Article| Volume 16, ISSUE 4, P580-588, 2008

Adding phytoestrogens to clomiphene induction in unexplained infertility patients – a randomized trial

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      This study investigated the role of oral phytoestrogens in improving pregnancy rate and cycle outcomes with clomiphene citrate. Patients with unexplained infertility and recurrent clomiphene citrate induction failure, were randomly divided into two groups: group I (n = 60) and group II (n = 59). Both groups received clomiphene citrate 150 mg per day (days 3 to 7). Group I received additional oral phytoestrogen (Cimicifuga racemosa) 120 mg/day from days 1 to 12. Human chorionic gonadotrophin (HCG) injection (10,000 IU i.m.) was given and timed intercourse was recommended when a leading follicle reached >17 mm and serum oestradiol exceeded 200 (pg/ml). There was a non-significant shortening of induction cycles in group I. Oestradiol and LH concentrations were higher in group I compared with group II. Endometrial thickness, serum progesterone and clinical pregnancy rate were significantly higher in group I (8.9 ± 1.4 mm versus 7.5 ± 1.3 mm, P < 0.001; 13.3 ± 3.1 ng/ml versus 9.3 ± 2.0 ng/ml, P < 0.01; 36.7% versus 13.6%, P < 0.01, respectively). It is concluded that adding C. racemosa rhizome dry extract to clomiphene citrate induction can improve the pregnancy rate and cycle outcomes in these couples.



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      Dr Ahmed Shahin graduated from Assuit School of Medicine, Egypt in 1995. A scholarship from the German Academic Exchange Organization allowed him to join 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 OB & Gyn in 2003. Awards include international guest-doctor prize (2002), and international prize for best research design (2006), both from the German Society for Obstetrics and Gynaecology. His specific interests include the improvement of reproductive health, implantation and ovarian tissue cryopreservation.