Adding phytoestrogens to clomiphene induction in unexplained infertility patients – a randomized trial

Shahin, Ahmed Y.; Ismail, Alaa M.; Zahran, Kamal M.; Makhlouf, Ahmed

doi:10.1016/s1472-6483(10)60465-8

Cited by 46 publications

(53 citation statements)

References 47 publications

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“…Three RCTs and 2 uncontrolled trials examined efficacy for hot flashes as their primary endpoint, [26][27][28][29][30] whereas 5 uncontrolled trials and 12 RCTs assessed the effect of black cohosh on estrogen responsive tissues. 9,10,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] These studies are summarized in Tables 3, 4, and 5.…”

Section: Resultsmentioning

confidence: 99%

“…35 All other studies reported no impact on FSH or LH level, with the exception of Duker 43 , who reported a significant decrease in LH only (P < .05). 10,30,32,35,37,38,[41][42][43][44] Of 3 uncontrolled trials assessing mammographic density, all 3 studies reported no significant changes overall with black cohosh use. 31,34,35 In a large trial of 400 participants, the authors reported an increase observed in one participant only, with higher density, after using black cohosh for the 1-year treatment period.…”

Section: Effect On Estrogen Responsive Tissuesmentioning

confidence: 99%

“…Two RCTs of infertile women on clomiphene citrate found that the addition of black cohosh to their fertility regime resulted in significantly greater endometrial thickness on the day of human chorionic gonadotropin injection mid-cycle (P < .001), however, this was deemed therapeutic. 36,37 One RCT conducted in peri-and postmenopausal women reported a borderline significant decrease in endometrial thickness (P = .05). 39 One RCT reported a mean 0.5-mm increase, which was, however, deemed "not clinically relevant."…”

Section: Effect On Estrogen Responsive Tissuesmentioning

confidence: 99%

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Black Cohosh and Breast Cancer

et al. 2013

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Background. Many women use black cohosh as a natural treatment for menopausal symptoms. However, controversy exists around safety in breast cancer, because of its purported estrogenic activity. We conducted a systematic review of black cohosh use in women with or at risk of breast cancer.Methods. We searched MEDLINE, Embase, the Cochrane Library, and AMED from inception to July 2012 and October 2012 for human interventional or observational data pertaining to the safety and efficacy of black cohosh in patients with or at risk of breast cancer, including an assessment of the effect of black cohosh on estrogen responsive tissues. Results. Of 450 records, we included 26 articles: 14 randomized controlled trials, 7 uncontrolled trials, and 5 observational studies.The evidence on efficacy for ho t flashes is divided, with some benefits seen when compared with baseline, but not when compared with placebo. Two observational studies found no association between black cohosh and risk of breast cancer, whereas 2 studies reported significant reductions in risk of primary breast cancer among postmenopausal women (adjusted odds ratio = 0.47, 95% confidence interval = 0.27-0.82), and risk of recurrence (adjusted hazard ratio = 0.75, 95% confidence interval = 0.63-0.89). Seventeen trials showed no significant impact on circulating hormone levels or proliferation in estrogen responsive tissues. Conclusions. Current evidence does not support an association between black cohosh and increased risk of breast cancer. There is a lack of evidence supporting the efficacy of black cohosh for reduction of hot flashes in breast cancer patients. Given conflicting but promising results, and apparent safety, further research is warranted.

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Section: Resultsmentioning

confidence: 99%

Section: Effect On Estrogen Responsive Tissuesmentioning

confidence: 99%

Section: Effect On Estrogen Responsive Tissuesmentioning

confidence: 99%

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Black Cohosh and Breast Cancer

et al. 2013

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“…Endometrial thickness, serum progesterone, and clinical pregnancy rate were significantly higher in group I (8.9 ± 1.4 mm versus 7.5 ± 1.3 mm, P \ 0.001; 13.3 ± 3.1 ng/ml versus 9.3 ± 2.0 ng/ml, P \ 0.01; 36.7 % versus 13.6 %, P \ 0.01, respectively). The study concluded that adding C. racemosa rhizome dry extract to clomiphene citrate induction can improve the pregnancy rate and cycle outcomes in these couples [25].…”

Section: Discussionmentioning

confidence: 96%

“…Shahin et al's study [25] investigated the role of oral phytoestrogens in improving pregnancy rate and cycle outcomes with clomiphene citrate. Patients with unexplained infertility and recurrent clomiphene citrate induction failure were randomly divided into two groups: group I (n = 60) and group II (n = 59).…”

Section: Discussionmentioning

confidence: 99%

Oral Drugs for Unexplained Infertility

Allahbadia

2015

J Obstet Gynecol India

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Nutrition in Human Fertility

Chavarro

Cardozo

Afeiche

2015

Obesity and Fertility

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Identifying the extent to which modifi able lifestyle factors infl uence human fertility is of major clinical and public health signifi cance. It is estimated that more than fi ve million children have been born worldwide as a result of assisted reproduction [ 1 ]. In 2010 alone, there were nearly 150,000 assisted reproduction cycles resulting in more than 47,000 deliveries and the birth of 61,564 children in the United States [ 2 ]. These impressive fi gures notwithstanding, the number of subfertile couples benefi ting from these therapies represents approximately one tenth of those estimated to meet the clinical defi nition of infertility and about 2 % of women estimated to be unable to get pregnant or carry a pregnancy to term nationwide [ 3 ]. This vast gap alone highlights the need to identify strategies to address infertility that do not rely solely on clinical interventions and can be implemented on a population-wide level.On the other hand, there is a critical need to further improve success rates of infertility treatments. While the proportion of live births per initiated assisted reproduction cycle in the United States improved gradually through the 1990s, it has remained steady, at about 30 %, for almost a decade (Fig. 4.1 ). Unfortunately, very few predictors of successful infertility treatment are known and the strongest and best-characterized risk factor for unsuccessful infertility treatment, age [ 4 , 5 ], is not modifi able. Moreover, the proportion of women delaying childbearing into their 30s and beyond 35 years has increased dramatically in the United States and other Western nations [ 6 ]. These facts highlight the need to identify potentially modifiable factors associated with fertility treatment outcomes. Emerging evidence further suggests that diet, a potentially modifi able factor, could have a major impact on human fertility independent of body weight. In this chapter we will review and summarize the current evidence linking diet to fertility in women and men, and to outcomes of infertility treatment. Diet and Female FertilityInterest in the role of diet on female fertility is longstanding. There are reports of animal models evaluating the effects of micronutrient defi ciencies on ovulatory function as early as the 1960s [ 7 ] and prospective studies in humans evaluating the role of other dietary factors on fertility since the 1980s [ 8 ]. Most of the existing literature revolves around the potential role of two purported reproductive toxicants on fertility, caffeine, and alcohol, and is plagued with poor quality research. Recent fi ndings, however, suggests that the role of diet on human fertility and on conditions associated with infertility may be much broader. Most of the interest in evaluating the role of caffeine on reproductive performance in general and on fertility in particular can be traced back to a series of experiments in rodents which documented an increased frequency of fetal resorption and congenital malformations of the skeleton in rats receiving caffeine via oral intub...

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Adding phytoestrogens to clomiphene induction in unexplained infertility patients – a randomized trial

Cited by 46 publications

References 47 publications

Black Cohosh and Breast Cancer

Black Cohosh and Breast Cancer

Oral Drugs for Unexplained Infertility

Nutrition in Human Fertility

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