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Clomifene has an onset of action of five to ten days following course of treatment and an elimination half-life about four to seven days. [2] [4] In one study, after a single 50 mg dose of clomifene, the half-life of clomifene was 128 hours (5.3 days), of 4-hydroxyclomifene was 13 hours, and of 4-hydroxy-N-desethylclomiphenewas 15 hours. [2]
It is one of the two stereoisomers of clomifene, which itself is a mixture of 38% zuclomifene and 62% enclomifene. [3] Enclomifene is the (E)-stereoisomer of clomifene, while zuclomifene is the (Z)-stereoisomer. [4] [5] Whereas zuclomifene is more estrogenic, enclomifene is more antiestrogenic. [3]
Between days 5 and 7, one follicle is selected to continue development while the others undergo atresia, a process influenced by anti-Müllerian hormone (AMH). By day 8, the selected follicle dominates by promoting its growth and inhibiting the development of others. [15]
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[7] [8] These values are substantially longer than those of testosterone enanthate (which, in castor oil, has values of 4.5 days and 8.5 days, respectively). [27] Testosterone undecaondate has very low bioavailability when taken orally, only about 3-7% in men and 4-10% in women.
In the largest U.S. study, which used data from a statewide registry of birth defects, [17] 6.2% of IVF-conceived children had major defects, as compared with 4.4% of naturally conceived children matched for maternal age and other factors (odds ratio, 1.3; 95% confidence interval, 1.00 to 1.67). [13]
Cyclofenil is used to treat menstrual disturbances and anovulatory infertility caused by insufficiency of the hypothalamic–pituitary–gonadal axis in women. [3] It has also been used to treat menopausal symptoms. [3] The medication is generally used at a dosage of 400 to 600 mg per day. [3] [8] [9]
[29] [5] In 10–20% of cases, no cause is found. [5] The most common cause of female infertility are ovulation problems, usually manifested by scanty or absent menstrual periods. [7] Male infertility is most commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity. [6]
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