hCG administration offers no outcome benefit over spontaneous ovulation in anovulatory women treated with clomiphene citrate. A prospective randomized trial comparing clomiphene citrate with tamoxifen citrate for ovulation induction.
This randomized controlled trial compared spontaneous ovulation versus hCG-triggered ovulation in anovulatory women treated with clomiphene citrate. No statistically significant differences were observed between the two groups in terms of ovulation and pregnancy rates. To compare the rates of ovulation and pregnancy after tamoxifen citrate (TMX) or clomiphene citrate (CC) among anovulatory women with infertility.
                Prospective randomized trial.
                Infertility clinic in a university teaching hospital.
                Eighty-six anovulatory women under 40 years of age undergoing ovulation induction.
                The women were assigned randomly to receive either TMX or CC on cycle days 5-9.
                Rates of ovulation and pregnancy for the two treatment modalities.
                The overall rate of ovulation in the TMX group was 50 of 113 (44.2%) and in the CC group, 41 of 91 (45.1%). There were 10 pregnancies in the TMX group and 6 pregnancies in the CC group. The cycle fecundity per ovulatory cycle was 20.0% in the TMX group and 14.6% in the CC group.
                The overall rate of ovulation and pregnancy were similar with TMX and CC. TMX is a suitable alternative agent to CC in the management of anovulatory infertility.
There is inadequate evidence to recommend or refute the use of urinary hCG, as an ovulation trigger, in anovulatory women being treated with clomiphene citrate. We did not find trials evaluating the use of ovulation triggers in anovulatory women, being treated with other ovulation inducing agents.