Evidence mapPaperPMID 42226879Full record

ArticleCureus2026

Addition of Clomiphene Citrate to a Low-Dose Gonadotropin-Releasing Hormone (GnRH)-Antagonist Protocol in Poor Responders: A Prospective Cohort Study.

Olga Triantafyllidou, Evangelia Panagodimou, Stamatia Chasiakou, Angelos Gkontelos, Konstantinos Karkalemis, Maria Simopoulou, Despina Tzanakaki, Nikolaos Syggelos, Theodoros Kalampokas, Panagiotis Vakas and 4 more

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Olga TriantafyllidouSecond Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Evangelia PanagodimouDepartment of Obstetrics and Gynaecology, IASO General Hospital, Athens, GRC.
Stamatia ChasiakouDepartment of Family Medicine, Hippokration General Hospital, Athens, GRC.
Angelos GkontelosDepartment of Primary Education, University of Crete, Rethymno, GRC.
Konstantinos KarkalemisSecond Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Maria SimopoulouDepartment of Physiology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Despina TzanakakiIVF Unit, Second Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Nikolaos SyggelosSecond Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Theodoros KalampokasSecond Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Panagiotis VakasSecond Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Alexandros LazaridisSecond Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Fotios VlahosSchool of Medicine, University of Milano Bicocca, Milan, ITA.
Panagiotis ChristopoulosSecond Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.
Nikolaos VlahosSecond Department of Obstetrics and Gynaecology, Aretaieio University Hospital Medical School, National and Kapodistrian University of Athens, Athens, GRC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate whether the addition of clomiphene citrate (CC) to a low-dose recombinant follicle-stimulating hormone (FSH) (r-FSH) gonadotropin-releasing hormone (GnRH)-antagonist protocol improves clinical outcomes in women with poor ovarian response (POR) compared with a standard high-dose antagonist regimen.

methodsThis prospective cohort study included 31 women with POR according to the Bologna criteria who underwent two sequential in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) stimulation cycles: a standard-dose r-FSH protocol (300 IU/day), followed by a low-dose r-FSH protocol (150 IU/day) combined with CC (100 mg/day, cycle days 3-7). Each patient served as her own control. The primary outcome was the ongoing pregnancy rate. Secondary outcomes included follicle number, metaphase II (MII) oocytes, embryos, fertilization rate, biochemical and clinical pregnancy, and miscarriage. Statistical analyses included paired t-tests, Wilcoxon signed-rank tests, and Fisher's exact tests.

resultsThe number of follicles ≥ 17 mm and the number of mature oocytes retrieved were comparable between the standard-dose and CC/low-dose protocols (3.00 vs 2.90 follicles, p=0.665; 2.19 vs 2.06 MII oocytes, p = 0.462). Fertilization rates (27/68 (39.7%) vs 35/64 (54.7%), p = 0.116), total embryos (27 (0.87) vs 35 (1.13), p = 0.101), transferred embryos, and biochemical or clinical pregnancy rates did not differ significantly between protocols. No ongoing pregnancies occurred in the standard group, while three (3/31) were achieved after CC/low-dose stimulation (0% vs 9.7%, p = 0.238).

conclusionsIn women with POR, adding CC to a low-dose GnRH-antagonist protocol results in comparable ovarian response and pregnancy outcomes to a standard high-dose regimen, with the potential advantages of lower gonadotropin use and reduced cost. CC-based mild stimulation represents a viable alternative following an unsuccessful high-dose cycle.

Indexed as

add-onclomiphene citrategnrh antagonist protocolin vitro fertilization (ivf)poor respondersretrospective cohort study

Identifiers

PMID42226879
PMCPMC13222733

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.