Clomiphene citrate (CC), also known as clomiphene and clomiphene, is the most widely used and clinically preferred ovulation-promoting drug, which is simple, inexpensive and non-teratogenic. Why can clomiphene promote ovulation? Let’s take a look at the introduction of experts from the Military General Hospital. Clomiphene has a weak agonistic and strong antagonistic dual effect on estrogen, stimulating ovulation may be in the hypothalamus, the first antagonistic dominance, through the competitive occupation of the hypothalamic estrogen receptors, interfering with the negative feedback of endogenous estrogen, prompting increased secretion of luteinizing hormone and follicle-producing hormone, followed by stimulation of follicle growth, follicle maturation, increased release of estrogen, stimulated by positive feedback The release of gonadotropins peaks before ovulation, so ovulation, and the treatment of male infertility may be related to the elevation of FSH and LH and the promotion of spermatogenesis. The chemical structure of CC is similar to estrogen and binds to estrogen receptors in the hypothalamus so that the hypothalamic receptors are occupied and do not recognize endogenous estrogen, thus the hypothalamus signals the pituitary gland to stimulate ovarian follicle development. Rather, the secretion of GnRH into the pituitary portal system stimulates the pituitary gland to secrete FSH and LH, which in turn promotes follicular development, often leading to the growth and maturation of a number of follicles. The main clinical application of CC is its racemic mixture citrate, 50 mg per tablet, for patients with anovulatory dysplasia, luteal insufficiency and anovulatory dysfunction. Patients with low estrogen do not respond to CC. CC alone cannot improve the quality of oocytes and therefore does not improve the pregnancy rate in women with regular ovulation. Dosage: Start on day 5 of natural or artificially induced menstrual cycle, initially 50mg/d for 5 days. After 3 cycles of application without ovulation, increase the dose to 100-150mg per day for 5 days, each dose can be tried for 2-3 cycles. If ovulation is still absent after 150 mg cycles or the luteal phase is shortened to 6-9 days (as indicated by basal body temperature), additional chorionic gonadotropin (HCG) 1000 IU may be administered intramuscularly to promote ovulation and prolong the luteal phase, and the addition of dexamethasone or extended clomiphene may help restore ovulation in patients with conventional dosage of anovulation. The increase of the dosage is not related to the hormone level of the patient, but to the weight of the patient. The increase in dose is not related to the patient’s hormone level but to the patient’s weight. CC can be considered ineffective if there is no ovulation after 3 cycles of high dose CC treatment. Although the ovulation rate of CC is high, averaging 80%, the pregnancy rate is only 30%-40%, and the spontaneous abortion rate after pregnancy is as high as 10%-33.3%. Studies have shown that clomiphene directly affects the response of the endometrium to hormones, leading to luteal insufficiency. The effect of clomiphene on cervical mucus is also a cause of low pregnancy rates. Because the basal body temperature and cervical mucus in patients with luteinized follicular nonrupture syndrome were similar to normal ovulation, the addition of ultrasound monitoring led to the understanding that luteinized follicular nonrupture syndrome was one of the reasons for the high ovulation rate and low pregnancy rate in CC. The incidence of follicular luteinization increased from 10% to 31% after CC compared with natural cycles. Hexestrol 0.05mg or Bemisil 0.625mg was added before and after ovulation to improve the quality of cervical mucus and increase the thickness and structure of the endometrium to facilitate the entry of sperm. For hyperandrogenemia, add prednisone 5mg or dexamethasone 0.5mg to lower the androgen level of adrenal glands, improve the responsiveness of follicles to gonadotropins, and enhance the ovulation-promoting effect of CC. Does clomiphene have any side effects? The side effects of CC are rare. Occasional facial flushing, abdominal distension or soreness, breast discomfort, nausea, vomiting, visual disturbances including blurred vision, flashes of light in front of the eyes or black spots or abnormal recognition may occur in about 1.5% of people, which often disappears 1-2 weeks after the drug is administered.