Fukushima, T., & Maeyama, M. (1983). Action of tamoxifen on folliculogenesis in the menstrual cycle of infertile patients. Fertility and Sterility, 40(2), 210-214. https://doi.org/10.1016/s0015-0282(16)47239-0
Fukushima T, Maeyama M. Action of tamoxifen on folliculogenesis in the menstrual cycle of infertile patients. Fertil Steril. 1983;40(2):210-214. doi:10.1016/s0015-0282(16)47239-0
Fukushima, Taito, and Masao Maeyama. "Action of tamoxifen on folliculogenesis in the menstrual cycle of infertile patients." Fertility and Sterility, vol. 40, no. 2, 1983, pp. 210-214.
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Tamoxifen lengthened the luteal phase in eight infertile women
In a 1983 before-and-after study of eight women with infertility and no apparent cause, tamoxifen lengthened the luteal phase from an average of 12.8 to 14.1 days. Estradiol rose, while FSH, LH and prolactin stayed similar. The authors suggest the drug may act on the ovary itself.
Key Findings
The follicular phase averaged 15.4 ± 0.8 days in untreated cycles and 14.0 ± 0.6 days in tamoxifen cycles, a difference that was not statistically significant.
The luteal phase lengthened from 12.8 ± 0.4 days to 14.1 ± 0.8 days (P < 0.05). Mean menstrual cycle length was unchanged.
In tamoxifen cycles, estradiol rose on day 8 and was significantly higher from day 10 to midcycle (P < 0.05). Follicular phase estradiol totaled 1.4 times the untreated cycle (P < 0.025).
FSH, LH and prolactin during the follicular phase and at the midcycle peak showed no significant difference from untreated cycles.
Midluteal estradiol and progesterone were both significantly higher after tamoxifen than in untreated cycles (P < 0.005 for each).
Interpretation
The study is a before-and-after comparison. Each of eight women served as her own control, with one untreated cycle followed by one tamoxifen cycle. The women were 26 to 33 years old, had tried to conceive for 1 to 7 years, and had regular cycles and open tubes. Daily blood samples through the follicular phase tracked hormones, and basal body temperature charts set the luteal length. Because pituitary hormones stayed similar while estradiol rose, the authors suggest the drug may act on the ovary itself.
RRM Context
Restorative reproductive medicine is cycle-charting-informed, and luteal length is one thing a chart can show. This study timed the luteal phase from basal body temperature charts. The authors start from the view that the luteal phase depends mainly on events before and around ovulation. Their earlier report linked tamoxifen to pregnancy in 6 of 17 patients with luteal phase deficiency.
Our editorial summary of this paper, not the article's abstract.
Abstract
Daily estimations of follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, and progesterone were made in the serum of eight infertile patients from day 1 through the follicular phase during menstrual cycles before and after tamoxifen therapy. Tamoxifen therapy was found to shorten the follicular phase from 15.4 +/- 0.8 days (mean +/- standard error of the mean) to 14.0 +/- 0.6 days (difference not significant) and to lengthen the luteal phase from 12.8 +/- 0.4 days to 14.1 +/- 0.8 days (P less than 0.05). The mean estradiol concentration in the eight patients during tamoxifen treatment cycles rose on day 8 (3 days after starting tamoxifen treatment) and increased significantly (P less than 0.05) from day 10 to midcycle. The integrated follicular phase estradiol concentration in the tamoxifen treatment cycle increased to 2450.1 +/- 208.1 pg/ml/cycle, and was significantly higher (P less than 0.025) than that in the nontreatment cycle. In contrast, the concentrations of follicle-stimulating hormone, luteinizing hormone, and prolactin during the follicular phase and at the midcycle peak of tamoxifen treatment cycles were not significantly different from those of the nontreatment cycle. These results suggest that the mechanism of tamoxifen in improving folliculogenesis may involve a direct action on the ovary without intervention of the hypothalamic-pituitary system.
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