Clomiphene Citrate with Estradiol Valerate versus Clomiphene Only in Treatment of Women with Unexplained Infertility: Randomized Controlled Trial

Abstract

Infertility is defined as failure to achieve successful pregnancy after 12 months or more of appropriate, timed unprotected intercourse or therapeutic donor insemination. Unexplained infertility (UI) is defined when thorough evaluation fails to identify any abnormalities or a specific diagnosis. About 4–17 % of couples have fertility problems resolved their infertility, but generally there are more cases unreported. Unexplained infertility affects about 15% - 37% of the couples seeking medical advice. The American Society of Reproductive Medicine guidelines for standard infertility evaluation includes semen analysis, assessment of ovulation, tubal patency and uterine abnormalities and, if indicated, tests for ovarian reserve and laparoscopy. Clinicians should counsel the couples with unexplained infertility about the empiric nature of available treatment options including IVF.