الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Ovulation induction remains a milestone in the
treatment of women with anovulatory infertility. For the last
40 years, the first line of treatment for anovulation in infertile
women was CC, it was appropriate, because the drug was
highly effective in inducing ovulation in selected patients with
the advantages of being orally administered, relatively safe,
and inexpensive. In spite of the high ovulation rate associated
with the use of CC (60–80%), the pregnancy rate is much
lower (around 20–40%). Moreover, there may be a higher than
expected incidence of miscarriage in conception cycles
following CC treatment.
Such discrepancy is believed to be due to its peripheral
anti-estrogenic effect of CC, particularly at the level of the
cervical mucus and endometrium. In addition to discrepancy
between ovulation and pregnancy rates, a 20 to 25% of
anovulatory women are resistant to CC and fail to ovulate at
doses up to 200 mg daily.
AI (letrozole) have been introduced as a new treatment
option that could challenge CC for ovulation induction. AIs
are a new group of drugs join the fertility treatments. They are
orally administered, easy to use and less expensive than other
measurements like gonadotrophines, but more expensive than
CC, and with minor side effects. Letrozole is a simple oral
Summary and Conclusion
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alternative to CC with no adverse effect on the endometrium
and endocervix avoiding the risk of multiple pregnancy and
ovarian hyper-stimulation syndrome.
TMX have been also introduced as a simple oral
alternative to CC in ovulation induction. It is similar in
structure to CC, but with no peripheral anti-estrogenic actions,
so, has no adverse effects on endometrial thickness and
cervical mucus.
In our study, we tried to compare the effect of CC,
letrozole and TMX on the endometrium in anovulatory
patients using endometrial thickness and spiral artery Doppler
as parameters for comparison during ovulation induction
cycle.
Our study revealed that:
Enometrial thickness was better under letrozole and
TMX therapy.
Spiral artery Doppler shows lower impedance with a
lower RI and PI under letrozole and TMX therapy.
Ovulation rate was not significantly different between
the three drugs.
Pregnancy rate was not significantly different between
the three drugs.