Clomiphene citrate or Letrozole as a first line treatment of anovulatory sub fertile polycystic ovarian syndrome women

Abstract

Background :  PCOS is associated with anovalation and a common cause of infertility affecting 4-6 % women in reproductive age , Clomiphene citrate has traditionally used as a drug of choice in treating women with anovulatory PCOS ,  in the last decade letrozole , an aromatase inhibitor has emerged as an alternative ovulation induction agent .

Objective :   to compare letrozole and clomiphene citrate as an ovulation induction drug in infertile PCOS women .

study design :  prospective study .

Patient and method :    PCOS women were treated randomly with 5mg letrozole or 100mg clomiphene citrate day 2 to day 6 menstrual cycle .

Main outcome : ovulation rate , mono or multi follicular rate , days to ovulation , endometrial thickness , serum estrogen and pregnancy rate .

Results: there is statistically significant LH and prolactin levels were significantly higher in Letrozole group but still within normal levels, and letrozole group was higher in number of responsive when compared with CC group but still not significant .

In letrozole group the number of monofollicle cycle was higher (69.57%) and multifollicles cycle was low (30.43%) when are comparing with that of CC group.

Conclusion:

Letrozole in patients with PCOS is as effective as Clomiphene citrate in inducing ovulation , ovulation rate and the incidence of pregnancy was higher with letrozole than that with Clomiphene citrate.

Apart from that, Letrozole treatment is prone to a production of monofollicles and hence leads to reduced incidences of the adverse pregnancy outcome of multiple fetuses as compared to treatment with Clomiphene citrate.

Aim of the study

This is prospective randomized central trial drugs study was carried out to compare the effects of 5mg of letrozole with 100mg CC as ovulation induction drug in treatment of sub fertile PCOS women.