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Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial.
Eur J Obstet Gynecol Reprod Biol. 2014 Sep; 180:148-52.EJ

Abstract

OBJECTIVE

To evaluate the effectiveness of L-carnitine on improving the ovulation and pregnancy rates as well as adverse metabolic indices in clomiphene-resistant PCOS.

DESIGN

Single center, double blinded, superiority, randomized controlled clinical trial.

SETTING

Women's Health Hospital, Assiut University.

METHODS

One hundred and seventy women diagnosed with PCOS were found to be clomiphene resistant. The women were randomly allocated into two groups: Group A (n=85), where patients received 250 mg clomiphene citrate from day three until day seven of the cycle plus L-carnitine (LC) 3g daily; and Group B (n=85) received 250 mg clomiphene citrate with placebo.

OUTCOME

Primary outcome is cumulative clinical pregnancy rate. Secondary outcomes are changes in serum glucose level and lipid profile.

RESULTS

The combination of L-carnitine and CC significantly improve both the ovulation and the cumulative pregnancy rates in clomiphene resistant PCOS (55 (64.4%) vs. 15 (17.4%) and 44 (51.5) % vs. 5 (5.8) %). The number of stimulated follicles reaching ≥17 mm diameter was significantly more in Group A to Group B (2.2 ± 0.77 vs. 0.16 ± 0.79; p<0.0001). Group A needed significantly fewer days for adequate follicular maturation, had a thicker endometrium and higher oestradiol concentration at the time of human chorionic gonadotrophin injection (10.1 ± 0.1mm vs. 6.8 ± 0.4mm; p<0.0001). The same group had a higher mean luteal-phase serum progesterone compared with the control group (13.55 ± 0.99 vs. 10.6 ± 0.98 ng; p<0.0001). A significant difference was found regarding the clinical pregnancy rates (42 (49.4%) vs. (1) 1.1% respectively p value <0.0001).

CONCLUSION

Adding L-carnitine when treating clomiphene-resistant PCOS patients not only improved the quality of ovulation and the pregnancy rate with an acceptable patient tolerability, but also enhanced the patient lipid profile and body mass index.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Ismail AM
Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Egypt.
Hamed AH
Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Egypt. Electronic address: aliamr22@hotmail.com.
Saso S
Division of Surgery and Cancer, Institute of Reproductive & Developmental Biology, Imperial College London, UK.
Thabet HH
Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Egypt.

MeSH

AdultCarnitineClomipheneDouble-Blind MethodDrug ResistanceDrug SynergismDrug Therapy, CombinationFemaleFertility Agents, FemaleFollicle Stimulating HormoneHumansInfertility, FemaleLuteinizing HormoneOvulationOvulation InductionPolycystic Ovary SyndromePregnancyPregnancy RateTreatment OutcomeVitamin B ComplexYoung Adult

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25015747

Clinical Trial Links

Effects of Triple Drug Cocktail Therapy on Metabolic, Endocrine Alterations and Perceived Stress in Patients With Poly Cystic Ovary Syndrome

Citation

Ismail, Alaa M., et al. "Adding L-carnitine to Clomiphene Resistant PCOS Women Improves the Quality of Ovulation and the Pregnancy Rate. a Randomized Clinical Trial." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 180, 2014, pp. 148-52.
Ismail AM, Hamed AH, Saso S, et al. Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2014;180:148-52.
Ismail, A. M., Hamed, A. H., Saso, S., & Thabet, H. H. (2014). Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 180, 148-52. https://doi.org/10.1016/j.ejogrb.2014.06.008
Ismail AM, et al. Adding L-carnitine to Clomiphene Resistant PCOS Women Improves the Quality of Ovulation and the Pregnancy Rate. a Randomized Clinical Trial. Eur J Obstet Gynecol Reprod Biol. 2014;180:148-52. PubMed PMID: 25015747.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial. AU - Ismail,Alaa M, AU - Hamed,Ali Hassan, AU - Saso,Srdjan, AU - Thabet,Hossam H, Y1 - 2014/06/23/ PY - 2014/02/23/received PY - 2014/06/08/revised PY - 2014/06/13/accepted PY - 2014/7/13/entrez PY - 2014/7/13/pubmed PY - 2016/3/30/medline KW - Induction of ovulation KW - Oxidative stress KW - PCOS KW - l-carnitine SP - 148 EP - 52 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 180 N2 - OBJECTIVE: To evaluate the effectiveness of L-carnitine on improving the ovulation and pregnancy rates as well as adverse metabolic indices in clomiphene-resistant PCOS. DESIGN: Single center, double blinded, superiority, randomized controlled clinical trial. SETTING: Women's Health Hospital, Assiut University. METHODS: One hundred and seventy women diagnosed with PCOS were found to be clomiphene resistant. The women were randomly allocated into two groups: Group A (n=85), where patients received 250 mg clomiphene citrate from day three until day seven of the cycle plus L-carnitine (LC) 3g daily; and Group B (n=85) received 250 mg clomiphene citrate with placebo. OUTCOME: Primary outcome is cumulative clinical pregnancy rate. Secondary outcomes are changes in serum glucose level and lipid profile. RESULTS: The combination of L-carnitine and CC significantly improve both the ovulation and the cumulative pregnancy rates in clomiphene resistant PCOS (55 (64.4%) vs. 15 (17.4%) and 44 (51.5) % vs. 5 (5.8) %). The number of stimulated follicles reaching ≥17 mm diameter was significantly more in Group A to Group B (2.2 ± 0.77 vs. 0.16 ± 0.79; p<0.0001). Group A needed significantly fewer days for adequate follicular maturation, had a thicker endometrium and higher oestradiol concentration at the time of human chorionic gonadotrophin injection (10.1 ± 0.1mm vs. 6.8 ± 0.4mm; p<0.0001). The same group had a higher mean luteal-phase serum progesterone compared with the control group (13.55 ± 0.99 vs. 10.6 ± 0.98 ng; p<0.0001). A significant difference was found regarding the clinical pregnancy rates (42 (49.4%) vs. (1) 1.1% respectively p value <0.0001). CONCLUSION: Adding L-carnitine when treating clomiphene-resistant PCOS patients not only improved the quality of ovulation and the pregnancy rate with an acceptable patient tolerability, but also enhanced the patient lipid profile and body mass index. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/25015747/Adding_L_carnitine_to_clomiphene_resistant_PCOS_women_improves_the_quality_of_ovulation_and_the_pregnancy_rate__A_randomized_clinical_trial_ DB - PRIME DP - Unbound Medicine ER -
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