A prospective study for the assement of follicular growth, endometrial thichness and serum estradioal levels in spontaneous and clomiphene citrate induced cycles in unexplained infertility patients

Abstract

ABSTRACT Aim Clomiphene citrate has an adverse effect on the normal cyclical growth of the endometrium by its antiestrogenic effect, thus making the endometrium thin and ineffective for subsequent implantation. Objective 1. To evaluate follicular growth, endometrial thickness in spontaneous and clomiphene citrate induced cycle. 2. To estimate serum estradiol levels and correlate them with follicular growth and endometrial thickness in spontaneous and clomiphene citrate induced cycle. Study Design This prospective study was conducted between Aug 2007 to Aug 2009 at the infertility clinic of department of OBG, Aarupadai Veedu Medical College, Pondicherry. This study was done to evaluate follicular growth, endometrial thickness and serum estradiol levels in spontaneous and clomiphene citrate induced cycles during preovulatory phase of menstrual cycle. Each woman was evaluated using transvaginal ultrasonography and serum estradiol level estimation from day ten of menstrual cycle until ovulation and result were analyzed using paired t-test. Result The groups were comparable with respect to wife age, husband’s age; sperm count follicular growth, endometrial thickness, serum estradiol level. In spontaneous cycle growth of follicle was 2.8mm per day, endometrial thickness growth was 0.57 mm per day, both were found to be significant (P<0.0001). Where as in study group growth of follicle was 2.87 mm per day and endometrial thickness growth was 0.47 mm per day the range of serum estradiol level was 45 to 2800 pg / ml in study group. In control group serum estradiol range was found to be 30-440 pg / ml from day 11 to day 14, Which was also statistically significant (P<0.0001). Conclusion The leading follicular diameter was significantly larger in study group compared to control group, endometrial thickness was significantly diminished in study group in spite of increased estradiol levels.