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Clomiphene‐Induced Changes in Endometrial Receptor Kinetics on the Day of Ovum Collection after Ovarian Stimulation: A Study on Cytosol and Nuclear Estrogen and Progestin Receptors and 17/β‐Hydroxysteroid Dehydrogenase
Author(s) -
RÖNNBERG LARS,
ISOTALO HANNU,
KAUPPILA ANTTI,
MARTIKAINEN HANNU,
VIHKO REIJO
Publication year - 1985
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1985.tb37547.x
Subject(s) - endocrinology , medicine , clomifene , human chorionic gonadotropin , estrogen , gonadotropin , stimulation , ovulation , progestin , estrogen receptor , receptor , ovary , biology , chemistry , ovulation induction , hormone , cancer , breast cancer
Clomiphene citrate (CC) in combination with human menopausal gonadotropin (hMG), human chorionic gonadotropin (hCG), or both (hMG‐hCG) has a central role in ovarian stimulation in present in vitro fertilization (IVF) programs. It is thought that the ovarian response to clomiphene citrate is dose‐dependent, which has led to the use of high doses of this compound. 1,2 However, the success rate in embryo transfer (ET) seems to be lower after high‐dose than low‐dose stimulation. 3,4 The reason for this undesirable effect is unknown. Besides having pituitary‐ovarian effects, clomiphene citrate, like other antiestrogens, also has endometrial actions. Antiestrogens bind to cytosolic estrogen receptors, and the estrogen‐receptor complex formed is transferred to the nucleus for an extended period of time, with resultant changes in female sex steroid receptor kinetics, as has been observed in animal 5–7 and human studies. 8,9 It is therefore possible that high doses of clomiphene citrate lead to changes in endometrial function that may be detrimental for the success of embryo transfer. We evaluated this possibility by taking endometrial specimens for determination of female sex steroid receptor and 17β‐hydroxysteroid dehydrogenase in patients receiving two different doses of clomiphene citrate for ovarian stimulation and in whom adhesions prevented oocyte collection. The results were compared with those obtained in healthy, untreated, ovulatory women.