Comparing Effectiveness of Letrozole versus Postmenopausal FSH in Patients with Clomiphene Citrate-Resistant Polycystic Ovary Syndrome

Abstract

Background: Follicle-stimulating hormone (FSH) is known for inducing multi-follicular growth in women. Letrozole (LE) is a third-generation aromatase inhibitor (AI) that is both powerful and selective. It was found to be effective in inducing ovulation, increased pregnancy rate, improve uterine environment, endometrial development with favorable cervical mucus. Aim of the work:To assess the effectiveness of Letrozole with postmenopausal FSH in the treatment of anovulation in Clomiphene Citrate-Resistant Polycystic Ovary Syndrome. Patients and methods: This was a randomized-controlled clinical trial involving 200 females with PCOS who were recruited from outpatient clinics at Al-Hussien University Hospital and Kafr EL-Sheikh General Hospital at the start of the study and followed up with after intervention to record the results from June 2020 to June 2021. Results: The rate of ovulation has slightly been better in the postmenopausal FSH group (58%) compared to the letrozole group (54%), but without a significant difference (P=0.569) with the mean value ± SD for the overall number of follicles throughout activation being considerably larger in the postmenopausal FSH group (2.12 ± 1.35) versus (1.7 ±0.99) in the letrozole group; P=0.05). Out of those ovulating cases, 63% had single follicles compared to 50% in the postmenopausal FSH group and the remaining had multiple follicles, 37% versus 50% in both groups, respectively. Conclusion: Letrozole and postmenopausal FSH were both beneficial in the treatment of patients with CC-resistant PCOS. Both medications were well tolerated, although letrozole was significantly easier to administer and less expensive.