Letrozole Compared With Clomiphene Citrate for Polycystic Ovarian Syndrome

Abstract

To estimate the effect of letrozole and clomiphene citrate in women with infertility and polycystic ovarian syndrome (PCOS). METHODS OF STUDY SELECTION: MEDLINE throughPubMed, Web of Science, EMBASE, Cochrane Library, and ClinicalTrials.gov were searched for relevant studies from inception to February 1, 2022. Two reviewers retrieved, filtered, and extracted data independently using the bibliographic software EndNote X9 and Excel workbook. We included randomized controlled trials (RCTs) reporting ovulation induction outcomes in women with infertility and PCOS treated with either letrozole or clomiphene citrate followed by timed intercourse or intrauterine insemination. The data were merged into a mean difference or risk ratio (RR) with 95% CI, depending on variable types. TABULATION, INTEGRATION, AND RESULTS: Data collection and organization were conducted in accor-dance with the 2020 PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Twenty-nine RCTs were eligible, which included 3,952 women and 7,633 ovulation induction cycles. We acquired evidence from 22 RCTs for the ovulation rate, 28 RCTs for the clinical pregnancy rate, and eight RCTs for live-birth rate. Pooled analysis indicated that letrozole treatment prevailed against clomiphene citrate in ovulation rate (

Strong early impact of letrozole on ovulation induction outperforms clomiphene citrate in polycystic ovary syndrome: a systematic review with meta-analysis

“…We have previously presented that patients in LE group had significantly higher odds of ovulation than in CC group. In comparison of our result with previous meta-analyses, He et al [58], Tsiami et al [61] and Zhuo et al [62] reported the same result. Wang et al pointed out that the ovulation rate was significantly better when patients were taking LE instead of CC [63].…”

“…We found that the odds of pregnancy were significantly higher in patients treated with letrozole than in CC group. In comparison of our result with previous meta-analyses, four were found to have significantly higher pregnancy rates [59, 62–64] and three were reported to have significantly higher odds of live birth [62–64] after letrozole treatment. Gadalla et al [11] and Hu et al [65] described similar differences between the two groups.…”

Letrozole vs clomiphene citrate in Sudanese patients with infertility secondary to polycystic ovary syndrome

“…Interestingly, LTZ has been claimed as more effective than CC in achieving better pregnancy rates and live birth rates as reported by Sakar and Oglak 2020; [ 18 ]. A meta-analysis by Liu et al 2023; reported similar findings but the authors concluded that there is still mixed quality of evidence [ 28 ]. According to Chi-square and logistic regression analysis in this study, no association was observed between the outcome measures and the patients’ clinical parameters which supports eliminating the confounding factors that may influence the efficacy of the two drugs.…”

current possible treatment approaches of Polycystic Ovary Syndrome (PCOS)

“…In a Zhuo Liu et al study, pooled analysis indicated that letrozole treatment prevailed against clomiphene citrate in ovulation rate (RR 1.14, 95% CI 1.06-1.21, P <.001), clinical pregnancy rate (RR 1.48, 95% CI 1.34-1.63, P <.001), and live-birth rate (RR 1.49, 95% CI 1.27-1.74, P <.001) [32].…”