A 'sweet' indication for ovulation induction

In diabetic patients, euglycaemia at the time of conception is crucial for the success of the pregnancy. In consideration of the difficulty in achieving and maintaining tight glycaemic control for long periods, we administered clomiphene citrate, which is usually indicated in cases of absent or infrequent ovulation, to enhance fecundability in 10 pregestational diabetic patients. All conceived within one to three cycles of the drug, and nine delivered healthy term babies after uneventful pregnancies; one aborted spontaneously in the eighth gestational week. No effect of the drug on the diabetes was noted as based on measurements of glycosylated haemoglobin and fructosamine concentrations and the absence of changes in the patients' insulin requirements. In the light of these successful results, and in view the importance of euglycaemia at the beginning of diabetic pregnancies, we suggest a new 'sweet' indication for the use of clomiphene citrate.