Clomiphene citrate throughout the duration of ovarian stimulation: an approach to decrease costs, reduce injection burden, and prevent premature ovulation in patients with diminished ovarian reserve

Clomiphene citrate (CC) has been widely utilized as an adjunct in ovarian stimulation protocols for in-vitro fertilization (IVF) to capitalize on pituitary follicle-stimulating hormone (FSH) release in patients with diminished ovarian reserve (DOR). In these protocols, CC is typically administered with gonadotropins for the first five days followed by GnRH antagonist to prevent premature ovulation. However, due to its antiestrogenic mechanism of action at the pituitary, CC may also effectively prevent the LH surge if continued until day of trigger.