الفهرس 
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Abstract
Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders. It produces symptoms in approximately 5% to 10% of women of reproductive age (12–45 years old). It is thought to be one of the leading causes of female subfertility. (1, 2)
The cardinal features are hyper-androgenemia, ovulatory dysfunction and/or ultrasonographic polycystic ovarian appearance (two out of these three features are diagnostic). (4)
Clomiphene citrate (CC) is the standard drug used for ovulation induction in women with PCOS. Successful ovulation is achieved in 70-85 % of cases and only 40–50 % will conceive. (45-47)
The discrepancy between ovulation and pregnancy rates may be explained by the peripheral anti-estrogenic effects of CC at the level of the endometrium and cervical mucus or by hyper-secretion of LH. (55)
Intrauterine insemination (IUI) is the first therapeutic step in assisted reproductive techniques due to its simplicity, easy management, low cost and absence of potentially serious complications. (87-89)
The aim of this work was to study the effect of induction of ovulation with clomiphene citrate and hCG in patients with PCOS with intrauterine insemination compared to timed intercourse.
The study was conducted upon 60 an-ovulatory PCOS infertile women, 18-35 years age group, who were attending El Shatby Infertility Unit, Alexandria faculty of Medicine by two out of the previous three criteria.
Patients were randomly allocated into two groups and received clomiphene citrate 100mg. /day for 5 days starting from day 3 of the cycle.
HCG was administered when the leading follicle reached 18 mm. or more.
The first group was subjected to timed intercourse (TIC) 40-48 hours after hCG administration.
The second group was subjected to intrauterine insemination (IUI) plus intercourse within the same day, 40-48 hours after hCG administration.
In IUI group, semen was obtained by masturbation after three to five days of abstinence then preparation was done by swim up technique then IUI was done. The patient was asked to rest for10-15 minutes following insemination.
Luteal phase support for the two groups by use of vaginal micronized progesterone 200 mg. has been used twice daily for two weeks.
Serum pregnancy test was done 2 weeks after hCG administration and if positive trans-vaginal ultrasound was done 2 weeks later to confirm clinical pregnancy.