Clomiphene-associated combined hyperlipidemia: a case report.

BACKGROUND

Hyperlipidemia associated with clomiphene use is an uncommon but potentiallly serious complication of this therapy. Clomiphene is structurally similar to other synthetic estrogen analogs, which are known to induce marked hypertriglyceridemia. There is a paucity of data regarding the effects of clomiphene on lipid metabolism in humans.

CASE: A 33-year-old woman with obesity, polycystic ovary syndrome and a long history of amenorrhea was treated with clomiphene therapy to induce ovulation. Baseline lipids were suggestive of an underlying lipid disorder, but there was a marked deterioration in her lipid profile in association with the use of clomiphene. On cessation of the clomiphene therapy her lipid profile slowly improved, and specific lipid-lowering therapy was not used. Further investigation for the possibility of an underlying lipid disorder confirmed the diagnosis of familial dysbetalipoproteinemia.

CONCLUSION

Clomiphene should be used cautiously in women known to have dyslipidemia. We recommend that patients with predisposing risk factors have their lipids measured prior to ovulation induction with clomiphene.