Randomized controlled trial of Letrozole versus Clomiphene citrate for induction of ovulation in polycystic ovarian syndrome (PCOS): A Malaysian experience

Hussain, Nik Hazlina Nik; Ismail, Munawwirah; Zain, Murizah Mohd; Yeu, Pu Chan; Ramli, Roszaman; Mohammad, Wan Mohd Zahiruddin Wan

doi:10.4236/ojog.2013.35a2003

Cited by 15 publications

(20 citation statements)

References 16 publications

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“…This might be related to the antiestrogen effects of CC on the endometrium, which can cause impaired placentation and subsequent early pregnancy loss. Higher endometrial thickness after ovulation stimulation with letrozole was demonstrated compared with CC, and the resulted improved endometrial receptivity might be a good justification for this finding . In our study, the incidence of other complications of pregnancy in the two groups of patients receiving letrozole and CC was not significantly different.…”

Section: Discussionsupporting

confidence: 43%

Comparison of the pregnancy outcomes and the incidence of fetal congenital abnormalities in infertile women treated with letrozole and clomiphene citrate

Sene

Ghorbani

Ashrafi

2018

J of Obstet and Gynaecol

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Section: Discussionsupporting

confidence: 43%

Comparison of the pregnancy outcomes and the incidence of fetal congenital abnormalities in infertile women treated with letrozole and clomiphene citrate

Sene

Ghorbani

Ashrafi

2018

J of Obstet and Gynaecol

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“…These findings were also similar to the studies conducted by Fouda et al, 12 and Sherif et al, 13 who showed the mean age of females with polycystic ovaries as 26 and 27 years, respectively. Hussain et al, 9 conducted a trial and observed the mean age of females as 29 years, which was higher than we observed in our study.…”

Section: Resultscontrasting

confidence: 84%

“…Sample size: Total sample of 120 cases (60 cases in each group) was estimated by using 80% power of test, 5% significance level and percentage of efficacy i.e. 78.7% 9 of Letrozole and 53.3% 9 of Clomiphene citrate in females with infertility due to polycystic ovaries.…”

Section: Study Period: Six Months Ie May To November 2020mentioning

confidence: 99%

Comparison of Efficacy Between Letrozole and Clomiphene Citrate in Females Presented With Infertility Due to Polycystic Ovaries.

Anjum

Ambreen

Bashir³

et al. 2020

ijmsdr

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Background: Polycystic ovarian syndrome (PCOS) is a genetically heterogeneous syndrome in which females often have to confront with the issue of infertility. Medical management of PCOS is aimed at the treatment of anovulation and menstrual irregularity. Letrozole and clomiphene citrate are two successful drugs for management of PCOS but contradiction is present in literature that which drug is more effective. So we conducted this study to find more successful drug to be implemented in future in local population. Objective: To compare the efficacy of oral Letrozole versus Clomiphene Citrate in females diagnosed with infertility due to polycystic ovaries Subjects & Methods: This randomized control trial was conducted at department of Gynaecology & Obstetrics, Fatima Memorial Hospital, Lahore for 6 months (May to November 2020). The non-probability, consecutive Sampling was used. Informed consent and demographic data was noted. Then females were randomly divided in two group by using lottery method. Females in Letrozole group were prescribed 2.5-7.5 mg daily from Day 2-Day 6 of menstruation and females in clomiphene citrate group was prescribed 50-150 mg daily from Day 2-Day 6 of menses. Females were advised to visit after every cycle till 3months. On every visit transvaginal ultrasonography was done to assess presence of follicles and number and size of follicles and endometrial thickness. All the data was entered on SPSS version 20. Results: The mean age of the patients was 26.13±5.07 years in group A and 27.17±5.95 years in group B. After 3rd month, the mean endometrial thickness in group A was 8.45±0.58 mm and in group B was 7.45±0.58 mm, the mean follicle was 23.75±4.253 in group A while 20.38±6.154 in group B. The ovulation occurred in 48 cases in group A and in 29 cases in group B. The efficacy was achieved in 36 cases in group A and 16 cases in group B and the difference in both groups was statistically significant i.e. p-value=0.000. Conclusion: Thus the Letrozole has significantly higher efficacy as compared to Clomiphene citrate. So from the results of our study we recommend letrozole as first line treatment for the management of PCOS. Keywords: Polycystic ovarian syndrome, PCOS, Letrozole, Clomiphene Citrate, Efficacy, Infertility

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“…The results were number of follicles were higher in CC than letrozole, ovulation rate was significantly higher in CC than letrozole, pregnancy rate was higher in letrozole group 25.3% than CC group 16% mean endometrial thickness was higher in letrozole group 9.2 mm than CC group 8.4mm and this study didn't include tamoxifen. 20 El Khateeb & Mahran show agreement with the current study, that trial included 200 infertile women PCOS defined according to Revised Rotterdam criteria divided into two groups letrozole and clomiphene citrate, endometrial thickness was highly significant in letrozole group (10.1mm) than CC group (8.02mm) ovulation was not statistically significant. Clinical pregnancy rate was significant higher in letrozole 14.8% than CC group 10.4% without no ovarian hyper stimulation syndrome in either groups.…”

Section: Discussionsupporting

confidence: 87%

“…Endometrial thickness shows significant difference which is thicker in TMX group > 8mm and CC < 8mm, corresponding with the results of the current study. 19 Also in agreement with, Hussain et al 20 who included 150 an ovulatory patients, divided into two groups (CC and letrozole). The results were number of follicles were higher in CC than letrozole, ovulation rate was significantly higher in CC than letrozole, pregnancy rate was higher in letrozole group 25.3% than CC group 16% mean endometrial thickness was higher in letrozole group 9.2 mm than CC group 8.4mm and this study didn't include tamoxifen.…”

Section: Discussionmentioning

confidence: 55%

Impact of clomiphene citrate, tamoxifen and letrozole to induce ovulation in anovulatory women with polycystic ovary syndrome on endometrial thickness and clinical pregnancy rates, a two center cohort study

Elshamy¹,

Khalafallah²

2018

OGIJ

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185 women, recruited from the Outpatient Infertility Clinic. Sample size was calculated based on the incidence of PCO in anovulatory infertile women from the literature, 11 80% of anovulatory infertility, so about 32% of all infertile women referred to our tertiary hospital per year at 99% confidence level , 5% CI, 170 patients were required. For drop out cases 200 women were included and 185 women completed follow up. This study followed the Ethical Committee rules of Obstetrics

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Randomized controlled trial of Letrozole versus Clomiphene citrate for induction of ovulation in polycystic ovarian syndrome (PCOS): A Malaysian experience

Cited by 15 publications

References 16 publications

Comparison of the pregnancy outcomes and the incidence of fetal congenital abnormalities in infertile women treated with letrozole and clomiphene citrate

Comparison of the pregnancy outcomes and the incidence of fetal congenital abnormalities in infertile women treated with letrozole and clomiphene citrate

Comparison of Efficacy Between Letrozole and Clomiphene Citrate in Females Presented With Infertility Due to Polycystic Ovaries.

Impact of clomiphene citrate, tamoxifen and letrozole to induce ovulation in anovulatory women with polycystic ovary syndrome on endometrial thickness and clinical pregnancy rates, a two center cohort study

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