Phytoestrogens as an alternative to estradiol in reversing the antiestrogenic effect of clomid on endometrium in ovulation induction in cases of PCO

Objective: to study the effect of phytoestrogens as an alternative to estradiol in reversing the antiestrogenic effect of clomid on endometrium in ovulation induction in cases of PCO Methods: prospective study conducted on 150 women with PCOS were randomly divided using automated web based randomization system into 3 groups: group I included 50 women received CC only50 mg orally every 8 hours started from cycle day 3 for 5 days, group II included 50 women received estradiol from cycle day 7 to day 11 in addition to CC and group III included 50 women received phytoestrogen (20mg of cimifuga racemosa from day 1to12) in addition to CC Results: There was a statistically significant difference between group I and the other two groups regarding occurrence of ovulation (82 vs.100 and 100 % respectively) There was a statistically significant difference between the three study groups regarding endometrial thickness (5.5±1.07 vs. 9.37±1.75 and 10.1±1.87 respectively ) There was a statistically significant difference between group I and the other two groups regarding pregnancy rate (18 vs.34 and 26 % respectively) Conclusion: Adding phytoestrogens to CC as an alternative to estradiol in women with PCOS have increased number of dominant follicles and improved endometrial thickness and pattern with improvement of both ovulation and pregnancy rates