This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
Side effects of clomiphene citrate include all, EXCEPT: 
Select and explain. 
A. Multiple pregnancy, B. Increase risk of ovarian ca, C. Multiple polycystic ovary, D. Teratogenic effect on offsprings
D: Teratogenic effect on offsprings
Answer: D: Teratogenic effect on offsprings 
Explanation: There is no evidence of teratogenicity observed in humans when the drug used to induce ovulation. Clomiphene increases gonadotropin secretion and stimulates ovulation. It increases the amplitude of LH and FSH pulses without changing pulse frequency. It acts largely at the pituitary level to block inhibitory actions of estrogen on gonadotropin release from the gland and causing the hypothalamus to release larger amounts of GnRH per pulse. Side effects of clomiphene include; Multiple gestation Ovarian hyperstimulation syndrome (OHSS) Ovarian cysts Hot flashes Blurred vision Risk of ovarian cancer Ref: Levin E.R., Hammes S.R. (2011). Chapter 40. Estrogens and Progestins. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.