Reproductive BioMedicine Online
Volume 19, Issue 4 , Pages 501-507, October 2009

Supplementation of clomiphene citrate cycles with Cimicifuga racemosa or ethinyl oestradiol – a randomized trial

  • Ahmed Y Shahin

      Affiliations

    • Department of Obstetrics and Gynecology, Women’s Health Centre, Faculty of Medicine, Assiut University, 71116 Assiut, Egypt
    • Corresponding Author InformationCorrespondence:
    • ,
  • Alaa M Ismail

      Affiliations

    • Department of Obstetrics and Gynecology, Women’s Health Centre, Faculty of Medicine, Assiut University, 71116 Assiut, Egypt
    • ,
  • Omar M Shaaban

      Affiliations

    • Department of Obstetrics and Gynecology, Women’s Health Centre, Faculty of Medicine, Assiut University, 71116 Assiut, Egypt

Received 30 October 2008; received in revised form 18 December 2008; accepted 1 June 2009. published online 02 August 2010.

Declaration: The authors report no financial or commercial conflicts of interest.

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.

Keywords: clomiphene citrate, ethinyl oestradiol, follicular-phase, phytoestrogens, unexplained infertility

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 Dr Ahmed Shahin graduated from Assiut School of Medicine, Egypt in 1995. He joined the endocrinology and infertility management team at Düsseldorf University Medical Centre where he learned clinical and laboratory principles of IVF and completed his MD thesis on laser assisted hatching of human embryos. He was certified by the German Board of Obstetrics and Gynecology in 2003. In 2008, he became head of the Department of Fertility and IVF at the International Hospital of Bahrain (IHB), Kingdom of Bahrain. He was granted a FIGO International Fellowship in 2009. His specific interests include the improvement of reproductive health, implantation and ovarian tissue cryopreservation. Dr Ahmed Shahin

PII: S1472-6483(09)00019-4

doi:10.1016/j.rbmo.2009.06.007

Reproductive BioMedicine Online
Volume 19, Issue 4 , Pages 501-507, October 2009

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