Use of ethinyl estradiol to reverse the antiestrogenic effects of clomiphene citrate in patients undergoing intrauterine insemination: a comparative, randomized study

Fertil Steril. 2000 Jan;73(1):85-9. doi: 10.1016/s0015-0282(99)00447-1.

Abstract

Objective: To compare the effectiveness of clomiphene citrate used alone and in combination with ethinyl E2 for the induction of ovulation in patients undergoing IUI.

Design: Randomized, double-blind study.

Setting: Four infertility treatment centers.

Patient(s): Women aged 25-35 years with infertility of at least 2 years' duration and oligomenorrhea or amenorrhea associated with a positive menstrual response to an IM progesterone challenge.

Intervention(s): A total of 64 patients were randomized to treatment with CC (100 mg daily for 5 days) or CC (100 mg daily for 5 days) plus ethinyl E2 (0.05 mg daily for 5 days).

Main outcome measure(s): The uterine artery pulsatility index, number of preovulatory follicles, endometrial thickness, and pregnancy rate.

Result(s): Both treatment regimens increased FSH, LH, and 17beta-E2 levels, with no statistically significant differences. There was a statistically significant difference in endometrial thickness between the two treatment groups. No statistically significant differences were noted in pulsatility index values or in the number of preovulatory follicles.

Conclusion(s): Ethinyl E2 can reverse the deleterious effects of CC on endometrial thickness, which may contribute to higher pregnancy rates.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Clomiphene / administration & dosage*
  • Clomiphene / therapeutic use
  • Double-Blind Method
  • Endometrium / pathology
  • Estradiol / blood
  • Ethinyl Estradiol / administration & dosage*
  • Ethinyl Estradiol / therapeutic use
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Infertility, Female / pathology
  • Infertility, Female / therapy*
  • Insemination, Artificial, Homologous*
  • Luteinizing Hormone / blood
  • Ovarian Follicle / pathology
  • Ovulation Induction*
  • Pregnancy
  • Pulsatile Flow
  • Uterus / blood supply

Substances

  • Clomiphene
  • Ethinyl Estradiol
  • Estradiol
  • Luteinizing Hormone
  • Follicle Stimulating Hormone