Comparative Evaluation of Follicular Development and Endometrial Thickness in Spontaneous and Clomiphene Citrate Induced Cycle in Unexplained Infertility

Abstract

Background: Unexplained infertility is one of the major causes of female infertility and ovulation induction is used as a standard treatment for such cases. Clomiphene citrate is commonly used drug for induction of ovulation. Aims: To assess follicular growth, endometrial thickness and timing of ovulation in Spontaneous and Clomiphene Citrate Induced Cycle in Unexplained Infertility. Material and Methods: This prospective study was conducted in Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India, after taking ethical clearance from institutional ethical committee. A total of thirty unexplained infertility cases were enrolled in the study. Each woman was evaluated by transvaginal ultrasound, first on day 3 of menstrual cycle for baseline assessment, then from day eight, every alternate day until ovulation. They were evaluated first in a spontaneous cycle followed by an induced cycle with clomiphene citrate 50 mg daily for 5 days from day 3 to 7 of cycle. SPSS software and paired t-test were used for analyzing the results. P value less than 0.05 was considered for statistical significance. Results: The leading follicular diameter was significantly larger, endometrial thickness was significantly diminished and ovulation occurred earlier in Clomiphene Citrate induced cycle when compared to spontaneous cycle. Conclusion: Clomiphene citrate induced cycles showed different follicular growth, endometrial thickness and timing of ovulation compared to spontaneous cycles.