Background: Ovulation disorders account for around 30% of infertility and are frequently accompanied by irregular menstrual (oligomenorrhoea) or an absence of periods (amenorrhea). Several therapies are easy and efficient, so couples might only require limited contact with doctors. This makes it simpler for a couple to retain a private love connection than in stressful situations. Aim of the work:To assess the impact of letrozole with letrozole plus metformin as an ovulation inducing agent in anovulatory overweight women.Patients and methods: Prospective study was performed on total 100 anovulatory overweight women attending infertility outpatient Clinic in Al-Hussein University Hospitals and Dar Ismail Hospital for Obstetrics and gynecology, Alexandria, Egypt, from 1st March to 31st December 2019.Results: There was an insignificant rise in the cumulative pregnancy rate between the metformin-letrozole and the letrozole groups. In the metformin-letrozole group, 42% of the patents got pregnant, compared with 36% of the patients in the letrozole group. There were no significant differences between the letrozole and the metformin-letrozole groups regarding ovulation rate, number of patients has growing follicle, number of growing follicles (follicles ≥ 18) at day 12, number of ruptured follicles after 48 hours of injection of HCG, serum E2, Parity, clinical presentation, Period of infertility, FSH, LH. There has been a significant rise in group B (8.77) compared to group A (8.23) as regards endometrial thickness. Conclusion: : Metformin added to letrozole does not improve the outcome of an overweight ovulated woman except that it improves endometrial thickness only.
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