Ahmed Badawy1, Ibrahim Abdel Aal2, Mohamed Abulatta3. 1. Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt. Electronic address: ambadawy@yahoo.com. 2. Department of Clinical Pathology, Mansoura University, Mansoura, Egypt. 3. Department of Radiology, Mansoura University, Mansoura, Egypt.
Abstract
OBJECTIVE: To compare the effects of letrozole (5 mg) and clomiphene citrate (100 mg) for ovulation induction in women with polycystic ovary syndrome (PCOS). DESIGN: Prospective randomized trial. SETTING:University teaching hospital and private practice setting. PATIENT(S): The study comprised a total of 438 infertile women (1063 cycles) with PCOS. INTERVENTION(S): Patients were randomized to treatment with 5 mg of letrozole daily (218 patients, 545 cycles) or 100 mg ofclomiphene citrate daily (220 patients, 518 cycles) for 5 days starting on day 3 of menses. Timed intercourse was advised 24 to 36 hours after hCG injection. MAIN OUTCOME MEASURE(S): Number of follicles, serum estradiol, serum progesterone, endometrial thickness, and pregnancy and miscarriage rates. RESULT(S): The mean age, parity, and duration of infertility in both groups were similar. The total number of follicles was statistically significantly greater in the clomiphene citrate group (6.8 +/- 0.3 versus 4.4 +/- 0.4). Endometrial thickness at the time of hCG administration was statistically significantly greater in the CC group (9.2 +/- 0.7 mm versus 8.1 +/- 0.2 mm). The duration to reach a dominant follicle was statistically significantly longer in the letrozole group (12.1 +/- 1.3 versus 8.8 +/- 2.9 days). Ovulation occurred in 365 out of 540 cycles (67.5%) in letrozole group and 371 out of 523 cycles (70.9%) without a statistically significant difference. Levels of serum estradiol and progesterone were statistically significantly higher in the clomiphene citrate group. The pregnancy rate per cycle was 15.1% in the letrozole group and 17.9% in the clomiphene citrate group without statistically difference between the groups. CONCLUSION(S): The results of this study did not show any advantage to the use of letrozole over clomiphene citrate as a first-line treatment for induction of ovulation in women with PCOS.
RCT Entities:
OBJECTIVE: To compare the effects of letrozole (5 mg) and clomiphene citrate (100 mg) for ovulation induction in women with polycystic ovary syndrome (PCOS). DESIGN: Prospective randomized trial. SETTING: University teaching hospital and private practice setting. PATIENT(S): The study comprised a total of 438 infertile women (1063 cycles) with PCOS. INTERVENTION(S): Patients were randomized to treatment with 5 mg of letrozole daily (218 patients, 545 cycles) or 100 mg of clomiphene citrate daily (220 patients, 518 cycles) for 5 days starting on day 3 of menses. Timed intercourse was advised 24 to 36 hours after hCG injection. MAIN OUTCOME MEASURE(S): Number of follicles, serum estradiol, serum progesterone, endometrial thickness, and pregnancy and miscarriage rates. RESULT(S): The mean age, parity, and duration of infertility in both groups were similar. The total number of follicles was statistically significantly greater in the clomiphene citrate group (6.8 +/- 0.3 versus 4.4 +/- 0.4). Endometrial thickness at the time of hCG administration was statistically significantly greater in the CC group (9.2 +/- 0.7 mm versus 8.1 +/- 0.2 mm). The duration to reach a dominant follicle was statistically significantly longer in the letrozole group (12.1 +/- 1.3 versus 8.8 +/- 2.9 days). Ovulation occurred in 365 out of 540 cycles (67.5%) in letrozole group and 371 out of 523 cycles (70.9%) without a statistically significant difference. Levels of serum estradiol and progesterone were statistically significantly higher in the clomiphene citrate group. The pregnancy rate per cycle was 15.1% in the letrozole group and 17.9% in the clomiphene citrate group without statistically difference between the groups. CONCLUSION(S): The results of this study did not show any advantage to the use of letrozole over clomiphene citrate as a first-line treatment for induction of ovulation in women with PCOS.
Authors: Enitome E Bafor; Adaeze P Uchendu; Omorede E Osayande; Osemelomen Omoruyi; Uyi G Omogiade; Evuarherhere E Panama; Olusola O Elekofehinti; Ebube L Oragwuncha; Asanat Momodu Journal: Reprod Sci Date: 2020-07-28 Impact factor: 3.060
Authors: Alexandra P Tsiami; Dimitrios G Goulis; Alexandros I Sotiriadis; Efstratios M Kolibianakis Journal: Hormones (Athens) Date: 2021-05-25 Impact factor: 2.885
Authors: Mohamed Abdel-Maboud; Amr Menshawy; Elfatih A Hasabo; Mohamed Ibrahim Abdelraoof; Mohamed Alshandidy; Muhammad Eid; Esraa Menshawy; Oumaima Outani; Ahmed Menshawy Journal: PLoS One Date: 2021-07-19 Impact factor: 3.240