Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial.
OBJECTIVE
Letrozole, though reported to be an effective ovulation inducing agent, warrants larger randomized trials. The purpose of this study is to compare the efficacy of letrozole with that of rFSH and clomiphene citrate(CC)/rFSH for ovarian stimulation in IUI cycles.


METHODS
Randomized, prospective, single-blinded clinical trial. 1387 PCOS women after CC failure were randomized into three groups: Group A received letrozole, Group B received CC with two doses rFSH and Group C received continuous rFSH day 2 onwards until hCG injection.


RESULTS
Group A, B and C had an ovulation rate of 79.30%, 56.95% and 89.89% and cycle cancellation rate of 20.70%, 43.05% and 10.11%, respectively. Pregnancy rates in Group A, B and C were 23.39%, 14.35% and 17.92%, while the miscarriage rates were 13.80%, 16.67% and 14.52%, respectively.


CONCLUSIONS
Letrozole appears to be a suitable ovulation inducing agent in PCOS women with CC failure and is found to be most effective when baseline estradiol level >60 pg/ml.
Ganesh
Ashalatha
A
School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India.
Goswami
Sourendra Kant
SK
Chattopadhyay
Ratna
R
Chaudhury
Koel
K
Chakravarty
Baidyanath
B
D000328:Adult; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D002996:Clomiphene / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage; D043373:Follicle Stimulating Hormone, Human / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D007246:Infertility / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000077289:Letrozole; D008297:Male; D009570:Nitriles / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications*; D011247:Pregnancy; D018873:Pregnancy Rate; D016037:Single-Blind Method; D014230:Triazoles / Q000008:administration & dosage*
D047072:Aromatase Inhibitors; D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D009570:Nitriles; D014230:Triazoles; D002996:Clomiphene; D004958:Estradiol; D000077289:Letrozole