1. Clomiphene therapy:
| a. | is usually started in a dosage of 100 mg. daily | False |
| b. | is usually started on day seven of the cycle | False |
| c. | is usually taken for seven days of the cycle | False |
| d. | is associated with an increased risk of multiple pregnancy | True |
| e. | is associated with a risk of ovarian hyperstimulation | True |
| f. | is a theoretical risk factor for ovarian cancer | True |
It is usually started between days two to
five in a dosage of 50 mg. daily and taken for five days each cycle.
The dosage can be increased, 50 mg. at a time, up to a maximum dosage of 200 mg. daily.
It hoodwinks the pituitary into thinking there is not a lot of oestrogen in circulation.
This makes the pituitary increase FSH production, thus encouraging ovulation.
It increases the risk of multiple pregnancy (from about 1% to more than 5%).
It is associated with ovarian cyst formation.
And its rare, but extreme, variant, OHSS, ovarian hyperstimulation syndrome (see MCQ paper 10, question 21).
There is no evidence that it is teratogenic.
Absence of ovulation due to pregnancy, lactation, breast feeding, the Pill etc. is protective with regard to ovarian cancer.By inducing ovulation, clomiphene becomes a theoretical risk factor.