الفهرس 
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Abstract
Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders. It is a complex, heterogeneous disorder of uncertain aetiology, but there is strong evidence that it can, to a large degree, be classified as a genetic disease. Genetic and environmental contributors to hormonal disturbances combine with other factors, including obesity. Ovarian dysfunction and hypothalamic pituitary abnormalities contribute to the etiology of PCOS.
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.
Clomiphene citrate is the traditional first line pharmacological treatment of ovulatory dysfunction associated with PCOS. Although CC is very successful in inducing ovulation, there is usually a discrepancy between ovulation and pregnancy rates (PR). This may be partly explained by the peripheral antiestrogenic effects at the level of the endometrium and cervical mucus, by hypersecretion of LH, or due to negative effects of CC on oocytes or granulosa cells (GC).
Approximately 15% of women who take CC have poor postcoital test results, and IUI is recommended for these women. It can be argued that these negative effects are augmented by the relatively long half-life of CC which is known to be 5 days. Therefore, if treatment is started late in the cycle these negative effects are more likely to be extended into the sensitive peri-implantation period.
Several studies made it evident that the earlier the day of starting CC the better the result.
Badawy et al., 2009 tested a novel protocol of luteal phase administration of CC for ovulation induction in women with polycystic ovary syndrome (PCOS), and concluded that early administration of CC in patients with PCOS will lead to more follicular growth and endometrial thickness, which might result in a higher pregnancy rate.
Hence this study had been done to compare between the effect of early start of CC in late luteal phase of preceding cycle and late start of CC the third day of follicular phase of menstrual cycle which was used for years.