A woman treated for infertility gives birth to triplets and experienced breast pain during treatment. Which drug is likely to have been administered?

Clomiphene is often used as a first-line treatment for women experiencing infertility, particularly in cases of ovulatory disorders. This medication works by blocking estrogen receptors in the hypothalamus, which in turn increases the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus and subsequently stimulates the pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This hormonal cascade promotes ovarian follicle development and can lead to ovulation.

One of the notable side effects of Clomiphene is breast discomfort or pain, which may result from the medication’s estrogen-blocking action. The increased production of hormones such as FSH and LH can lead to ovarian hyperstimulation as well, contributing to the likelihood of multiple pregnancies, such as triplets, which can occur due to the stimulation of multiple follicles.

In comparison, the other medications listed, such as gonadotropins, progesterone, and letrozole, are also used in fertility treatments but have differing mechanisms and side effects. Gonadotropins directly stimulate the ovaries and can also lead to multiple pregnancies but are less directly associated with breast tenderness compared to Clomiphene. Progesterone is