Clomiphene Citrate for Induction of Ovulation in Women with Unexplained Infertility

Objective: The aim of the current study was to compare the efficacy of CC to expectant management in women with unexplained infertility over three successive cycles. Methods: The current randomized controlled trial was conducted at Ain Shams University Maternity Hospital. The study included women presenting with unexplained infertility for at least 12 months of unprotected regular marital life. Eligible recruited women were randomized into one of two groups: group I, including women who received Clomiphene citrate at a single daily dose of 100 mg for 5 days; and group II, including women who were expectantly followed up without induction of ovulation. The primary outcome was the clinical pregnancy rate. Results: A total of 113 women were enrolled in the current trial. The mean age of included women was 25.3 ± 3.1 years (range: 20 – 33 years). The clinical pregnancy rate was slightly, but significantly, higher in women of the CC group when compared to the control group; both per case [7/57 (12.3% vs. 4/56 (7.1%), respectively, p=0.357; RR 1.72, 95% CI (0.53 to 5.55); number needed to treat (NNT) = 19] and per cycle [7/163 (4.3%) vs. 4/160 (2.5%), respectively, p=0.374;RR 1.72, 95% CI (0.51 to 5.75); NNT = 56]. Conclusion: CC seems to be not effective in improving clinical pregnancy outcome when compared to observation alone in women with unexplained infertility