الفهرس 
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Abstract
This present study aimed at assessment of the effectiveness of adding L- carnitine to clomiphene citrate (CC) on the improvement of quality of ovulation and clinical pregnancy rate in women with polycystic ovary syndrome (PCOS). It was a prospective interventional randomized clinical trial. The study was hold in the Gynecology and Obstetrics department at the Fayoum General Hospital on 100 PCO infertile women. Randomly allocated into two groups; group (A): 50 females aged from (21) to (33) with an average of (26.85 ±3.4) years old; and infertility duration ranged from (1) to (5) with an average of (3.16 ±1.7) years duration received oral clomiphene citrate (CC) 50 mg tablet, two times per day from the third day of the cycle until the seventh day of the cycle plus oral L- carnitine 1g tablet, three times per day from the third day for three months. And group (B): 50 females aged from (20) to (34) with an average of (27.04 ±3.7) years old; and infertility duration ranged from (1) to (7) with an average of (3.46
±1.5) years duration received oral clomiphene citrate 50 mg tablet, two times per day from the third day of the cycle until the seventh day of the cycle for three months. There were statistically significant difference between both studied groups regarding age, infertility duration and type of infertility. No statistically significant difference between both studied groups regarding their body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters). No statistically significant difference between both studied groups regarding their basal hormonal profile levels (FSH and LH). The number of pre-ovulatory follicles >17 mm in this present study was significantly higher among group (A) as compared with group (B); p-value (0.001). In the ovulation rate; there was significant difference between two groups. In group (A) ovulation occurred in (78%) of cases while in group (B) the ovulating cases were (44%); (p-value= 0.001). Endometrial thickness showed highly statistical significant difference between studied groups. It was significantly higher among group (A) as compared with group (B) p-value (0.001). Days until HCG injection showed highly statistical significant difference between studied groups. It was significantly lower among group (A) as compared with group (B) p-value (0.001). Serum estradiol on day of hCG injection (pg/mL) showed significantly higher level among group (A) as compared with group (B). Prevalence of pregnancy was higher among studied group received CC + L‐Carnitine as compared with studied group received CC only with a statistically significant p-value (0.001). According to our findings; addition L-carnitine to clomiphene citrate in the follicular phase and extending through the luteal phase in patients with clomiphene-resistant PCOS at the given dose and duration, may have a significant role in improving the quality of ovulation and the clinical pregnancy rate.