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Am Fam Physician. 2026;113(1):online

Author disclosure: No relevant financial relationships.

DETAILS FOR THIS REVIEW

Study Population: 15 studies conducted in Asia, Europe, and North America with a total of 2,348 women with normogonadotropic anovulation or polycystic ovary syndrome (PCOS) and clomiphene resistance or failure

Efficacy End Points: Live birth rate per woman; clinical pregnancy rate per woman

Harm End Points: Rates of multiple pregnancy, miscarriage, ectopic pregnancy, and ovarian hyperstimulation syndrome per woman

Benefits
1 in 11: increased live birth rate per woman
1 in 8: increased clinical pregnancy rate per woman
Harms
1 in 25: miscarriages per woman

Narrative: In women with PCOS who are trying to conceive, clomiphene has often been used as a first-line agent to induce ovulation.1,2 Clomiphene induces or restores ovulation in approximately 75% of women, but only approximately one-half of those women conceive after 6 months of treatment.3,4

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Copyright ©2026 MD Aware, LLC (theNNT.com). Used with permission.

This series is coordinated by Christopher W. Bunt, MD, AFP assistant medical editor, and the NNT Group.

A collection of Medicine by the Numbers published in AFP is available at https:// www.aafp.org/afp/mbtn.

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