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Clomiphene does not appear to increase the risk of congenital abnormalities or spontaneous abortion with normal use

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If appetite suppression makes eating enough protein difficult, a provider may recommend protein supplementation or adjust the dosing schedule to minimize nausea during meals

IM injections allow for slow absorption into the blood, providing a longer-lasting effect

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An endocrine workup including cortisol and ACTH levels would be an appropriate next step