Observations on the combination of clomiphene citrate-human menopausal gonadotropin-human chorionic gonadotropin in the management of anovulation.

To study the effects of the addition of clomiphene citrate to human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG), 23 cycles of clomiphene citrate-hMG-hCG (CHH) were administered to 10 anovulatory women. Of these 10 women, 5 also received 15 cycles of hMG-hCG (HH). Although there was a significant increase in the ovulation rate in the CHH group (p less than 0.01), there was no difference in the pregnancy rate (p less than 0.05). Patients in the CHH group required significantly less hMG for ovulation induction than the HH group (p less than 0.01). Patients receiving CHH who had low serum levels of follicle-stimulating hormone required significantly more hMG than those with normal values. The luteinizing hormone releasing hormone test may predict those patients who will require less hMG during CHH therapy. The relative safety of the CHH treatment is discussed.