Being a selective estrogen receptor inhibitor (SERM) tamoxifen may be used an alternative to clomiphene citrate for ovulation induction in women with anovulatory infertility. This study was conducted to evaluate the safety and efficacy of tamoxifen as compared to clomiphene citrate in women with primary or secondary anovulatory infertility.
Methods: One hundred women suffering from anovulatory infertility and attending the infertility clinic and were recruited for the study. Patients were randomized to receive either clomiphene citrate (50 mg) or tamoxifen treatment (40 mg). The ovulation was monitored from day 3 to day 7 of menstrual cycle followed up by transvaginal ultrasound from day 11 every alternate day for 10 days. Ovulation and pregnancy rates were calculated.
Results: The baseline characteristics of mean age, weight, and mean duration of infertility were comparable between both the study groups. Out of 100 patients who received clomiphene citrate, 51 showed successful ovulation (ovulation rate of 45.94%) and 5 patients conceived (pregnancy rate of 10%). In tamoxifen group 67 women showed successful ovulation (ovulation rate of 59.82%) and 9 women conceived (pregnancy rate of 18%). The difference was significantly different (p>0.05). No major adverse effects were noted in both the study groups.
Conclusions: Tamoxifen has shown comparable efficacy and safety as compared to clomiphene citrate and it can be a good alternative to clomiphene citrate in patients of primary or secondary anovulatory infertility.