الفهرس 
Introduction
Polycystic ovary syndromeOnly 14 pages are availabe for public view
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Abstract
Polycystic ovarian syndrome (PCOS) happens to be a frequent endocrinal disorder, it affects around 10% of women, being considered a major cause of anovulatory infertility. The majority of PCOS women have insulin resistance, anovulation, hyperandrogenism, and obesity. Insulin resistance in PCOS women is relied on oxidative stress (OS). Oxidative stress is negatively impacting folliculogenesis, oocyte maturation, luteolysis, and causes defective embryo development which leads to early embryonic death. Sildenafil citrate (SC) is inhibiting type 5-specific phosphodiestrase (PDE) which prevents cGMP breakdown to increase NO level, relaxing the vascular smooth muscle. El-Far et al. reported, for the first time, that SC could be used as a safe anti-abortive treatment for unexplained recurrent spontaneous miscarriage. Vaginal SC is also reported to decrease natural killer (NK) cell activity, augment antioxidant levels, and suppress lipid peroxidation as well as nitrosative stress, increasing uterine blood flow which can be used for treating recurrent miscarriage and poor endometrium. Silymarin (SM) is a mix of flavonolignans obtained out of milk thistles seeds and fruits with main components silibinin. El-Far et al. reported the powerful antioxidant properties of SM and silibinin and reported their equivalent therapeutic effects against diabetes. In addition, SM can improve the ovulation in PCOS women.The most important results of the present study are summarized and discussed as following:1- Sildenafil citrate alone or silymarin alone caused significant increase in levels of TAC, GSH and SOD in both serum and FF as compared with untreated PCOS patients.2-Also caused significant decrease in levels of MDA and NO in both serum and FF when compared with PCOS patients.- The most effect was obtained by using the combination of sildenafil citrate and silymarin as compared with each alone.4- It was observed that the combination of sildenafil citrate and silymarin made the oocytes and developing embryos much better than that observed in untreated PCOS group.5- The pregnancy rate in the combination group was more than other groups with no miscarriage.