Which medication is commonly used to induce ovulation in women with anovulatory infertility?

Which medication is commonly used to induce ovulation in women with anovulatory infertility?

• A. Metformin
• B. Gonadotropins
• C. Letrozole
• D. Clomiphene

Answer: (D)

Clomiphene citrate is the first-line medicine used to trigger ovulation in many cases of anovulatory infertility. It works as a selective estrogen receptor modulator, binding to estrogen receptors in the hypothalamus and blocking estrogen’s normal negative feedback. With this blockade, GnRH pulses become more frequent, which stimulates the pituitary to release more FSH and LH. The rise in these gonadotropins promotes follicular growth and ultimately ovulation. It’s taken orally and is inexpensive, easy to use, and effective for many women with ovulatory dysfunction, especially in conditions like PCOS. However, its antiestrogenic effects can thin the lining of the uterus and alter cervical mucus, and there’s a small risk of multiple pregnancies due to increased follicular development. If clomiphene isn’t effective or isn’t well-tolerated, other options include letrozole (an aromatase inhibitor) or injectable gonadotropins, which carry higher costs and monitoring requirements. Metformin can help some women with PCOS by improving insulin resistance and may aid ovulation in specific cases, but it’s not the most common single-agent choice for inducing ovulation.

Clomiphene citrate is the first-line medicine used to trigger ovulation in many cases of anovulatory infertility. It works as a selective estrogen receptor modulator, binding to estrogen receptors in the hypothalamus and blocking estrogen’s normal negative feedback. With this blockade, GnRH pulses become more frequent, which stimulates the pituitary to release more FSH and LH. The rise in these gonadotropins promotes follicular growth and ultimately ovulation.

It’s taken orally and is inexpensive, easy to use, and effective for many women with ovulatory dysfunction, especially in conditions like PCOS. However, its antiestrogenic effects can thin the lining of the uterus and alter cervical mucus, and there’s a small risk of multiple pregnancies due to increased follicular development. If clomiphene isn’t effective or isn’t well-tolerated, other options include letrozole (an aromatase inhibitor) or injectable gonadotropins, which carry higher costs and monitoring requirements. Metformin can help some women with PCOS by improving insulin resistance and may aid ovulation in specific cases, but it’s not the most common single-agent choice for inducing ovulation.