Nitric oxide donors increases pregnancy rate in clomiphene citrate treated polycystic ovary infertile patients

Objectives: To test if treatment of polycystic ovary (PCO) infertile patients with clomiphene citrate (CC) and the nitric oxide (NO) donors isosobid mononitrate (ISMN) might improve the ovulation and pregnancy rates compared to treatment with CC alone. Study design: Prospective, randomized, controlled study. Setting: Benha university hospital. January 2008 to January 2009. Subjects and methods: The study included thirty PCO infertile patients divided randomly into a control and a study groups each fifteen cases. Patients in the control group were treated with 100mg CC for five days starting from the fifth day of the cycle. The study group received in addition to CC, 20mg ISMN tablet applied vaginally till the diagnosis of ovulation and pregnancy. Primary outcome measures: Ovulation and pregnancy rate in the CC+ISMN group compared to the CC alone group. Secondary outcome measures: Number of mature follicles (⩾18mm), cervical mucus score and endometrial thickness in both groups. Results: There was a significant increase in the ovulation and pregnancy rates in the CC+ISMN group. The number of mature follicles, the cervical mucus score and the endometrial thickness were significantly higher in this group. Conclusions: This novel treatment of infertile PCO patients with combination of CC and NO donors is simple and promising. The ovulation and pregnancy rates are increased due to improvement of follicular maturation, cervical mucus quality and endometrial receptivity