Treatment with clomiphene citrate should be limited to ---- ovulatory cycles?
High-Yield Explanation
Clomiphene citrate is a weak synthetic estrogen that mimics the activity of an estrogen antagonist when given at typical pharmacologic doses for the induction of ovulation.A functional hypothalamic-pituitary-ovarian axis is usually required for appropriate clomiphene citrate action. More specifically, clomiphene citrate is thought to bind and block estrogen receptors in the hypothalamus for prolonged periods, thereby decreasing the normal ovarian-hypothalamic estrogen feedback loop. This blockade increases GnRH pulsatility, leading to increased pituitary secretion of gonadotropins, which promote ovarian follicular development.Treatment should be limited to 6 ovulatory cycles or 12 total cycles.Reference: Novak's Gynecology; 14th edition; Chapter 32; Infeility and Assisted Reproductive Technology