Adding l -carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial

Abstract Objective To evaluate the effectiveness of l -carnitine on improving the ovulation and pregnancy rates as well as adverse metabolic indices in clomiphene-resistant PCOS. Design Single center, double blinded, superiority, randomized controlled clinical trial. Setting Women’s Health Hospital,...

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Bibliographic Details
Published in:European journal of obstetrics & gynecology and reproductive biology 2014-09, Vol.180, p.148-152
Main Authors: Ismail, Alaa M, Hamed, Ali Hassan, Saso, Srdjan, Thabet, Hossam H
Format: Article
Language:English
Subjects:
Adult
Carnitine - therapeutic use
Clomiphene - therapeutic use
Double-Blind Method
Drug Resistance
Drug Synergism
Drug Therapy, Combination
Female
Fertility Agents, Female - therapeutic use
Follicle Stimulating Hormone - blood
Humans
Infertility, Female - drug therapy
Infertility, Female - etiology
Luteinizing Hormone - blood
Obstetrics and Gynecology
Ovulation
Ovulation Induction - methods
Polycystic Ovary Syndrome - complications
Polycystic Ovary Syndrome - drug therapy
Pregnancy
Pregnancy Rate
Treatment Outcome
Vitamin B Complex - therapeutic use
Young Adult
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Summary:Abstract Objective To evaluate the effectiveness of l -carnitine on improving the ovulation and pregnancy rates as well as adverse metabolic indices in clomiphene-resistant PCOS. Design Single center, double blinded, superiority, randomized controlled clinical trial. Setting Women’s Health Hospital, Assiut University. Methods One hundred and seventy women diagnosed with PCOS were found to be clomiphene resistant. The women were randomly allocated into two groups: Group A ( n = 85), where patients received 250 mg clomiphene citrate from day three until day seven of the cycle plus l -carnitine (LC) 3 g daily; and Group B ( n = 85) received 250 mg clomiphene citrate with placebo. Outcome Primary outcome is cumulative clinical pregnancy rate. Secondary outcomes are changes in serum glucose level and lipid profile. Results The combination of l -carnitine and CC significantly improve both the ovulation and the cumulative pregnancy rates in clomiphene resistant PCOS (55 (64.4%) vs. 15 (17.4%) and 44 (51.5) % vs. 5 (5.8) %). The number of stimulated follicles reaching ≥17 mm diameter was significantly more in Group A to Group B (2.2 ± 0.77 vs. 0.16 ± 0.79; p < 0.0001). Group A needed significantly fewer days for adequate follicular maturation, had a thicker endometrium and higher oestradiol concentration at the time of human chorionic gonadotrophin injection (10.1 ± 0.1 mm vs. 6.8 ± 0.4 mm; p < 0.0001). The same group had a higher mean luteal-phase serum progesterone compared with the control group (13.55 ± 0.99 vs. 10.6 ± 0.98 ng; p < 0.0001). A significant difference was found regarding the clinical pregnancy rates (42 (49.4%) vs. (1) 1.1% respectively p value
ISSN:0301-2115
1872-7654
DOI:10.1016/j.ejogrb.2014.06.008