An extended regimen of clomiphene citrate in women unresponsive to standard therapy

An extended regimen of clomiphene consisting of 250mg of clomiphene for 8days followed by the administration of 10,000IU of human chorionic gonadotropin (hCG) 6days later was administered to 13 oligomenorrheic women who had previously failed to ovulate when treated with 250mg of clomiphene for 5days and hCG. Eight of these 13 women ovulated. Their postovulatory mean progesterone (P) level 7days after hCG was 16±2ng/ml. Three pregnancies occurred during 25 treatment cycles. Posttreatment estrogen levels were higher when women were treated for 8days than for 5days. Women ovulating after 8days of treatment had increased concentrations of luteinizing hormone (LH) and testosterone (T) prior to hCG administration and higher pretreatment levels of estrogen and T, compared with women who did not ovulate. Changes in the timing of hCG administration may induce ovulation in some women who fail to ovulate when hCG is given on day 14. Because this 8-day regimen of clomiphene and hCG was successful in more than 50% of women failing to ovulate after 5days, this regimen should be used prior to human menopausal gonadotropin (hMG) therapy.