OC-Clomiphene Tx aids Ovulation. (Randomized, Controlled Trial).

RANCHO MIRAGE, CALIF.--Ovulation and pregnancy rates soared in women who had previously failed clomiphene citrate--based infertility therapy when they received 2 months of monophasic oral contraception before trying clomiphene again, Dr. Emmett F. Branigan reported.

Results from the prospective, randomized, controlled trial of 48 patients confirmed conclusions drawn from an earlier, observational study of the approach in infertile young women who previously failed to ovulate despite doses of clomiphene of 150 mg or more, he said at the annual meeting of the Pacific Coast Obstetrical and Gynecological Society.

Furthermore, endocrine profiles conducted in conjunction with the current study point convincingly to androgen changes as an explanation for why the regimen works so well, said Dr. Branigan, director of the Bellingham (Wash.) IVF and Infertility Care Center.

Infertility patients who failed to ovulate on maximal doses of clomiphene were randomized to one of two groups:

* The treatment group was composed of 24 women who were given a continuous oral monophasic contraceptive for 42-50 days and, following withdrawal bleeding, were given 100 mg of clomiphene citrate on days 5-9 of their cycles.

* The control group was composed of 24 women. They were instructed to wait for 1-2 drug-free spontaneous menstrual cycles (38-56 days), after which they received 100 mg of clomiphene citrate on cycle days 5-9.

Clomiphene cycles were repeated in up to six cycles in any patient who ovulated but did not become pregnant.