin (HCG) was ≥ 25 mIU and no sac was seen or abortion occurred earlier. The overall incidence of abortion was higher for clomiphene pregnancies (23.7%), compared with spontaneous pregnancies (20.4%) (P <0.01). Preclinical abortions were increased by clomiphene for all ages (5.8 versus 3.9%, P <0.01) and for age ≥30 years (8.0 versus 4.9%, P <0.001), but not for age <30 years (3.7 versus 3.0%). Clinical abortions were increased by clomiphene for age <30 years (15.9 versus 11.2%) (P <0.01), but not for age ≥30 years (20.1 versus 223%) or all ages (18.0 versus 16.4%). Clinical abortions occurred 22% less often following clomiphene compared with spontaneous pregnancies for patients with luteal insufficiency (18.3 versus 23.6%, P <0.05). We conclude that the increase in abortion due to clomiphene is small and may be related to different causes for women aged <30 and ≥30 years, and also that clomiphene may decrease clinical abortions in patients with luteal insufficiency.

Key words: abortion/clinical abortion/clomiphene citrate/human menopausal gonadotrophin/preclinical abortion


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