Efficacy of letrozole versus clomiphene citrate on ovulation induction in patients with polycystic ovarian syndrome

Objectives: To compare the efficacy of letrozole (LTZ) vs clomiphene citrate (CC) for ovulation induction in patients having polycystic ovarian syndrome (PCOS).

Methods: This randomized controlled trial was conducted at The Department of Obstetrics & Gynecology, Nishtar Medical University Hospital, Multan, Pakistan from January 2021 to June 2021. A total of 78 women aged 18 to 30 years, diagnosed having PCOS were enrolled. In Group-A, 39 women were given LTZ, 5mg for five days of menstrual cycle. In Group-B, 39 women were given CC, 100mg for five days of menstrual cycle. All patients underwent transvaginal scan (TVS) for the evaluation of efficacy in terms of ovulation induction.

Results: Overall mean age was noted to be 25.41±2.84 years. Most of the patients, 51 (65.4%) belonged to rural area of residence. There were 52 (66.7%) patients with BMI less than 25 kg/m2. Overall, mean duration of infertility was found to be 2.62±0.74 years. Among 70 patients who completed the follow ups and analyzed regarding efficacy, in Group-A, efficacy was noted in 23 (59.0%) patients in comparison to 14 (35.9%) in Group-B (p=0.0413). Mean endometrial thickness was significantly better in Group-A versus Group-B (8.1±1.5 mm vs. 6.8±1.9 mm, p=0.0022).

Conclusion: Aiming ovulation induction, letrozole in comparison to clomiphene citrate was found to have significantly better efficacy among women having anovulatory PCOS.