Polycystic Ovary Syndrome Clinical Trial
Official title:
L-Carnitine and Clomiphene Citrate for Induction of Ovulation in Women With Polycystic Ovary Syndrome
The purpose of the study to assess the efficacy of adding L-carnitine to clomiphene citrate for increasing the ovulation and the pregnancy rate in women with PCOS.
A total of 106 women with the diagnosis of PCOS based on the European Society of Human
Reproduction and Embryology/ American Society for Reproductive Medicine (ESHRE/ASRM)
guidelines criteria (Rotterdam Criteria, 2003) will be randomly assigned using a
computer-generated randomization sheet and they will be distributed into two groups:
1. Group L (53 patients):
This group will receive oral clomiphene citrate (Clomid, Global Napi Pharmaceuticals
(GNP), Egypt) (50 mg tablet, two times per day) from the third day of the cycle until
the seventh day of the cycle plus oral carnitine supplementation (Carnivita Forte, Eva
Pharma, Egypt) (1g tablet, three times per day) from the third day of the cycle until
the day of the pregnancy test.
2. Group C (53 patients):
This group will receive oral clomiphene citrate only (Clomid, Global Napi Pharmaceuticals
(GNP), Egypt) (50 mg tablet, two times per day) from the third day of the cycle until the
seventh day of the cycle. Serum FSH, LH & free testosterone concentrations will be measured
on day 3 (basal) of the cycle. Trans-vaginal folliculometry will be performed on all women on
days 7 and 9 of the cycle and then individualized according to the response. When one leading
follicle attains a diameter of 17mm or more, the endometrial thickness will be measured and
10,000 IU of Human chorionic gonadotropin (hCG) will be given (im injection; Pregnyl,
organon, Holland). Timed intercourse will be advised after 36-48 hours from the night of hCG
administration for 2 successive days. Ovulation success will be confirmed by transvaginal
ultrasound which will show that the leading follicle has collapsed, and some fluid appeared
in the Douglas pouch.
Serum progesterone will be measured on day 8 post hCG injection, ovulation will be confirmed
if the serum progesterone level is ≥ 5 ng/ml (Leiva et al., 2015).
Luteal-phase support will not be provided in both groups. Pregnancy test will be done in the
form of testing the level of beta hCG in the blood after 14 days once the success of the
ovulation process has been confirmed.
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