Comparison of efficacy of aromatase inhibitor and clomiphene citrate in induction of ovulation in polycystic ovarian syndrome.
OBJECTIVE
To compare the effectiveness of letrozole and clomiphene citrate (CC) in induction of ovulation in polycystic ovary syndrome (PCOS).


METHODS
Prospective, randomized, not blinded, controlled trial.


METHODS
A tertiary level infertility care center.


METHODS
Sixty-four anovulatory patients with PCOS, who failed to ovulate when taking 100 mg/day CC in previous cycles.


METHODS
Patients were randomly divided into two groups by lottery and treated with either 7.5 mg/day letrozole (an aromatase inhibitor) or 150 mg/day CC for 5 days starting from day 3 of the menstrual cycle.


METHODS
Occurrence of ovulation, endometrial thickness, and pregnancy rate (PR).


RESULTS
Twenty (62.5%) patients from the letrozole group and 12 (37.50%) patients from the CC group ovulated during the observation period. Mean serum E2 level was 817.75 pg/mL and 448.03 pg/mL in the CC and letrozole groups, respectively, on the day of hCG administration. The mean endometrial thickness on the day of hCG administration was 9.03 mm and 10.37 mm in the CC and letrozole groups, respectively. The mean D21 serum P was 13.09 ng/mL and 19.09 ng/mL in the CC and letrozole groups, respectively. Thirteen patients from the letrozole group (40.63%) and six patients from the CC group (18.75%) became pregnant.


CONCLUSIONS
Letrozole has better ovulation and PR in comparison to CC in patients with PCOS.
Begum
Mosammat Rashida
MR
Dhaka Medical College, Dhaka, Bangladesh. Electronic address: rashida_icrc@yahoo.com.
Ferdous
Jannatul
J
Bangabandhu Sheik Mujib University, Dhaka, Bangladesh.
Begum
Anowara
A
Dhaka Medical College, Dhaka, Bangladesh.
Quadir
Ehsan
E
Sir Salimullah Medical College, Dhaka, Bangladesh.
D000328:Adult; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D002996:Clomiphene / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004717:Endometrium / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D000077289:Letrozole; D009570:Nitriles / Q000627:therapeutic use*; D010060:Ovulation / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
D047072:Aromatase Inhibitors; D005300:Fertility Agents, Female; D009570:Nitriles; D014230:Triazoles; D002996:Clomiphene; D000077289:Letrozole