The Impact of Adding a Nitric Oxide Donor as Adjuvant Therapy to Clomiphene Citrate

Document Type : Original Article

Authors

1 Obstetrics and gynecology , Kasr Al Aini , Cairo , Egypt.

2 Obstetrics and gynecology , Kasr Al Aini , Cairo , Egypt

Abstract

Aim: This study aimed to compare the effect of adding a nitric oxide donor to clomiphene citrate in women with polycystic ovarian syndrome for induction of ovulation to attempt and reverse the anti-estrogenic effect and thus improve the clinical pregnancy rate.
Material and Methods: This is an open labelled randomized controlled trial in a University Hospital infertility out-patient clinic. Eighty participants, fulfilling the inclusion criteria were enrolled in the study from January 2019 till December 2019. They were divided into 2 groups, group A received clomiphene citrate (CC) and Isosorbide mononitrate (ISMN), while group B received CC only. The primary outcome was the clinical pregnancy rate.
Results: The clinical pregnancy rate was higher in the ISMN group but did not show statistical significance. Although, the addition of ISMN had a favorable outcome on the number of follicles, endometrial volume, cervical mucus score, uterine artery RI.
Conclusion: The addition of nitric oxide donors to CC in the induction of ovulation in polycystic ovarian syndrome improved cycle parameters but did not significantly increase clinical pregnancy rates and thus should be cautiously used for such purpose.

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