Comparison of efficacy of letrozole and clomiphene citrate in ovulation induction in Indian women with polycystic ovarian syndrome

Abstract

Objectives: The objective of this study was to compare the efficacy of letrozole versus clomiphene citrate as an ovulation induction drug in polycystic ovarian syndrome (PCOS) patients of Indian origin.

Method: One hundred and forty seven infertile PCOS patients were randomly given letrozole (2.5 mg) (n = 69) or clomiphene (100 mg) (n = 78) from day 3 to day 7 of menstrual cycle, followed-up with transvaginal serial folliculometry from day 9. 10,000 IU of human chorionic gonadotropin (hCG) was administered when at least 1 ovarian follicle was ≥ 18 mm in size.

Results: The pertinent results of the study are as follows: on the day of hCG injection, mean E2 level was significantly higher in the clomphene citrate group (817 ± 286.70 pg/ml) in comparison with letrozole group (444.03 ± 85.42 pg/ml). Mean endometrial development was 8.72 ± 1.41 mm in the letrozole and 8.78 ± 1.16 mm in the clomiphene group (P = 0.004).

Conclusion: Letrozole has beneficial effect on endometrium, thereby potentially increasing pregnancy rates after successful ovulation induction in women with PCOS.