European Journal of Molecular & Clinical Medicine

This study was conducted to compare  Clomiphene Citrate Vs Letrozole for ovulation induction in infertile PCOS women.
Methods: This study includes 200 infertile PCOS women attending GOPD Department of Obstetrics and Gynaecology, NMCH from January 2021 to  December 2022. The patients were divided in two groups. 100 women received 100mg CC once daily from D2-D6 of cycle. 100 women received 2.5 mg Letrozole once daily from D2-D6 of cycle – both groups for 3 cycles each.  Follicular monitoring was done daily from D12-D16 of cycle. Inj HCG 5000IU was administrated IM when atleast one follicle with a mean diameter of more than equal to 18 mm was achieved. After 36 hours of HCG administration ovulation was confirmed on ultrasound.    
Results : Both groups were comparable with respect to age, BMI and mean duration of infertility. Both groups were compared with respect to number of follicles, mean diameter of largest follicle, rate of ovulation, mean endometrial thickness and serum progesterone level on D21 of cycle. The number of mature follicle was significantly lower but but the endometrial thickness and ovulation rate was significantly higher in Letrozole group than CC group. Conclusion: My study showed that Letrozole has better ovulation rate than CC and should be considered as 1st line drug for ovulation induction in infertile PCOS women

-Polycystic ovary syndrome is a complex disorder for which multiple treatment approaches are required, depending on the reason a patient seeks treatment. Its deal with pregnancy with pcos and how to cure, commonly treatment and medication which are used for pcos, infertility will affect women pregnancy and cure how to give hormonal therapy and alternative remedies for pcos like diet excessive, insulin resistance, pills or surgical , Clomiphene has shown the best results in treating infertility, whereas data are limited regarding the pharmacological treatment of androgenic symptoms. Long-term consequences of PCOS, which include type-2 diabetes and cardiovascular disease, can be treated with antidiabetic drugs and statins. Pcos inflammable to tissue and pathophysiology of pcos

Introduction: Infertility is a multidimensional health problem with social & economic consequences. Female factor remains the foremost reason (40%-55%) and ovulatory disorders is the most common identifiable female factor. Ovulation induction is one of the most successful treatment of infertility due to anovulation.
Aim: To compare the effects of letrozole and clomiphene citrate (CC) for ovulation induction in women with anovulatory infertility.
Materials And Methods: In this assessor blind randomized controlled trial 80 infertile women with anovulatory infertility were randomized to receive either letrozole or CC for ovulation induction in incremental doses for a maximum of three cycles. Main outcomes studied were endometrial thickness, ovulation rate, pregnancy rate and rate of mono-follicular development. Both the groups were followed by ultrasound until the dominant follicle reached a diameter ≥18 mm, human chorionic gonadotropin (hCG) 10,000 IU was given, and timed intercourse was advised.
Results : The mean age, duration of infertility,  body mass index, and endocrine status in both the groups were similar at baseline. Ovulation occurred in 36 subjects (90.0%) in the letrozole group and 29 (72.5%) in the CC group, with a statistically significant difference between the two groups (P=0.045). Mono-follicular development was seen in 60.0% of ovulatory cycles in letrozole group compared to 22.5 % in clomiphene group (p=0.001).  Pregnancy was achieved in 37.5% women in letrozole group and 25.0% in clomiphene group (p=0.228).  There was no statistically significant difference in endometrial thickness between the two groups at the time of hCG administration (9.71±1.16mm vs. 9.6±1.03 mm with letrozole and clomiphene respectively (p = 0.648).
Conclusion: The effect of letrozole showed a better ovulation rate and monofollicular  development as compared with CC. Letrozole may have a role as a first-line treatment for anovulatory patients with anouvulatory infertility.

Background: Low socio economic group hailing from rural population was the maximum group of girls studied. To study various gynaecologicalproblems and etiological factors encountered in adolescent girls who attended the gynaecological OPD, at GMC, Kadapa.
Materials and Methods: A total of 200 cases of adolescent girls aged 10 -19 years who attended gynaecological OPD and emergency department. Detailed history with regard to gynaecological problems was taken from the patient and girl‟s mother was also interviewed to get accurate details about any previous medical problems if present.
Results: Maximum incidence of gynaecological problems was seen in age group of 17years. Among the various presenting complaints in studied adolescent girls, menstrual irregularities were the most common. Oligomenorrhoea was the most common menstrual problem in this study. Anovulation is the most common cause of menorrhagia in adolescents. Majority of adolescent girls suffered from anemia ranging from mild to severe types of anemia. 5.56% patients with puberty menorrhagia received blood transfusion. The most common cause of oligomenorrhoea was the hypothalamic pitutary gonadal dysfunction. Counselling and reassurance was an integral part of treatment strategies. PCOS and hypothyroidisms were the other endocrinological abnormalities common among the adolescent girls. Leucorrhoea in adolescent girls in my study were most commonly. physiological, counselled and explained to maintain proper hygiene.
Conclusion: A combined effort of team comprising gynaecologist, endocrinologist is required in arriving final diagnosis in case of primary amenorrhoea.

