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

Area of Science:

• Reproductive endocrinology and infertility research.
• Phytotherapy and its application in assisted reproductive technologies.

Background:

• Unexplained infertility affects numerous couples, with clomiphene citrate being a common induction agent.
• Recurrent clomiphene citrate failure necessitates exploring adjunct therapies to improve outcomes.

Purpose of the Study:

• To evaluate the efficacy of oral phytoestrogens, specifically Cimicifuga racemosa, as an adjunct to clomiphene citrate therapy.
• To assess the impact of this combination on pregnancy rates and key cycle parameters in patients with unexplained infertility and clomiphene resistance.

Main Methods:

• A randomized controlled trial involving two groups of patients with unexplained infertility and clomiphene citrate failure.
• Group I received clomiphene citrate plus oral Cimicifuga racemosa, while Group II received clomiphene citrate alone.
• Hormonal levels, endometrial thickness, and pregnancy rates were monitored and compared between groups.

Main Results:

• Patients receiving Cimicifuga racemosa showed significantly higher endometrial thickness, serum progesterone, and clinical pregnancy rates compared to the control group.
• Elevated serum oestradiol and luteinizing hormone (LH) concentrations were observed in the phytoestrogen group.
• A trend towards shorter induction cycles was noted in the group supplemented with Cimicifuga racemosa.

Conclusions:

• Oral phytoestrogen (Cimicifuga racemosa) combined with clomiphene citrate significantly improves pregnancy rates and cycle outcomes.
• This therapeutic approach is beneficial for patients with unexplained infertility experiencing clomiphene citrate resistance.
• Cimicifuga racemosa may enhance the endometrial environment and hormonal milieu conducive to conception.