title: Intrauterine insemination versus timed intercourse with clomiphene citrate in polycystic ovary syndrome: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the efficacy of intrauterine insemination vs. timed intercourse with clomiphene citrate as a first-line treatment for anovulatory infertility associated with polycystic ovary syndrome.
  
  
  METHODS
  A randomized controlled trial following the CONSORT criteria.
  
  
  METHODS
  A university hospital and a private practice setting.
  
  
  METHODS
  188 women (525 cycles) with polycystic ovary syndrome.
  
  
  METHODS
  Women received three consecutive cycles of ovulation induction with clomiphene citrate and intrauterine insemination (n=93, 259 cycles) or three consecutive cycles of clomiphene citrate with timed intercourse (n=95, 266 cycles).
  
  
  METHODS
  Clinical pregnancy rate per cycle, number of growing and mature follicles, serum estradiol, endometrial thickness at the hCG day, serum progesterone, ovulation, miscarriage and live birth rates.
  
  
  RESULTS
  There were no differences between the two groups regarding the clinical pregnancy rate per cycle or per woman (8.49 vs. 7.89% and 23.6 vs. 22.1%; p=0.26 and p=0.33, respectively). Two twin pregnancies occurred in each group. Miscarriage and live birth rates were comparable (18.1 vs. 19% and 19.35 vs. 17.89%; p=0.31 and p=0.33, respectively). No ectopic, higher-order pregnancies or cases of ovarian hyperstimulation syndrome occurred. No differences were found regarding the number of follicles, serum progesterone, ovulation rates, estradiol levels or endometrial thickness at the hCG day (7.7±0.4 vs. 7.5±0.6mm; p=0.54).
  
  
  CONCLUSIONS
  Ovulation induction with clomiphene citrate and timed intercourse is as effective as that with intrauterine insemination for achieving pregnancy in polycystic ovary syndrome and could represent the initial treatment option, being less invasive and less expensive than intrauterine insemination.
authors.affiliation: Department of Obstetrics & Gynecology Department of Diagnostic Radiology Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt. hatem_ah@hotmail.com
authors.forename: Hatem
authors.initials: H
authors.lastname: Abu Hashim
authors.forename: Osama
authors.initials: O
authors.lastname: Ombar
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abd Elaal
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002996:Clomiphene / Q000008:administration & dosage*; D003075:Coitus / Q000502:physiology*; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods*; D008297:Male; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol