Evaluation of clomiphene citrate therapy on fertility success rate in infertile patients with ovulatory factors in Sarem hospital 1394-1396

Aims: Ovarian factor is one of the most common causes of infertility in couples and various treatment methods have been adopted to treat it. Clomiphene drug is one of the safest, least expensive and most effective methods in these people. The drug is used with or without gonadotropins and IUI (Intra uterine insemination) method in infertile and subfertile couples with ovarian factors and health in the hypothalamic-pituitary-ovarian axis. The aim of this study was to evaluate the success rate of this drug in infertile women with ovarian factor that leads to a positive result. Positive results include pregnancies with a confirmed βhCG test, vaginal ultrasound, and a pregnancy sac seen inside the uterine cavity. Therefore, the results of this study can be effective and useful in the physician's decision to continue treatment. Methods: This study is a retrospective cross-sectional study that the results of treatment with clomiphene with or without IUI in 785 patients referred to the IVF clinic of Sarem subspecialty hospital with ovarian factor during 2015 to 1396 has been reviewed. Hormones level such as thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), and antimalarial hormone (AMH) were measured on the third day of menstruation and then clomiphene was prescribed. In all patients, spermogram test were performed twice, which was normal after the spermation process (Capacitation). Findings: The results showed that there was no significant relationship between the type of menstruation and treatment protocol used for the patients (P=0.109). Also, there was no significant relationship between the presence of acne and hirsutism in patients and the type of treatment protocol (P=0.281 and P=0.232, respectively). In this study, there was no significant relationship between the type of clomiphene treatment or clomiphene with IUI and the levels of LH (P=0.783), FSH (P=0.516), AMH (P=0.679) and PRL (P=0.345) and also there was no significant relationship between body mass index (BMI) with the type of patient treatment (P=0.584). Clomiphene treatment alone did not have a significant effect on the success of pregnancy outcomes, but in the clomiphene and IUI treatment protocol, there were 127 positive pregnancies, which 3% of them were ectopic pregnancies, and 5% of them was led to abortion. Finally, 124 cases resulted in the birth of a live baby, which based on the results of statistical analysis showed a significant relationship (P=0.036). Conclusion: Clomiphene as a drug with low complication, low cost and available can be used as a suitable option in the treatment of infertile patients with ovarian factor in combination with IUI treatment method.