Background. Despite the high prevalence of polycystic ovary syndrome (PCOS), its pathogenesis has not been well understood. This study was designed to evaluate the reproductive and metabolic effects of L-carnitine in clomiphene citrate (CC)-resistant PCOS women. Methods. The triple-blind randomized controlled clinical trial was conducted in the infertility clinic of the Imam Hossein hospital and registered with registration number: IRCT20210415050980N1. A total of 148 CC-resistance PCOS women have randomly divided into two groups; group A received 150 mg/day CC from day 5 to day 9 of the ovulation cycle and 3g oral L-carnitine, and Group B received 150mg/day oral CC plus placebo. The primary outcome was the clinical pregnancy rate. The secondary outcomes were hormonal and metabolic profile changes. Findings. L-carnitine significantly improves ovulation and pregnancy rate (71.4% vs. 28.6%; p<0.001 and 33% vs. 11%; p<0.001). The number of stimulated follicles reaching >17mm diameter was significantly higher in Group A...

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