Successful induction of ovulation in normogonadotrophic clomiphene resistant anovulatory women by combined naltrexone and clomiphene citrate treatment

Patients suffering from normogonadotrophic anovulation and infertility are initially treated with clomiphene citrate. Those who do not respond to clomiphene citrate usually receive gonadotrophin treatment which is labour-intensive, expensive, and associated with an increased risk of multiple pregnan...

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Bibliographic Details
Published in:Human reproduction (Oxford) 1997-08, Vol.12 (8), p.1720-1722
Main Authors: Roozenburg, B J, van Dessel, H J, Evers, J L, Bots, R S
Format: Article
Language:English
Subjects:
Administration, Oral
Adult
Anovulation - drug therapy
Biological and medical sciences
Clomiphene - therapeutic use
Drug Resistance
Drug Therapy, Combination
Female
Fertility Agents, Female - therapeutic use
Genital system. Reproduction
Gonadotropins - physiology
Humans
Medical sciences
Naltrexone - therapeutic use
Narcotic Antagonists - therapeutic use
Ovulation Induction - methods
Pharmacology. Drug treatments
Pregnancy
Pregnancy Rate
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Summary:Patients suffering from normogonadotrophic anovulation and infertility are initially treated with clomiphene citrate. Those who do not respond to clomiphene citrate usually receive gonadotrophin treatment which is labour-intensive, expensive, and associated with an increased risk of multiple pregnancies and ovarian hyperstimulation syndrome. We treated 22 patients with clomiphene resistant normogonadotrophic anovulation with naltrexone (an opioid receptor blocker) alone or naltrexone in combination with an antioestrogen. In 19 patients ovulation and resumption of a regular menstrual cycle was achieved and in 12 out of 19 a singleton pregnancy was observed. In conclusion, ovulation can be induced successfully using naltrexone alone or naltrexone in combination with an anti-oestrogen in clomiphene citrate resistant anovulatory patients. Compared to gonadotrophin induction of ovulation, this method is safe, simple and inexpensive.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/12.8.1720