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 ,Revised 18 December 2008 ,Accepted 1 June 2009.

References 

  1. Adams NR. A changed responsiveness to oestrogen in ewes with clover disease. Journal of Reproduction and Fertility. 1981;30:S223–S230
  2. Badawy A, Baker EL, Nashar A, El Totongy M. Clomiphene citrate plus N-acetyl cysteine versus clomiphene citrate for augmenting ovulation in the management of unexplained infertility: a randomized double-blind controlled trial. Fertility and Sterility. 2006;86:647–650
  3. Barkhem T, Carlsson B, Nilsson Y, et al. Differential response of estrogen receptor alpha and estrogen receptor beta to partial estrogen agonists/antagonists. Molecular Pharmacology. 1998;54:105–112
  4. Belcher SM, Zsarnovszky A. Estrogenic actions in the brain: estrogen, phytoestrogens, and rapid intracellular signalling mechanisms. Journal of Pharmacological Experimental Therapy. 2001;299:408–414
  5. Bhattacharya S. Effective use of assisted reproduction. Human Fertility. 2003;6:60–62
  6. Bhattacharya S, Harrild K, Mollison J, et al. Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial. British Medical Journal. 2008;337:a716
  7. Biljan MM, Mahutte NG, Tulandi T, et al. Prospective randomized double-blind trial of the correlation between time of administration and antiestrogenic effects of clomiphene citrate on reproductive end organs. Fertility and Sterility. 1999;71:633–638
  8. Biteker G, Ugur M, Deveer R. The effect of clomiphene citrate on uterine and ovarian blood flow in patients with unexplained infertility. Does estrogen and progesterone treatment reverse these changes?. Fertility and Sterility. 2004;82:S145–S145
  9. Brinker F. The toxicology of botanical medicines. Sandy, Oregon: Eclectic Medical Publications; 2000;
  10. Casper RF. Phytoestrogens, clomiphene, and the uterus. Journal of the Society for Gynecologic Investigations. 2004;11:261–262
  11. Check JH. Diagnosis and treatment of cervical mucus abnormalities. Clinical and Experimental Obstetrics and Gynecology. 2006;33:140–142
  12. Chung H, Craig AW. The effect of therapy initiation day on clomiphene citrate therapy. Fertility and Sterility. 1989;52:564–568
  13. Clark JH, Markaverich BM. The agonist-antagonist properties of clomiphene. Pharmacology and Therapeutics. 1981;15:467–519
  14. Cook NC, Samman S. Flavanoids – chemistry, metabolism, cardioprotective effects and dietary sources. Journal of Nutritional Biochemistry. 1996;7:66–76
  15. Diel P, Smolnikar K, Schulz T, et al. Phytoestrogens and carcinogenesis – differential effects of genistein in experimental models of normal and malignant rat endometrium. Human Reproduction. 2001;16:997–1006
  16. Diel P, Schulz T, Smolnikar K, et al. Ability of xeno- and phytoestrogens to modulate expression of estrogen-sensitive genes in rat uterus: estrogenicity profiles and uterotropic activity. Journal of Steroid Biochemistry and Molecular Biology. 2000;73:1–10
  17. Duker EM, Kopanski L, Jarry H, et al. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Medica. 1991;57:420–424
  18. Einer-Jensen N, Zhao J, Andersen KP, et al. Cimicifuga and Melbrosia lack oestrogenic effects in mice and rats. Maturitas. 1996;25:149–153
  19. Fujii S, Fukui A, Fukushi Y, et al. The effects of clomiphene citrate on normally ovulatory women. Fertility and Sterility. 1997;68:997–999
  20. Gerli S, Gholami H, Manna C, et al. Use of ethinyl estradiol to reverse the antiestrogenic effects of clomiphene citrate in patients undergoing intrauterine insemination: a comparative, randomized study. Fertility and Sterility. 2000;73:85–89[Erratum in Manna C 2000 Fertility and Sterility 74, 424]
  21. Guzick DS, Grefenstette I, Baffone K, et al. Infertility evaluation in fertile women: a model for assessing the efficacy of infertility testing. Human Reproduction. 1994;9:2306–2310
  22. Han DH, Denison MS, Tachibana H, et al. Relationship between estrogen receptor-binding and estrogenic activities of environmental estrogens and suppression by flavonoids. Bioscience, Biotechnology, and Biochemistry. 2002;66:1479–1487
  23. Hernández Muñoz G, Pluchino S. Cimicifuga racemosa for the treatment of hot flushes in women surviving breast cancer. Maturitas. 2003;44:S59–S65
