補充雌激素可改善排卵藥對子宮內膜之不良影響

排卵藥clomid具抑制雌激素作用，進而對子宮內膜有抑制作用
月經第8天開始補充雌激素賀爾蒙，排卵日開始補充雌激素，可改善排卵藥對子宮內膜之不良影響

http://humrep.oxfordjournals.org/content/17/2/295.full

Abstract

BACKGROUND: We investigated the possibility of correcting the endometrial alterations induced with clomiphene citrate (CC) by vaginal hormonal supplementation (HS) with estradiol (E₂) and progesterone gel. METHODS: Oligo-ovulatory women were prospectively randomized into four groups receiving either 50 mg (groups 1 and 2) or 100 mg (groups 3 and 4) of CC from cycle day 3–8. Groups 2 and 4 also received vaginal E₂ cream 0.1 mg twice daily from day 8 until the LH surge and vaginal progesterone gel, starting 3 days after ovulation. All participants had an endometrial biopsy performed 10 ± 1 days after ovulation. RESULTS: All biopsies in the HS groups (2 and 4) showed complete predecidual changes, and were `in-phase' with findings normally made 10 days post-ovulation (± 2 days of clinical dating). However, without HS (groups 1 and 3), only 4/6 and 3/6 biopsies showed predecidual changes in women receiving 50 and 100 mg of CC. CONCLUSION: The addition of vaginal E₂and progesterone to CC ovulation induction regimens normalizes the alterations in endometrial morphology. Hormonal treatment combining vaginal E₂ and progesterone may improve endometrial receptivity in CC cycles and ultimately yield higher pregnancy rates.

Sequential hormonal supplementation with vaginal estradiol and progesterone gel corrects the effect of clomiphene on the endometrium in oligo-ovulatory women

Table IV.

Mid-cycle ultrasound and LH determinations

Group	Treatment	Day of LHpeak	Day 13 (± 1)number of preovulatoryfollicles (>10 mm)	Endometrialthickness (mm)
All data presented as mean (range).
1	50 mg CC	14.7 (12–18)	1.7 (1–2)	7.8 ± 0.5
2	50 mg CC + HS	13.7 (12–16)	2.5 (2–4)	7.8 ± 0.3
3	100 mg CC	15.0 (13–16)	2.7 (1–4)	7.2 ± 0.3
4	100 mg CC + HS	13.8 (12–15)	3.0 (2–5)	8.5 ± 0.3