Tamoxifen anovulatory infertility

Women with anovulatory infertility should be offered full endocrinological evaluation, considering potential diagnoses such as hypothalamic-pituitary disease, polycystic ovary syndrome and primary gonadal disease. Hyperprolactinaemia must be sought as a potential cause, and its treatment is outlined below. The main treatments available include the anti-oestrogens clomiphene and tamoxifen, and gonadotrophin therapy. 

Tamoxifen is a nonsteroid competitive oestrogen antagonist on target organs. Although available for anovulatory infertility (20 mg daily on days 2, 3, 4 and 5 of the cycle) its main use now is in the treatment of oestrogen-dependent breast cancer. Treatment with tamoxifen delays the growth of metastases and increases survival if tolerated it should be continued for 5 years. 

Clomiphene is an ovulation stimulant that induces ovulation in selected anovulatory women. It is indicated in the treatment of ovulatory failure in women desiring pregnancy when the partner is fertile and potent. Clomiphene (Clomid, serophene, others) is approved for the treatment of infertility in anovulatory women, and fulvestrant is used for the treatment of breast cancer in women with disease progression after tamoxifen. 

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See also in sourсe #XX -- [ ]

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