Which of the following statement regarding Clomiphene citrate is true?
Clomiphene citrate is a racemic mixture of enclomiphene & zuclomiphene. Clomiphene citrate is a triphenylethylene; its two isomers, zuclomiphene (cis-clomiphene) and enclomiphene (trans-clomiphene), are a weak estrogen agonist and a potent antagonist, respectively. The incidence of multiple pregnancies is approximately 10%. Although clomiphene is effective in inducing ovulation in perhaps 75% of women, successful pregnancy ensues in only 40-50% of those who ovulate. Clomiphene also may be used to evaluate the male reproductive system because testosterone feedback on the hypothalamus and pituitary is mediated to a large degree by estrogens formed from aromatization of the androgen. Enclomiphene is a more potent anti-oestrogenic isomer and the one primarily responsible for the ovulation-inducing actions of clomiphene citrate. Intrauterine insemination and clomiphene citrate increase pregnancy rate 3 times as compared to placebo. Incidence of twin pregnancy following clomiphene citrate ovulation induction is 10%, while that of triplets is 1%. A randomized control study showed that use of clomiphene has improved sperm motility and percent of normal forms but has not established an increased feility. Indications of clomiphene: Ovulation induction To aid invitro feilization when given with gonadotrophins In oligozoospermia: it increases gonadotrophin secretion and promotes spermatogenesis and testosterone secretion Adverse effects of clomiphene: Polycystic ovaries Multiple pregnancy Hot flushes Gastric upset Increased risk of ovarian tumor
Enclomiphene is anti-estrogenic
Increases pregnancy rate 3 times as compared to placebo
Incidence of twin pregnancy is 5-6%
It has been shown to increase feility in oligospermic males in randomized controlled trials