Question 1

What is the Meaning of Clomiphene-Resistant?

Accepted Answer

Clomiphene-Resistant is a specific clinical designation applied to patients, typically women with anovulatory infertility, who fail to ovulate despite receiving a maximal therapeutic dose of the selective estrogen receptor modulator, clomiphene citrate. This state indicates a failure of the hypothalamic-pituitary-ovarian axis to respond adequately to the anti-estrogenic signaling intended to stimulate gonadotropin release. Identifying this resistance is a crucial clinical step that necessitates the escalation of fertility treatment protocols.

Question 2

What is the Origin of Clomiphene-Resistant?

Accepted Answer

The term originated in reproductive endocrinology following the introduction of clomiphene citrate (Clomid) as the primary oral agent for ovulation induction in the 1960s. It is a clinical descriptor that reflects a specific pharmacological failure within the delicate endocrine feedback system. The resistance is often associated with underlying conditions such as severe polycystic ovary syndrome (PCOS) or significant obesity, which can exacerbate insulin resistance and peripheral androgen excess.

Question 3

What is the Mechanism of Clomiphene-Resistant?

Accepted Answer

Clomiphene citrate acts by competitively binding to estrogen receptors in the hypothalamus, which the body interprets as low estrogen levels, thereby stimulating the release of Gonadotropin-Releasing Hormone (GnRH). In clomiphene-resistant individuals, high circulating estrogen from peripheral aromatization or an intrinsic hypothalamic-pituitary insensitivity may effectively override this negative feedback blockade. This mechanism prevents the necessary robust surge of Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) required for follicular maturation and subsequent ovulation.

Clomiphene-Resistant

Meaning

Origin

Mechanism

Can Anastrozole Be Used for Female Fertility Restoration?

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