  24. Horstein MD, Schust D. Infertility Novak’s gynecology. 18th ed.. Philadelphia: Lippincott Williams and Wilkins Co.; 1996;
  25. Jänne O, Kontula K, Luukkainen T, et al. Oestrogen-induced progesterone receptor in human uterus. Journal of Steroid Biochemistry. 1975;6:501–509
  26. Jarry H, Harnischfeger G, Duker E. The endocrine effects of constituents of Cimicifuga racemosa. 2. In-vitro binding of constituents to estrogen receptors. Planta Medica. 1985;4:316–319
  27. Jellin JM, Batz F, Hitchens K. Natural medicines comprehensive database. Stockton, CA: Therapeutic Research Faculty; 2004;1530
  28. Kelada E, Ghani R. Bilateral ovarian abscesses following transvaginal oocyte retrieval for IVF: a case report and review of literature. Journal of Assisted Reproduction and Genetics. 2007;24:143–145
  29. Kruse SO, Lohning A, Pauli GF, et al. Fukiic and piscidic acid esters from the rhizome of Cimicifuga racemosa and the in-vitro estrogenic activity of ukinolic acid. Planta Medica. 1999;65:763–764
  30. Kuiper GG, Carlsson B, Grandien K, et al. Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta. Endocrinology. 1997;138:863–870
  31. Massai MR, Ziegler DD, Lesobre V, et al. Clomiphene citrate affects cervical mucus and endometrial morphology independently of the changes in plasma hormonal levels induced by multiple follicular recruitment. Fertility and Sterility. 1993;59:1179–1186
  32. Morito K, Aomori T, Hirose T, et al. Interaction of phytoestrogens with estrogen receptors alpha and beta (II). Biological and Pharmaceutical Bulletin. 2002;25:48–52
  33. Morito K, Hirose T, Kinjo J. Interaction of phytoestrogens with estrogen receptors alpha and beta. Biological and Pharmaceutical Bulletin. 2001;24:351–356
  34. Ohno Y, Fujimoto Y. Endometrial oestrogen and progesterone receptors and their relationship to sonographic appearance of the endometrium. Human Reproduction Update. 1998;4:560–564
  35. Pike AC, Brzozowski AM, Hubbard RE, et al. Structure of the ligand-binding domain of oestrogen receptor beta in the presence of a partial agonist and a full antagonist. EMBO Journal. 1999;18:4608–4618
  36. Salvatori L, Pallante P, Ravenna L, et al. Oestrogens and selective oestrogen receptor (ER) modulators regulate EGF receptor gene expression through human ER alpha and beta subtypes via an Sp1 site. Oncogene. 2003;22:4875–4881
  37. Shahin AY. The problem of IVF cost in developing countries: has natural cycle IVF a place?. Reproductive BioMedicine Online. 2007;15:51–56
  38. Shahin AY, Ismail AM, Zahran KM, et al. Adding phytoestrogens to clomiphene induction in unexplained infertility-a randomized trial. Reproductive BioMedicine Online. 2008;16:580–588
  39. Shutt DA, Cox RI. Steroid and phyto-oestrogen binding to sheep uterine receptors. Journal of Endocrinology. 1972;52:299–310
  40. Unfer V, Casini ML, Costabile L, et al. High dose of phytoestrogens can reverse the antiestrogenic effects of clomiphene citrate on the endometrium in patients undergoing intrauterine insemination: a randomized trial. Journal of the Society of Gynecological Investigations. 2004;11:323–328
  41. Verhaak CM, Smeenk JM, Evers AW, et al. Women’s emotional adjustment to IVF: a systematic review of 25 years of research. Human Reproduction Update. 2007;13:27–36
  42. Vlahos NF, Coker L, Lawler C, et al. Women with ovulatory dysfunction undergoing ovarian stimulation with clomiphene citrate for intrauterine insemination may benefit from administration of human chorionic gonadotropin. Fertility and Sterility. 2005;83:1510–1516
  43. Winterhoff H, Spengler B, Christoffel V, et al. Cimicifuga extract BNO 1055: reduction of hot flushes and hints on antidepressant activity. Maturitas. 2003;14:S51–S58
  44. Wu CH, Winkel CA. The effect of therapy initiation day on clomiphene citrate therapy. Fertility and Sterility. 1989;52:564–568
  45. Yagel S, Ben-Chetrit A, Anteby E, et al. The effect of ethinyl estradiol on endometrial thickness and uterine volume during ovulation induction by clomiphene citrate. Fertility and Sterility. 1992;57:33–36
  46. Zierau O, Bodinet C, Kolba S, et al. Antiestrogenic activities of Cimicifuga racemosa extracts. Journal of Steroid Biochemistry and Molecular Biology. 2002;80:125–130

 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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