Clomifene Health Dictionary

The inability to produce offspring, which may result from a problem in either the male or the female reproductive system, or, in many cases, from a combination of problems in both.

The main cause of male infertility is a lack of healthy sperm. In azoospermia, no sperm are produced; in oligospermia only a few sperm are produced. In some cases, sperm are produced but are malformed or short-lived. The underlying cause of these problems may be blockage of the spermatic tubes or damage to the spermatic ducts, usually due to a sexually transmitted infection. Abnormal development of the testes due to an endocrine disorder (see hypogonadism) or damage to the testes by orchitis may also cause defective sperm. Smoking, toxins, or various drugs can lower the sperm count. Other causes are disorders affecting ejaculation (see ejaculation, disorders of). Rarely, male infertility is due to a chromosomal abnormality, such as Klinefelter’s syndrome, or a genetic disease, such as cystic fibrosis.

The most common cause of female infertility is failure to ovulate. Other causes are blocked, damaged or absent fallopian tubes; disorders of the uterus, such as fibroids and endometriosis; problems with fertilization, or implantation in the uterus (see implantation, egg). Infertility also occurs if the woman’s cervical mucus provides antibodies that kill or immobilize her partner’s sperm. Rarely, a chromosomal abnormality, such as Turner’s syndrome, is the cause of a woman’s infertility.

Investigations to discover the cause of a woman’s infertility may include blood and urine tests, to check that ovulation is occurring, and laparoscopy to determine whether or not an abnormality is present. The initial investigation for male infertility is seminal fluid analysis.

Treatment of male infertility is limited. The only option for azoospermia is adoption of children or artificial insemination by a donor. If the sperm count is low, artificial insemination by the male partner may be tried. In some cases of male infertility due to a hormonal imbalance, drugs such as clomifene or gonadotrophin hormone therapy may prove useful.

Failure of the woman to ovulate requires ovarian stimulation with a drug such as clomifene, either with or without a gonadotrophin hormone. Microsurgery can sometimes repair damage to the fallopian tubes. If surgery is unsuccessful, in vitro fertilization (IVF) is the only option. Uterine abnormalities or disorders, such as fibroids, may require treatment. In some cases, provided the woman has normal fallopian tubes, gamete intrafallopian transfer (GIFT) or zygote intrafallopian transfer (ZIFT) may be carried out.... infertility

A group of hormonal or hormone-related drugs used to treat some types of infertility.

In women, fertility drugs may be given when abnormal hormone production by the pituitary gland or ovaries disrupts ovulation or causes mucus around the cervix to become so thick that sperm cannot penetrate it. In men, fertility drugs are less effective, but they may be used when abnormal hormone production by the pituitary gland or testes interferes with sperm production. (See also clomifene; gonadotrophin hormones; testosterone.)... fertility drugs

A condition, also called Stein–Leventhal syndrome, that is characterized by oligomenorrhea or amenorrhoea (scanty or absent periods), infertility, hirsutism (excessive hairiness), and obesity. Often, there are multiple ovarian cysts. Most women with polycystic ovaries begin menstruation at a normal age, but after a year or two periods become highly irregular and then cease. Hirsutism and obesity occur in about 50 per cent of cases.

The condition results from an imbalance of two gonadotrophin hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This hormonal imbalance is associated with raised levels of testosterone and oestrogen.

Treatments include clomifene and oral contraceptives. Polycystic ovaries are often associated with high oestrogen levels in the body, which increase the risk of endometrial cancer (see uterus, cancer of); treatment with progesterone may be recommended for this problem. ... ovary, polycystic

(oestrogen-receptor antagonist) n. one of a group of drugs that oppose the action of oestrogen by binding to *oestrogen receptors in the body’s tissues. The most important of these drugs is currently *tamoxifen, which is used in the treatment of breast cancers dependent on oestrogen. Because they stimulate the production of pituitary *gonadotrophins, some anti-oestrogens (e.g. *clomifene, tamoxifen) are used to induce or stimulate ovulation in infertility treatment. Side-effects of anti-oestrogens include hot flushes, itching of the vulva, nausea, vomiting, fluid retention, and sometimes vaginal bleeding.... anti-oestrogen

(PCOS, Stein–Leventhal syndrome) a heterogeneous disorder characterized by *hyperandrogenism (clinical hirsutism, biochemical hyperandrogenism, or both) and ovarian dysfunction (with *polycystic ovaries), which results in amenorrhoea or oligomenorrhoea (absent or infrequent menstrual periods) and is associated with subfertility (from lack of ovulatory menstrual cycles). The condition is associated with obesity and *insulin resistance, which increase the risk of type 2 *diabetes mellitus, endometrial cancer, and cardiovascular disease. Treatment is based on dietary and exercise advice, *metformin, hormones to regulate the menstrual cycle, and in cases of subfertility, *clomifene to induce ovulation; the hyperandrogenism usually responds to *anti-androgens.... polycystic ovary syndrome