Role of phyto-oestrogens in ovulation induction in women with polycystic ovarian syndrome

Objective

To study the role of a phyto-oestrogen, Cimicifuga racimosa extract (Klimadynon^®, Bionorica, Neumarkt i.d.OBf., Germany), in ovulation induction in women with polycystic ovarian syndrome (PCOS).

Study design

Prospective randomized controlled trial in Minia University Hospital, Minia, Egypt. One hundred women with PCOS were allocated into one of two groups: one group (n = 50) received clomiphene citrate 100 mg daily for 5 days, and the other group (n = 50) received C. racimosa 20 mg daily for 10 days. Both groups received medication starting from the second day of the cycle for three consecutive cycles, during which changes in follicle-stimulating hormone (FSH), luteinizing hormone (LH), FSH/LH ratio, progesterone, endometrial thickness and pregnancy rate were measured.

Results

The groups were similar in terms of age, clinical presentation and hormonal levels before treatment. Following treatment, significant favourable changes in LH level and FSH/LH ratio (p = 0.007 and 0.06, respectively) were seen in the Klimadynon group. In this group the progesterone level was higher from the first treatment cycle, indicating better ovulation (p = 0.0001), and endometrial thickness was greater (p = 0.0004). The pregnancy rate was higher in the Klimadynon group but the difference between the groups was not significant (p = 0.1).

Conclusion

Phyto-oestrogen can be used as an alternative to clomiphene citrate for ovulation induction in women with polycystic ovarian syndrome.