Objective: To evaluate fertility outcomes on ovulation induction with clomiphene citrate versus letrozole among anovulatory Polycystic Ovarian Syndrome (PCOS) women.
Material and Methods: This randomized controlled study was conducted in the infertility clinic of our institute between 2015 to 2018. 106 subjects from 18-39 years, BMI \(<\) 30 kg/m\(^2\), anovulatory infertility, at least one patent fallopian tube, diagnosis of PCOS, and male partner sperm concentration of at least 15 million/ml were included. These subjects were randomly allocated into 2 groups. One group was given letrozole and the other group clomiphene citrate. Follow-up with serial transvaginal ultrasonography was done for follicular growth. Inj. Human chorionic Gonadotropin (hCG) was administered 36 hours prior to ovulation as predicted by folliculometry, and a check scan was done for ovulation. The result was evaluated in terms of the number of follicles, ovulation rate, endometrial thickness from D11 to D14, successful pregnancy outcome, complications, and failure.
Results: A total of 106 patients were included, 52 cases were treated with Letrozole and 54 cases with clomiphene. Most subjects in either group had oligomenorrhea (57.4% & 61.4%) with regular cycles. Ovulation occurred in 27 (51.9%) subjects with letrozole and 18 (33.3%) with clomiphene. Successful pregnancy outcomes were seen in 24 out of 52 (46.1%) with letrozole and 16 out of 54 (29.6%) with Clomiphene.
Conclusion: Successful pregnancy outcome was higher with letrozole despite a lesser number of mature follicles. Clomiphene citrate could be replaced by Letrozole as the key medication for chronic anovulation in PCOS.
