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CompletedNCT07769476Updated Aug 18, 2026

Comparison of Clomiphene Alone Versus Clomiphene Plus Sildenafil for Ovulation in Women With Polycystic Ovary Syndrome

A Phase 4 interventional study of Clomiphene Citrate 100 mg and Sildenafil Citrate 25Mg Tab in Polycystic Ovarian Syndrome (PCOS) and Polyendocrine Metabolic Ovarian Syndrome (PMOS), sponsored by Nishtar Medical University. Completed at 1 site in Pakistan. Open to female participants aged 18 Years to 45 Years. Per ClinicalTrials.gov, last updated 2026-08-18.

Sponsored by Nishtar Medical University · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
98
Allocation
Randomized
Ages
18 Years to 45 Years
Sex
Female
01

Study summary

The goal of this randomized clinical trial is to compare the effectiveness of clomiphene citrate alone with clomiphene citrate combined with sildenafil citrate for inducing ovulation and achieving pregnancy in women with polycystic ovary syndrome (PCOS) who have difficulty becoming pregnant.

The main question the study aims to answer is:

Does adding sildenafil citrate to clomiphene citrate increase the chance of ovulation and pregnancy compared with clomiphene citrate alone in women with PCOS?

The study will include 98 women aged 18-45 years with PCOS and a history of difficulty achieving pregnancy for more than 2 years. Participants will be randomly assigned to one of two groups.

  • Participants in Group A will receive clomiphene citrate 100 mg once daily from days 3-7 of the menstrual cycle, plus sildenafil citrate 25 mg twice daily from days 8-12.
  • Participants in Group B will receive clomiphene citrate 100 mg once daily from days 3-7, plus a placebo twice daily from days 8-12.

Treatment will be given for 12 weeks. Participants will be assessed for ovulation, pregnancy, and endometrial thickness. Ovulation will be assessed using transvaginal ultrasound and/or a blood progesterone test. Pregnancy will be assessed using a urine pregnancy test and/or ultrasound.

The primary hypothesis is that women receiving clomiphene citrate plus sildenafil citrate will have a higher rate of pregnancy than women receiving clomiphene citrate alone. The study will also determine whether adding sildenafil improves ovulation and endometrial thickness.

02

Conditions studied

  • Polycystic Ovarian Syndrome (PCOS)
  • Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Keywords

  • Clomiphene Citrate
  • Sildenafil Citrate
  • Ovulation Induction
  • Pregnancy
  • Polycystic Ovarian Syndrome
  • Endometrial Thickness
  • Subfertility
03

Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Women with PCOS,
  • Sub-fertility attributed to PCOS, > 2 years

Exclusion criteria

Exclusion Criteria:

  • Comorbidities; diabetes, hypertension
  • Chronic medical illness (liver, heart, kidney disease)
  • Undergone ovarian drilling
  • Recent administration of hormonal therapy
  • Abnormal prolactin levels (>500 mIU/L), or thyroid function tests (TSH >5.2 mIU/L, T3 \<70 ng/dl and T4 \<5.2 μg/dl)
  • Obstructed fallopian tubes documented on hysterosalpingography and
  • Abnormal semen analysis of their partners
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
98 participants (actual)

Study arms

  • Experimental
    Clomiphene Citrate + Sildenafil Citrate

    Oral Clomiphene Citrate and Sildenafil Citrate will be given to participants in this Arm

    Drug: Clomiphene Citrate 100 mg · Drug: Sildenafil Citrate 25Mg Tab

  • Placebo comparator
    Clomiphene Citrate + Placebo

    Participants in this arm will be given clomiphene citrate and placebo

    Drug: Clomiphene Citrate 100 mg · Drug: Placebo

Interventions

  • DrugClomiphene Citrate 100 mg

    Clomiphene citrate 100 mg administered orally once daily from menstrual cycle days 3-7 for ovulation induction. Treatment will be repeated for 12 weeks.

  • DrugSildenafil Citrate 25Mg Tab

    Sildenafil citrate 25 mg administered orally twice daily from menstrual cycle days 8-12, in addition to clomiphene citrate, for ovulation induction. Treatment will be repeated for 12 weeks.

  • DrugPlacebo

    Matching placebo containing starch administered orally twice daily from menstrual cycle days 8-12, in addition to clomiphene citrate. Treatment will be repeated for 12 weeks.

05

What researchers measure

Primary outcomes

  1. Pregnancy

    Pregnancy will be considered achieved when a urine human chorionic gonadotropin (hCG) test is positive after 7 days of a missed menstrual period and/or a gestational sac is detected by ultrasound.

    Time frame: From initiation of treatment (1st cycle) through completion of third treatment cycle, up to 12 weeks

Other outcomes

  1. Ovulation

    Ovulation will be considered present when a collapsed follicle and free fluid in the pouch of Douglas are observed on transvaginal ultrasound and/or serum progesterone is ≥3 ng/mL. Transvaginal ultrasound will be start around cycle day 10-12, then repeat every 1-2 days until evidence of ovulation. Serum progesterone will be measured approximately 7 days after the expected ovulation (often around cycle day 21 in a 28-day cycle).

    Time frame: From initiation of treatment (first cycle) through completion of the third cycle, up to 12 weeks

  2. Endometrial Thickness

    Endometrial thickness will be measured by transvaginal ultrasonography once during each treatment cycle, at the peri-ovulatory assessment when the dominant follicle reaches approximately 18-22 mm in diameter, before evidence of follicular rupture. Measurements will therefore be obtained during each of the three treatment cycles.

    Time frame: From initiation of treatment (first cycle) through completion of the third cycle, up to 12 weeks

06

Study locations

1 site
  • Nishtar Medical University
    Multan, Punjab Province 60000, Pakistan
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07769476
Lead sponsor
Nishtar Medical University
Responsible party
Asma Ramzan (Principal Investigator, Nishtar Medical University) — Principal investigator
First posted
Aug 18, 2026
Start date
Jul 1, 2025
Primary completion
Dec 30, 2025
Completion
Dec 30, 2025
Last update
Aug 18, 2026

Study contacts

Hajira M Associate Professor, FCPS
study chair · Nishtar Medical University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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