General consideration

1. Clomiphen citrate (clomid, serophen) a. nature : synthetic, nonsteroidal, biologically weak long-acting estrogen agonist b. action : competitive inhibitor of estrogen blocking estrogen Rc at the hypothalamic & pituipaty level - increase FSH release from pituitary by (-) feedback c. criteria for the selection of patients for clomid ① evidance of pituitary fx ② no evidance of primary ovarian failure ③ normal prolactin assay ④ normal thyroid & adrenal fx ⑤ no other treatable cause of amenorrhea ⑥ no obvious infertility factor d. dosage & duration : 50-100 mg/day for 5-10 days from cycle day 3-5 (dosage↑- FSH 보강, duration↑- LH 보강) e. monitoring : BBT(basal body temperature, 일어나자 마자 움직이지 말고 혀 밑에서 잼) cervical mucus(clomiphen day 12-14), E2, LH, ultrasonogram, P4, endometrial Bx(clomiphen day 25-27) * if 배란이 없으면 ① daily dose 증가 (FSH 증가) ② duration 증가 (poor estrogenic mucus -- LH 증가) ③ administration of hCG (ovulation does not occur but excellent rstrogenic mucus, fai…
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