title: A randomized controlled trial evaluating the effect of ethinyl estradiol during clomiphene citrate cycles among women with polycystic ovary syndrome.
abstract: OBJECTIVE
  To investigate the effects of low-dose ethinyl estradiol (EE) on the clinical pregnancy rate among women with polycystic ovary syndrome (PCOS) undergoing ovulation induction with clomiphene citrate (CC).
  
  
  METHODS
  Between March 12, 2011, and February 10, 2013, a randomized, double-blind, placebo-controlled trial was conducted at the Royan Institute Research Center, Tehran, Iran, among women with PCOS who were aged 25-30 years, were undergoing their first intrauterine insemination cycle, and had a history (≥2 years) of infertility, oligomenorrhea, or amenorrhea. Participants were randomly allocated to receive EE (0.05 mg daily for 5 days) or placebo, co-administered with CC cycles (100 mg daily for 5 days). The primary outcome was clinical pregnancy rate. Analyses were per protocol: patients who discontinued the intervention were excluded.
  
  
  RESULTS
  Analyses included 45 women who received CC and EE, and 50 women who received CC and placebo. The number of women who achieved a clinical pregnancy was higher among participants who received CC and EE (13 [29%]) than among those in the control group (5 [10%]; P =0 .02). No adverse effects of EE were reported.
  
  
  CONCLUSIONS
  The combination of CC and EE seems to increase the clinical pregnancy rate among women with PCOS undergoing intrauterine insemination. ClinicalTrials.gov:NCT01219101.
authors.affiliation: Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran; Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran; Department of Gynecology and Obstetrics, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Moini
authors.affiliation: Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.
authors.forename: Firoozeh
authors.initials: F
authors.lastname: Ahmadi
authors.affiliation: Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran. Electronic address: jahangiri_n@yahoo.com.
authors.forename: Nadia
authors.initials: N
authors.lastname: Jahangiri
authors.affiliation: Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.
authors.forename: Jila
authors.initials: J
authors.lastname: Ahmadi
authors.affiliation: Department of Statistics, Mathematical Science and Computer Faculty, Shahid Chamran University, Ahvaz, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Akhoond
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000188:drug therapy / Q000209:etiology; D002996:Clomiphene / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000008:administration & dosage*; D004997:Ethinyl Estradiol / Q000008:administration & dosage*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology; D007315:Insemination, Artificial / Q000706:statistics & numerical data; D007492:Iran; D009839:Oligomenorrhea / Q000188:drug therapy / Q000209:etiology; D010062:Ovulation Induction / Q000379:methods* / Q000706:statistics & numerical data; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate
chemical_list: D004967:Estrogens; D005300:Fertility Agents, Female; D002996:Clomiphene; D004997:Ethinyl Estradiol
keywords: Clomiphene citrate; Ethinyl estradiol; Intrauterine insemination; Polycystic ovary syndrome; Pulsatility index; Reproductive outcome