An infertile patient has received two 5-day courses of clomiphene [Clomid] to help her conceive. An ultrasound 1 week after the last dose reveals that follicular maturation has occurred without ovulation
The nurse expects the next step for this patient to be: a. administration of human chorionic gona-dotropin (hCG).
b. an order for cabergoline to be given twice weekly.
c. evaluation of ovarian and pituitary func-tion.
d. repeating clomiphene once daily for 5 days.
A
When treatment with clomiphene has failed to produce ovulation after two courses, hCG is used to promote ovulation after follicular maturation has occurred. Cabergoline is used to treat hyper-prolactinemia when excessive prolactin secretion occurs. Ovarian and pituitary function should be evaluated before a patient begins treatment with clomiphene. If ovulation had occurred, another cycle of clomiphene would be indicated.
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