Comparison of clomiphene citrate plus estradiol, with tamoxifen citrate effects in induction of ovulation and pregnancy in poly cystic ovarian syndrome patients

Abstract

The aim of this study was to compare the rates of ovulation and pregnancy after tamoxifen citrate, clomiphene citrate and after adding estradiol (E2) to clomiphene citrate among anovulatory women with infertility. This study was a randomized double blind clinical trial conducted from Aug. 2006 to Aug. 2007 in present Infertility Clinic of Imam Education and Research Hospital, Sari, Iran. The patients were 157 anovulatory women under 35 years of age undergoing ovulation induction. Of total, 144 cases completed the study. They were assigned randomly to receive either tamoxifen citrate or clomiphene citrate on cycle days 3-9 and/or clomiphene citrate on cycle days 3-9 plus E2 on cycle days 8 until all patients undergo HCG injection. Rates of ovulation and pregnaricy for the three treatment modalities were measured. Although not statistically significant, the ovulation rates was higher in TAX group compared with clomiphene citrate group or clomiphene citrate plus E2 group (77.1 vs. 60.4 vs. 58.3% p = 0.1). The overall pregnancy rates was significantly higher in women who received tamoxifen citrate compared with those who received clomiphene citrate or clomiphene citrate plus E2 (52.1 vs. 33.3 vs. 22.9%, p = 0.01). This study demonstrated Hormonal supplementation with oral Estradiol following clomiphene citrate therapy in comparison with clomiphene citrate or tamoxifen citrate could not increase ovulation and pregnancy rate.