Comparative study of clomiphene citrate versus letrozole as first-line ovulation induction drug in infertile polycystic ovary syndrome women

Abstract

Background: Polycystic ovary syndrome is the commonest endocrinopathy resulting in anovulatory infertile young women. Clomifene citrate (clomiphene) is a long-standing standard drug for ovulation induction, and is still considered as first line option in PCOS women. However, clomiphene has certain disadvantage letrozole an aromatase inhibitor acts by reducing estrogen production and has no adverse effects on endometrium and cervical mucous. Indian PCOS women have high prevalence of insulin resistance and thus are likely to have high clomiphene resistance. So letrozole could prove to be a good alternative for ovulation induction in such women.Methods: This was a prospective randomized, parallel, comparative clinical trial of two ovulation induction drugs letrozole 5 mg versus clomiphene citrate 100 mg as first-line ovulation induction drug in infertile polycystic ovarian syndrome women. The target population of the study was one hundred infertile women with PCO (taking at least 2 Rotterdam’s parameters). 50 women were allocated to clomifene citrate and 50 were allocated to Letrozole for ovulation induction. Parameters like age, duration of infertility, B MI, ovulation rate, number of follicles, pregnancy rate, endometrial thickness were noted and analyzed.Results: In letrozole group, the ovulation rate, mono-follicular development, mean endometrial thickness and pregnancy rate was better in comparison to clomifene citrate group.Conclusions: The result of this study suggests that letrozole may replace clomiphene as the first line drug for ovulation induction in infertile PCOS women.

Interplay of Gut Microbiota in Polycystic Ovarian Syndrome: Role of Gut Microbiota, Mechanistic Pathways and Potential Treatment Strategies

“…Clomiphene is the first-line therapy for infertile women [ 162 ]. Recent clinical trials show that letrozole (in the right dose) improves ovulation rate, monofollicular formation, mean endometrial thickness, and pregnancy rate better than clomifene citrate [ 163 ]. Metformin is another drug used in the treatment of PCOS and is also used to help women conceive.…”