A Comparative Study of Letrozole Versus Clomiphene Citrate in Ovulation Induction in Patients with the Polycystic Ovarian Syndrome

Abstract

Introduction:

Polycystic ovarian syndrome (PCOS) is characterized by ovarian dysfunction. Ovulation was induced either by Selective estrogen receptor modulators (SERMS: Clomiphene citrate) or aromatase Inhibitors (Letrozole). Hence, the present study was conducted with an aim to assess the comparative efficacy and safety of Letrozole v/s Clomiphene Citrate in ovulation induction in patients with the polycystic ovarian syndrome.

Methodology:

A randomised trial was conducted in the department of Obstetrics and Gynecology, Rohilkhand Medical College and Hospital, Bareilly among 96 women with infertility in the age group of 21-35 years. All the eligible cases were randomly divided into two groups. Group A and group B were administered 50 mg Clomiphene Citrate and 2.5 mg Letrozole, respectively. Both groups were subjected to transvaginal ultrasonographic monitoring for detecting ovulation. The analysis was carried out on SPSS 24.0 version.

Observations:

Letrozole-treated patients (66.7%) had better ovulation rates than Clomiphene Citrate-treated patients (52.1%). With Letrozole, 52.1% of patients developed monofollicle and the mean endometrial thickness was 8.6 mm. However, the mean diameter of the largest follicle was more with clomiphene (21.15 mm).

Conclusion:

The results of this study suggested that aromatase inhibitors are safer and more effective in comparison to clomiphene citrate in terms of ovulation induction. With some limitations of the present study, we found that the advantages of administering Letrozole were more than clomiphene citrate for ovulation induction in women with PCOS.