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    However, unlike estrogen, clomiphene binds to nuclear estrogen receptors for an extended interval of time and thereby depletes receptor concentrations by interfering with receptor cycling.


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    In addition to desirable central actions, clomiphene can exert less desirable anti-estrogenic effects at peripheral sites in the reproductive system.

    Estrogen plays a critical role in the formation of endometrium in natural cycles. Apart from its major role in proliferative phase, it also primes the endometrium for the luteal phase by the further proliferation of the basal cell layer and the induction of P- receptors 6, thereby ensuring the capacity of the endometrium to become secretory.

    Hence to counteract anti-estrogenic effects of clomiphene on endometrium, estrogen supplementation was initiated in the proliferative phase in clomiphene citrate stimulated IUI cycles in the present study. A sequential medication regimen, in which HMG is taken after clomiphene, has also been found to improve pregnancy rates in clomiphene cycles.

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  • We therefore hypothesized that patients un- dergoing the CC-SS ovulation induction cycle would have a higher follicular response than in a subsequent CC cycle.
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