Role of phyto-oestrogens in ovulation induction in women with polycystic ovarian syndrome

Abstract

Objective: To study the role of a phyto-oestrogen, Cimicifuga racimosa extract (Klimadynon(®), Bionorica, Neumarkt i.d.OBf., Germany), in ovulation induction in women with polycystic ovarian syndrome (PCOS).

Study design: Prospective randomized controlled trial in Minia University Hospital, Minia, Egypt. One hundred women with PCOS were allocated into one of two groups: one group (n=50) received clomiphene citrate 100mg daily for 5 days, and the other group (n=50) received C. racimosa 20mg daily for 10 days. Both groups received medication starting from the second day of the cycle for three consecutive cycles, during which changes in follicle-stimulating hormone (FSH), luteinizing hormone (LH), FSH/LH ratio, progesterone, endometrial thickness and pregnancy rate were measured.

Results: The groups were similar in terms of age, clinical presentation and hormonal levels before treatment. Following treatment, significant favourable changes in LH level and FSH/LH ratio (p=0.007 and 0.06, respectively) were seen in the Klimadynon group. In this group the progesterone level was higher from the first treatment cycle, indicating better ovulation (p=0.0001), and endometrial thickness was greater (p=0.0004). The pregnancy rate was higher in the Klimadynon group but the difference between the groups was not significant (p=0.1).

Conclusion: Phyto-oestrogen can be used as an alternative to clomiphene citrate for ovulation induction in women with polycystic ovarian syndrome.