You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Which of the following is true about clomiphenc citrate? and explain in detail?
Ans. a. Enclomipheneis anti-estrogenic Eticlomiphene is more potent isomer and antiestrogenic whereas zuclomiphene is weak antiestrogenic (AIIMS May 2010, May 2009 Repeat).Clomiphene Citrate: It is usual first choice for ovulation induction in most patients because of relative safety, efficacy, route of administration and relatively low cost. Novak s 14/e p1064"Clomiphene Citrate: Multiple ovulation and multiple pregnancy in IOdeg/k "- Shaw 15/e p3l4Pregnancy occurs in 40-50% of women following treatment and even though the dosage is carefully monitored. 5-10% of the conceptions are multiple. "-Jeffcoates 7/e p105A randomized clinical trial conducted by WHO involving nearly 200 men and over 1300 couple months of observation found no differences among men treated with clomiphene or placebo.Moreover a meta analysis including 10 randomized trials involving over 700 men concluded that evidence is inefficient to indicate anti-estrogen treatment improves semen quality or male infertility. Leon speroff 8/e p1281Clomiphene Citrate* It is non-steroidal triphenylethylene compound related to diethylstilbestrol (DES).* It is an isomer of cis and trans form.* Enciomiphene is more potent isomer and antiestrogenic whereas zuclomiphene is weakantiestrogenic.Mechanism of Action:* It hinds to estrogen receptors in the hypothalamus, so the negative feedback of estrogen on FSH is prevented resulting in pulsatile GnRH frequency and rise in FSH and LH.* The antiestrogenic effects of clomiphene are seen on cervix and endometrium.Clomiphene CitrateIndicationsContraindications* Anovulation, PCOS* Anovulatory DUB with infertilityAmenorrhea and anovulation following the use of OCPs (Postpill amenorrhea)* IVF, GIFT technique and assisted reproduction technique* Cystic ovaries* Chronic liver disease* Scotoma* Hypogonadotrphic and hypoestrogenic statesResult:* 60-80% ovulate but 30-40% conceive because of antiestrogenic effect of clomiphene in cervical mucus leading to thick cervical mucus.* Multiple pregnancy chances with clomiphene are 10%.