Reappraisal of the use of clomifene for ovulation induction

Abstract

Ovulatory disorders represent at least 20% of causes of infertility. Women suffering from polycystic ovary syndrome are considered a subgroup of the World Heath Organization Group II ovulatory disorders, accounting for 80% of all cases of anovulation. Clomifene has traditionally been the first line of treatment, followed by gonadotrophins as a second line. However, changing concepts and better understanding of the pathophysiology of ovulatory disorders, particularly polycystic ovary syndrome, have allowed modification of the traditional approach. We describe a more individually tailored approach for ovulation induction based on the characteristics of each woman's initial screening. This is more likely to result in a further improvement of the balance between the chances of success versus complications, while keeping down the cost of treatment.