Human Reproduction, Vol 12, 449-453, Copyright © 1997 by Oxford University Press
RP Dickey, SN Taylor, DN Curole, PH Rye, PY Lu and R Pyrzak
Our objective was to examine the relationship between patient weight and
the dose of clomiphene required for pregnancy so as to assess the validity
of recommendations that the dose of clomiphene be limited to 100 mg. We
retrospectively analysed the weight-dose relationship in 1681 clomiphene
pregnancies and the relationship between dose and pregnancy, births,
multiple births, number of pre-ovulatory follicles and endometrial
thickness in 2841 cycles of clomiphene treatment, 25- 250 mg, for 5 days
before intrauterine insemination (IUI). Doses of clomiphene >100 mg/day
were used before pregnancies in 27.4% of patients who weighed >90 kg and
in 14.7% of all pregnancies. In IUI cycles, pregnancies and births, but not
multiple births or abortions, were related to dose. An increase in dose
from 25 to 100 mg resulted in higher pregnancy and birth rates, and in an
increase in the average number of pre-ovulatory follicles > or =12 mm in
diameter, from 2.0 to 2.8, with no additional increase at higher doses.
Endometrial thickness and cycle day of insemination were not related to
dose. We conclude that doses of clomiphene may safely be increased beyond
100 mg, and that doses > or =100 mg are required in significant numbers
of patients.
ARTICLES
Relationship of clomiphene dose and patient weight to successful treatment
Fertility Institute of New Orleans, LA 70128, USA.
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