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High dose of phytoestrogens can reverse the antiestrogenic effects of clomiphene citrate on the endometrium

OBJECTIVE: To compare the effectiveness of clomiphene citrate (CC) alone or combined with phytoestrogens (PE) in ovulation induction in patients who had intrauterine insemination in a randomized, double-blind study.

METHODS: A total of 134 women aged 25-35 years, who were infertilefor at least 2 years and who had oligomenorrhea or amenorrhea associated with a positive menstrual response to the intramuscular progesterone-challenge test were enrolled. They were randomly treated with CC (100 mg dailyfor 5 days) and CC (100 mg dailyfor 5 days) in combination with PE (1500 mg dailyfor 10 days). We estimated the diference in uterine artery pulsatily index, number ofpreovulatoryfollicles, endometrial thickness, and pregnancy rate.

RESULTS: Both treatments increased follicle-stimulating hormone, luteinizing hormone, and 17festradiol plasma concentrations, but the differences were not statistically significant. However, the differences in endometrial thickness of the two groups were statistically significant. No significant differences in the pulsatility index values and in the number ofpreovulatoryfollicles were noted.

CONCLUSION: A high dose ofphytoestrogens can reverse the deleterious effects of clomiphene citrate on endometrial thickness and could contribute to higher pregnancy rates. (J Soc Gynecol Investig 2004; 11: 323-8) Copyright © 2004 by the Societyfor Gynecologic Investigation.

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