Effects of Exogenous Ethinyl Estradiol on Endometrial Receptivity in Clomiphene Induced Cycles in Infertile Women with Polycystic Ovaries

ABSTRACT

To compare the effectiveness of clomiphene citrate used alone and in combination with ethinyl estradiol on endometrial receptivity in infertile women with polycystic ovaries (PCO). Color doppler ultrasonographic evaluation of endometrial thickness (ET) and pulsatility index (PI) was done for 27 infertile women with polycystic ovaries. These women were studied for one control unmedicated cycle and randomized to receive clomiphene citrate (CC) alone and CC with ethinyl estradiol (EE) in subsequent 2 cycles. The total duration of follow up of patients was 77 months in which 2 women conceived in control cycle and 1 conceived in CC+ EE cycle. On day of HCGinjection, mean ET was 6.96 + 1.63mmin control cycle, 7.25 + 1.64mmin CC and 8.53 + 1.36mmin CC + EE cycle, whereas, the mean pulsatility index (PI) of dominant uterine arteries was 4.09 + 0.97 in control cycle, 3.96 + 0.95 in CC cycle and 3.75 + 0.98 in CC + EE cycle. On day of HCG injection, mean PI of non-dominant uterine arteries was 4.06 + 1.01 in control, 4.00 + 1.02 in CC and 3.71 + 0.95 in CC + EE cycles. A statistically significant change (p< 0.05) was observed in ET and PI of dominant and non-dominant uterine arteries in control and CC+ EE cycle and those in CC and CC+ EE cycles. Addition of ethinyl estradiol to clomiphene induced cycles produces a favorable endometrial response in infertile women with PCO.