الفهرس 
Unexplained InfertilityOnly 14 pages are availabe for public view
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Abstract
The management of couples with unexplained infertility should balance the efficacy, cost, safety, and risks of various treatment alternatives. A common approach is to start with treatments that consume few resources and are patient-directed (eg, lifestyle changes or timed intercourse), and then move sequentially to treatments requiring proportionately greater resources (clomiphene citrate [CC] plus intrauterine insemination [IUI]), and finally to high-resource interventions (gonadotropin injections plus IUI, in vitro fertilization [IVF])
The approach to treatment should be individualized for each couple. In general, if a specific fertility treatment does not result in pregnancy after three cycles, alternative treatments should be considered
This prospective comparative study has been performed from July 2016 to January 2019 upon one hundred patients with unexplained infertility attending the infertility outpatient clinic at Benha University Hospital, One Hundred patients with unexplained infertility were selected as having unexplained infertility, All patients eligible for this study were subjected to the followings: History taking, Examination and Investigations: laboratory (serum basal FSH, LH, TSH, E2,& Prolactin) and radiological (Transvaginal US) to exclude any ovarian, uterine or cervical abnormalities
The results revealed that:
•There was no statistically significant difference in any demographic characters among women of letrozole & CC groups.
•No significant difference between the studied groups as regard baseline biochemical data.
•The mean number of dominant follicles (≥18 mm) in the letrozole and CC group was statistically different (CC 1.9 ± 0.4 vs. letrozole 1.5 ± 0.3, P < 0.001). The mean mid-cycle trilaminar layer of endometrial thickness in the letrozole group was 8.93± 2.38 mm compared to 5.6 ± 1.63 mm in CC group which was statistically significant (P < 0.001).
•that pregnancy rates were significantly higher in patients with subgroup 3 penetration compared with subgroup 1 or subgroup 2 penetrations (8 and 7&5) & (5 and 1&1) respectively in both groups.
•that there was highly significant number of pregnancies as evidenced by positive pregnancy test and intrauterine gestational sacs in letrozole group more than CC group (20 cases or 40 % versus 12 cases or 24 % respectively). The difference between letrozole group & CC group was statistically significant, also rate of pregnancy per cycle was (12.42 % versus 6.93 %) the difference was also statistically significant.
Based on the results it is recommended that Educational health programs related to infertility and women health should be comprehensive, coordinated and participatory in order to be effective.