Vitamin E supplementation for Infertile Women with Clomiphene Citrate-Resistant Polycystic Ovary Syndrome: Could it Improve Outcome?

Abstract

Introduction and aim: Polycystic ovary syndrome (PCOS) is a common medical condition and resistance to Clomiphene Citrate (CC) is common. Oxidative stress plays a role in PCOS pathogenesis. Thus, antioxidants could play a role in management. Vitamin E in higher doses did not fully addressed in PCOS. Thus, the current work aimed to evaluate the effects of vitamin-E treatment on ovulation and pregnancy rates in PCOS resistant to CC treatment.

Methodology: This study included 100 women with CC-resistant PCOS.  Patient demographics and basal hormonal assay (FSH, LH, prolactin and TSH, were evaluated and recorded. The vitamin E group received 2000 IU/day from metformin starting till the end of the study.  Dominant follicles (≥ 18 mm) and endometrial thickness were evaluated by transvaginal ultrasound. The primary outcome was the ovulation and pregnancy rates in each cycle. The secondary outcomes were the number of dominant follicles, the endometrial thickness (ET), and progesterone levels.

Results: The study and control groups showed non-significant differences regarding studied outcomes except significant increase of ET in the study than the control groups (8.82±1.88 vs 7.90±1.74 mm, 9.47±2.11 vs 8.14±1.79 mm, and 9.95±2.39 vs 8.44±1.94 in the first, second and third cycles, successively). In addition, the ovulation rate was significantly increased in the third cycle in the study than the control group (93.2% vs 76.6%, respectively).  No significant side effects were recorded.

Conclusion: The use of higher doses of vitamin E improved the ovulation and pregnancy in PCOS women resistant to CC-treatment. However, it did not reach statistical significance. However, it significantly increased endometrium thickness from the first cycles and ovulation rate significantly increased in the third cycle.