Use of ethinyl estradiol to reverse the antiestrogenic effects of clomiphene citrate in patients undergoing intrauterine insemination: a comparative, randomized study.
OBJECTIVE
To compare the effectiveness of clomiphene citrate used alone and in combination with ethinyl E2 for the induction of ovulation in patients undergoing IUI.


METHODS
Randomized, double-blind study.


METHODS
Four infertility treatment centers.


METHODS
Women aged 25-35 years with infertility of at least 2 years' duration and oligomenorrhea or amenorrhea associated with a positive menstrual response to an IM progesterone challenge.


METHODS
A total of 64 patients were randomized to treatment with CC (100 mg daily for 5 days) or CC (100 mg daily for 5 days) plus ethinyl E2 (0.05 mg daily for 5 days).


METHODS
The uterine artery pulsatility index, number of preovulatory follicles, endometrial thickness, and pregnancy rate.


RESULTS
Both treatment regimens increased FSH, LH, and 17beta-E2 levels, with no statistically significant differences. There was a statistically significant difference in endometrial thickness between the two treatment groups. No statistically significant differences were noted in pulsatility index values or in the number of preovulatory follicles.


CONCLUSIONS
Ethinyl E2 can reverse the deleterious effects of CC on endometrial thickness, which may contribute to higher pregnancy rates.
Gerli
S
S
Department of Obstetrics and Gynecology, University of Perugia, Italy.
Gholami
H
H
Manna
C
C
Di Frega
A S
AS
Vitiello
C
C
Unfer
V
V
Manna
A
A
D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage* / Q000627:therapeutic use; D004311:Double-Blind Method; D004717:Endometrium / Q000473:pathology; D004958:Estradiol / Q000097:blood; D004997:Ethinyl Estradiol / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000473:pathology / Q000628:therapy*; D007317:Insemination, Artificial, Homologous; D007986:Luteinizing Hormone / Q000097:blood; D006080:Ovarian Follicle / Q000473:pathology; D010062:Ovulation Induction; D011247:Pregnancy; D011673:Pulsatile Flow; D014599:Uterus / Q000098:blood supply
D002996:Clomiphene; D004997:Ethinyl Estradiol; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone