The New Indian Journal of OBGYN. Epub Ahead of Print

Clomiphene citrate vs letrozole for ovulation induction in subfertile women with polycystic ovary syndrome: a randomized controlled trial

Nazmashamim,Lokeshwari K,Vinodkumarsuresh Basavaradder

ABSTRACT

Objectives : To compare the efficacy of letrozole and clomiphene citrate (CC) for ovulation induction, endometrial thickness and pregnancy rate in subfertile women with polycystic ovary syndrome (PCOS) . Material and methods: A prospective randomized clinical trial was conducted from 1st October 2019 to 31st December 2020, in Basaveshwara Medical College Hospital and Research Centre, Chitradurga. A total of 63 participants were allocated into two groups. Group 1 (N=31) received clomiphene citrate 50 mg twice daily, group 2 (N=32) received letrozole 2.5 mg twice daily. Both study groups were randomly administered CC or letrozole from day 2 to day 6 of a regular menstrual cycle. Transabdominal ultrasonography was done from day 10 till dominant follicle appeared. Inj. Hcg 5000 IU was administered within 24 hrs after appearance of dominant follicle. Parameters assessed were ovulation rate – appearance of dominant follicles, endometrial thickness, and pregnancy rate. Results: Baseline characteristics were comparable between two groups. Mean endometrial thickness of 7.2 ± 0.61 in CC group as compared with letrozole group 8.06 ± 0.38 (P=0.000). Ovulation rate as assessed by appearance of dominant follicle was significantly higher in letrozole group (22.45 ± 2.21) as compared with CC group (19.98 ± 1.88). Analysis of pregnancy rate in the two groups showed higher pregnancy rate of 81% in group 2 compared to 22% in group 1 (P=0.00). Conclusion: This study showed significant improvement in endometrial thickness and pregnancy rates in letrozole group as compared to CC used for ovulation induction in infertile PCOS. Furthermore we noted a substantially increased ovulation rate in letrozole group (P<0.00).