The clomiphene test is a functional test of the hypothalamus (section of the diencephalon). Clomiphene (3-methoxy-17-epiestriol) is an ovulation trigger from the group of antiestrogens. The term ovulation trigger refers to drugs that can trigger ovulation (ovulation) by stimulating endogenous (the body’s own) hormones.
Clomiphene acts via feedback inhibition of estrogens. Thus, the central antiestrogenic effect (hypothalamic-pituitary) enhances gonadotropin release, that is, the mitcyclic FSH/LH increase (peak), and induces ovulation (ovulation).
The procedure
In the clomiphene test, the patient takes 50 mg of clomiphene twice daily for five days. In the case of infertility therapy: starting on the 3rd-5th day of the cycle (of a spontaneous cycle) or following a drug-induced abortion bleeding, 50 mg (starting with a lower dose if necessary) of clomiphene (Dyneric, Pergotime) for 5 days. After cessation of intake, ovulation is triggered if the hormonal system (hypothalamus–pituitary gland) is intact and anatomical conditions are normal.
Various side effects may occur with the clomiphene test. Chief among these are:
- Hot flashes / sweating.
- Flush
- Gastrointestinal symptoms such as abdominal pain, nausea, vomiting.
- Ovarian hyperstimulation with enlargement of the ovaries, ovarian cysts (especially in women with polycystic ovaries; PCO syndrome).
- Visual disturbances (visual disturbances)
In addition, multiple pregnancies are more common after treatment with ovulation triggers.
Indications
- After positive gestagen test in fertility patients.
- For fertility diagnostics or infertility therapy in cases of suspected
- Corpus luteum insufficiency (luteal weakness) – disturbance of the cycle, which may be the cause of infertility.
- Anovulatory cycles – cycles without ovulation.
- Normogonadotropic amenorrhea – absence of menstruation with normal levels of gonad-stimulating hormones (gonadotropins).
Contraindications
- Brain tumors
- Liver dysfunction
- Ovarian cysts (ovarian cysts)
- Tumors of the ovaries (ovaries)
- Unclear genital bleeding
Interpretation
- Follicular maturation (oocyte maturation) and ovulation (ovulation), if present, can be detected sonographically (by ultrasound). The corpus luteum function is determined by progesterone determinations.
- Detection of the stimulation effect on gonadotropin secretion can be done by LH determination in serum
