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The goal of this study is to assess the effectiveness of phytoestrogen with clomiphene citrate for ovulation induction in women with polycystic ovarian syndrome to overcome the antiestrogenic effect of clomiphene citrate on endometrium, were randomly grouped into two groups, 50 in each group. Group 1: receiving CC 100 mg twice daily from third day of cycle for five days and group 2: receiving CC from 3rd of cycle for 5 days plus phytoestrogen (Klimadynon(®), Bionorica, Neumarkt i.d.OBf., Germany) (20mg of cimifuga racemosa from day 1to12). Women receiving CC plus phytoestrogen have increase number of dominant follicles, endometrial thickness with improvement of both ovulation rate and pregnancy rate.

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Background: Pre-Eclampsia (PE) is a common, pregnancyspecific syndrome defined by clinical findings of elevated blood pressure combined with proteinuria and edema. It affects 2-8% of pregnancies worldwide. Hypertensive disorders (including pre-eclampsia) are one of the most common causes of death during pregnancy. It also increases the risk of poor outcomes for both the mother and the baby. It is characterized by a generalized dysfunction of the maternal endothelium, as demonstrated by the increased levels of factor VIII, total and cellular Fibronectin (FN), thrombomodulin, endothelin. Endothelial-platelet dysfunction new concept shows a vital role of endothelial cell and platelet: Endothelial dysfunction, increased vascular reactivity and platelet activation. Aim of Study: The present study was designed to evaluate the value of serum fibronectin and Von Willebrand Factor (VWF) as indicators of endothelial and platelet dysfunction in pre-eclampsia and its severity. Patients and Methods: The study was done on 50 pregnant women divided into 2 groups with 25 patients in each group. The levels of FN, VWF were measured by ELISA and Platelet Count (PLT) was measured by an automated cell counter. Results: The level of both FN and VWF were significantly higher while PLT count was significantly lower in cases group compared to the control group. Also, the level of FN was significantly higher in cases of severe pre-eclampsia compared to cases of mild pre-eclampsia. Conclusion: Endothelial-platelet dysfunction may explain the pathogenesis of pre-eclampsia. FN, VWF level and PLT count may be used as a marker of endothelial and platelet dysfunction in pre-eclampsia and may play a role in confirming the diagnosis. FN level may be also used to differentiate between mild and severe pre-eclampsia.