Comparison between Tamoxifen and Clomiphene Citrate in Pregnancy Rate in Infertile Women with Ovulation Dysfunction

Ovulation disorders are one of the most important causes of infertility in women. Clomiphene citrate is used commonly in such patients for the induction of ovulation. But some of the patients are resistant to this drug or even if they have successful ovulation, they may not become pregnant. Tamoxifen is a non steroidal compound like as clomiphene, that is used for ovulation induction, while it doesn’t have undesirable effect of clomiphene on endometrium. The purpose of this study, is comparison between these two drugs for ovulation induction and pregnancy. In this clinical trial, 144 women with infertility were placed in two groups in Block randomization form, who were referred to clinics since March 2006 till March 2008 and were diagnosed to have only ovulatory factor infertility by different tests. (The number of patients was determined according to the pilot study). The treatment of first group was 40mg/day by Tamoxifen and of second group was clomiphene150mg/day from days3 till 7 of menstrual cycle. Then, by using transvaginal sonography in 12-16 days of cycle, they were tested for follicular growth, endometrial thickness and pattern. Finally, the patients were followed up for pregnancy and side effects related to it. Afterwards, descriptive statistics and x2 and T-Test and SPSS software statistical analysis were carried out. (P<0.05) was considered as statistically significant). In each group, 72 patients were treated. The ovulation rate in group 2 was meaningfully higher than that in group 1 (P<0.05). The pregnancy rate in the patients who had ovulation in both groups was similar. But pregnancy rate in patients who received clomiphene citrate was higher. There was no significant difference between the 2 groups in terms of endometrial thickness, pattern and the side effect of treatment. The patients’ conditions in 2 groups were similar in terms of BMI, age, the duration of infertility and ovarian volume. The results of this study show that using TMX as the first treatment for ovulation induction is not effective and suitable.