A nomogram to predict the probability of live birth after clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility

Fertil Steril. 2002 Jan;77(1):91-7. doi: 10.1016/s0015-0282(01)02929-6.


Objective: To establish whether initial screening characteristics of normogonadotropic anovulatory infertile women can aid in predicting live birth after induction of ovulation with clomiphene citrate (CC).

Design: Prospective longitudinal single-center study.

Setting: Specialist academic fertility unit.

Patient(s): Two hundred fifty-nine couples with a history of infertility, oligoamenorrhea, and normal follicle-stimulating hormone (FSH) concentrations who have not been previously treated with any ovulation-induction medication.

Intervention(s): 50, 100, or 150 mg of oral CC per day, for 5 subsequent days per cycle.

Main outcome measure(s): Conception leading to live birth after CC administration.

Result(s): After receiving CC, 98 (38%) women conceived, leading to live birth. The cumulative live birth rate within 12 months was 42% for the total study population and 56% for the ovulatory women who had received CC. Factors predicting the chances for live birth included free androgen index (testosterone/sex hormone-binding globulin ratio), body mass index, cycle history (oligomenorrhea versus amenorrhea), and the woman's age.

Conclusion(s): It is possible to predict the individual chances of live birth after CC administration using two distinct prediction models combined in a nomogram. Applying this nomogram in the clinic may be a step forward in optimizing the decision-making process in the treatment of normogonadotropic anovulatory infertility. Alternative first line of treatment options could be considered for some women who have limited chances for success.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Spontaneous / epidemiology
  • Amenorrhea / blood
  • Amenorrhea / drug therapy*
  • Clomiphene / therapeutic use*
  • Ejaculation
  • Female
  • Fertility Agents, Female / therapeutic use*
  • Follicle Stimulating Hormone / blood
  • Humans
  • Infant, Newborn
  • Infertility, Female / blood
  • Infertility, Female / drug therapy
  • Infertility, Female / etiology
  • Insulin-Like Growth Factor I / analysis
  • Leptin / blood
  • Male
  • Odds Ratio
  • Oligomenorrhea / blood
  • Oligomenorrhea / drug therapy*
  • Ovulation / drug effects
  • Ovulation / physiology
  • Ovulation Induction / methods*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome*
  • Probability
  • Retrospective Studies
  • Sperm Count
  • Treatment Outcome


  • Fertility Agents, Female
  • Leptin
  • Clomiphene
  • Insulin-Like Growth Factor I
  • Follicle Stimulating Hormone