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Multiple pregnancy rate in patients undergoing treatment with clomifene citrate for WHO group II ovulatory disorders: a systematic review

Lookup NU author(s): Dr Jane Stewart


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© 2021 The British Fertility Society.Clomifene citrate has long been associated with a multiple pregnancy rate of up to 8–10%. Studies from which these figures originated have largely included patients who received clomifene outside of current national and international treatment guidelines. In January 2020, a systematic review of MEDLINE and relevant reference lists was conducted. Studies were included that reported multiple pregnancy rate in a cohort of patients undergoing treatment with single agent clomifene citrate for WHO group II dysovulatory subfertility. Twelve studies were included in the analysis, with a total sample size of 1,387 patients. The overall multiple pregnancy rate was 3.8% (3.6% twins/0.2% triplets); this dropped to 2.4% (all twins) when studies with a mean BMI ≥35kg/m2 were excluded. This review suggests that contemporary single agent clomifene use following current guidelines in terms of indication, results in a lower than expected multiple pregnancy rate. Further evidence from clinical practice is required to ensure that patients are adequately informed.

Publication metadata

Author(s): Garthwaite H, Stewart J, Wilkes S

Publication type: Review

Publication status: Published

Journal: Human Fertility

Year: 2022

Volume: 25

Issue: 4

Pages: 618-624

Online publication date: 15/01/2021

Acceptance date: 16/11/2020

ISSN (print): 1464-7273

ISSN (electronic): 1742-8149

Publisher: Taylor and Francis Ltd.


DOI: 10.1080/14647273.2021.1872803

PubMed id: 33451262