الفهرس 
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Abstract
Infertility is a disease, a defined by the failure to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse. Earlier evaluation and treatment may be justified based on medical history and physical findings and is warranted after 6 months for women over age 35 years.
Clomiphene has negative effects on the expression of endometrial estrogen. Although clomiphene induced ovulation rates are between 80% and 85%, conception rates are only around 40%.
Our study was conducted on 100 pregnant women attended Beni-Suefgeneral hospital from June to December 2016. The cases were allocated into 2 main groups: group (A): 50 cases received clomiphene citrate only by: 100 mg clomiphene citrate from day 2-6 of the menstrual cycle. group (B): 50 cases received clomiphene citrate and cimicifugaracemosa (Klimadynon) ® by: 100 mg of clomiphene + 80 mg cimicifugaracemosa during follicular phase (from day 2 till day of βhcg administration).
Assessment of follicular number and size, endometrial thickness, endometrial pattern, , day 21 progesterone, chemical pregnancies rate and clinical pregnancies rate was done. The subjects enrolled in the study aged 18- 35 years old, has primary or secondary infertility due to chronic anovulation, had no other factors of infertility and normal semen analysis of their husbands.
Our results were that chemical pregnancy rate and clinical pregnancy rate are significantly improved with use of cimicifugaracemosa plus clomiphene citrate in ovulation induction with p.value = 0.012 and 0.016 for chemical pregnancy and clinical pregnancy respectively. Also there is significant improvement in endometrial thickness, endometrial pattern, and day 21 progesterone level.
Finally we recommend that more studies are needed to evaluate the effect of Cimicifugaracemosa on implantation through studying endometrial and subendometrial blood flow in peri-implantation period.