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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Reproduction
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1512821
Clomiphene Citrate Reduces Premature LH Surge in Obese Women During Controlled Ovarian Stimulation: A Retrospective Cohort Study
Provisionally accepted- Department of Assisted Reproductive Medicine, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Background: Clomiphene citrate effectively suppressed the negative feedback of estrogen on the hypothalamus and induces luteinizing hormone (LH) elevation during controlled ovulation stimulation, while obese women often have impaired hypothalamic-pituitary function. This study aimed to investigate whether the utilization of clomiphene citrate for controlled ovulation stimulation in obese women can effectively decrease the likelihood of premature LH elevation.Methods: A retrospective study was conducted on women under the age of 38 with normal menstrual cycles and ovarian reserve who underwent controlled ovulation stimulation (COH) using clomiphene citrate. The participants were categorized by the Asian body mass index (BMI) classification. The dynamic reproductive endocrinological profiles during COH, especially the probability of serum LH concentration exceeding 10 IU/L, as well as the outcomes related to the embryo development and pregnancy, were compared among three BMI groups.Results: The basal levels of LH exhibited a significant reduction in overweight and obese women (p<0.001). Additionally, there was a significant decrease in the incidence of LH concentration exceeding 10 IU/L during controlled ovulation stimulation among overweight and obese women (7.19% vs 3.62% vs2.27%, p<0.05). Moreover, there were no significant differences observed among the three BMI groups regarding embryo transfer numbers, implantation, pregnancy or live birth rates.Conclusions: In obese women, clomiphene citrate effectively controlled LH levels, resulting a low prevalence of premature LH surge compared to patients with normal weight. This evidence contributes to a safer and more effective treatment for infertility in obese individuals.
Keywords: Obesity, Clomiphene citrate (CC), Luteinizing hormone (LH), In vitro fertilization(IVF), Assisted reproductive technology (ART)
Received: 17 Oct 2024; Accepted: 28 Feb 2025.
Copyright: © 2025 Zeng, Huang, Liu, SHEN, Nie, Wang and Kuang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Li Wang, Department of Assisted Reproductive Medicine, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Yanping Kuang, Department of Assisted Reproductive Medicine, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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