title: Supplementation of clomiphene citrate cycles with Cimicifuga racemosa or ethinyl oestradiol--a randomized trial.
abstract: The anti-oestrogenic activity of clomiphene citrate (CC) on the cervical mucous and endometrium may be the reason for the relatively low pregnancy rates in CC induction cycles. Various follicular-phase supplements have been tried to improve cycle outcome in these patients. This study compared follicular-phase supplementation with either phytoestrogen (PE) or ethinyl oestradiol (EE) in CC induction cycles for the treatment of unexplained infertility. A total of 134 patients were randomly allocated to each treatment group (67 each). The PE group needed significantly fewer days for adequate follicular maturation, had a thicker endometrium and higher oestradiol concentration at the time of human chorionic gonadotrophin injection (all P < 0.001). The PE group had higher luteal-phase serum progesterone compared with the EE group. No significant difference was found regarding clinical pregnancy rates (14.0% versus 21.1%, respectively). In conclusion, the cycle characteristics in unexplained infertility women treated with clomiphene citrate induction and timed intercourse improved after follicular-phase supplementation with PE compared with EE supplementation. Further studies are needed to confirm the mechanism beyond these effects.
authors.affiliation: Department of Obstetrics and Gynecology, Women's Health Centre, Faculty of Medicine, Assiut University, 71116 Assiut, Egypt. Ahmed.Shahin@web.de
authors.forename: Ahmed Y
authors.initials: AY
authors.lastname: Shahin
authors.forename: Alaa M
authors.initials: AM
authors.lastname: Ismail
authors.forename: Omar M
authors.initials: OM
authors.lastname: Shaaban
mesh_terms: D000328:Adult; D031885:Cimicifuga / Q000737:chemistry*; D002996:Clomiphene / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D048789:Phytoestrogens / Q000627:therapeutic use*; D010936:Plant Extracts / Q000627:therapeutic use; D011247:Pregnancy
chemical_list: D005300:Fertility Agents, Female; D048789:Phytoestrogens; D010936:Plant Extracts; D002996:Clomiphene; D004997:Ethinyl Estradiol; D004958:Estradiol