title: Reproductive outcome after letrozole versus laparoscopic ovarian drilling for clomiphene-resistant polycystic ovary syndrome.
abstract: OBJECTIVE
  To compare the clinical outcomes of letrozole and laparoscopic ovarian drilling (LOD) in patients with clomiphene-citrate-resistant polycystic ovary syndrome (PCOS).
  
  
  METHODS
  In the present prospective randomized trial, 140 women with clomiphene-citrate-resistant PCOS were randomly allocated to receive 5mg letrozole from day 3 to day 7 of menses for 6 consecutive cycles, or to undergo LOD. When a leading follicle of at least 18 mm was present, ovulation was triggered with human chorionic gonadotropin (hCG). The 6-month rates of ovulation, pregnancy, abortion, and live births were evaluated.
  
  
  RESULTS
  The groups were similar with regard to baseline clinical characteristics and hormonal profiles. The ovulation rate was significantly higher in the letrozole group than in the LOD group (59.0% versus 47.5%). On the days of the hCG injection, women in the letrozole group had a significantly thicker endometrium than those in the LOD group (P<0.0001). Women receiving letrozole had a higher pregnancy rate (35.7% versus 28.6%) and a lower rate of spontaneous abortion (8.0% versus 20.0%, respectively), but these differences were not statistically significant.
  
  
  CONCLUSIONS
  Letrozole seems to be a suitable second-line ovulation-inducing alternative to LOD in women with PCOS who do not conceive with clomiphene citrate.
authors: Women's Health Center, Assiut University, Assiut, Egypt. msayed21@yahoo.com
authors: Mohamad S
authors: MS
authors: Abdellah
mesh_terms: D000328:Adult; D000858:Anovulation / Q000209:etiology / Q000628:therapy*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D002996:Clomiphene / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004351:Drug Resistance; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D010535:Laparoscopy / Q000379:methods*; D000077289:Letrozole; D009570:Nitriles / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D012098:Reproduction; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D047072:Aromatase Inhibitors; D005300:Fertility Agents, Female; D009570:Nitriles; D014230:Triazoles; D002996:Clomiphene; D000077289:Letrozole