Aim: to evaluate Letrozole as suitable ovulating induction agent in patients with PCOS induced infertility. Material & Method: The main source of data for this study are the women with primary and secondary infertility with anovulation attending the Department of Obstetrics & Gynecology, RVM Institute of Medical Sciences and Research Centre, Siddipet, Telangana, India. This is a prospective study with a total of 200 women satisfied the inclusion and exclusion criteria of the study. The present study consists of cases of infertility due to anovulation which were thoroughly evaluated before the diagnosis of anovulation was confirmed. Results: In this study mean age of the patients were 28.0 years and mean age of husbands were 32.4 year. 105 patients underwent diagnostic hysterolaparoscopy with chromopertubation + ovarian drilling. Conclusion: Letrozole can be considered as suitable ovulating induction agent in patients with PCOS induced infertility. It is a better drug in terms of mono follicular ovulation and better endometrial thickness than other ovulation induction agents. It has high ovulation rate with significant conception rate, with only drawbacks being miscarriages.

Introduction:Polycystic ovary syndrome (PCOS) is the most common endocrine
abnormality affecting women of reproductive age, but this condition is still not
completely understood. As it is linked with many chronic conditions such as
cardiovascular and diabetes, there is need to identify the condition at the earliest.
Methods: A cross-sectional Community-based study was conducted in urban
Visakhapatnam in November 2020 among 132 adolescent girls aged between 15 to 19
years to study the prevalence of PCOS among adolescents to identify the risk factors for
polycystic ovarian syndrome. Multistage sampling was used to select the study
participants from six urban zones, information collected using a PCOS validated
questionnaire modified to suit locally. Diagnosis of PCOS was based on
Rotterdam/ESHRE criteria examination for obesity, hirsutism, acne and acanthosis.
Results: Six percentof the study subjects were found to have possible diagnosis of
PCOS. Family history of risk factors for PCOS such as maternal menstrual
irregularities, diabetes and obesity was found in 12.1% of study subjects.Increased BMI
was seen in 6.8% girls and 24 .1% had abnormal menstruation.
Conclusion:Family history, increased BMIand presence of clinical findings as abnormal
growth of hair and acne are found to be significantly associated.

Background:Living as an involuntarily childless woman is challenging for feminity and female roles in society. Infertility affects about 10-15% of reproductive age couples. WHO estimates that 60-80 million couples worldwide currently suffer from infertility. The causes of female infertility are multifactorial and necessitate comprehensive evaluation. Laparoscopy with chromopertubation is viewed as the “gold standard” test for tubal assessment. Adding Hysteroscopy to the procedure allows for concomitant evaluation of intrauterine cavity. With this preview, my study aims at evaluating the role of diagnostic hystero-laparoscopy as a safe & cost- effective tool for assessment of unexplained female infertility.
Materials and Methods: An observational hospital based study on 260 patients was carried out in a tertiary care centerDr. PSIMS &RF, Vijayawada, Andhra Pradesh, India -over a period of 2.5 years from October 2019 to April 2022. Women aged 18-40yr with normal hormone profile without male factor infertility were included.
Results: Out of 260 cases, 60.93% patients had primary infertility. PCOS was found to be the most commonly associated with primary infertility. Whereas the most common causes of secondary infertility were found to be PID, endometriosis and endometrial polyps each respectively. Hysterolaparoscopy revealed intrauterine lesions and therapeutic measures like ovarian drilling, lysis of intrauterineadhesions, cystectomy, polypectomy and septal resection were carried out.
Conclusion: Hysterolaparoscopy is an effective diagnostic tool for evaluation of correctable tuboperitoneal pathologies like endometriosis, polycystic ovaries, adnexal pathologies and subseptate uterus which are usually missed by other imaging modalities. When done by a trained and experienced investigator and with proper selection of patients, hysterolaparoscopy proves to be a definitive investigative procedure for evaluation of female infertility. It also helps in formulation of a treatment modality.

Aim: To investigate the relation of vitamin D concentration and parathyroid hormone with
insulin resistance in PCOS women.
Methods: In the department of Obstetrics and Gynecology at Dr. Baba Saheb Ambedkar
medical college & hospital Rohini Delhi, a one-year observational study was conducted. The
levels of 25, hydroxyvitamin D and PTH, as well as the levels of fasting sugar and insulin in
the blood, were tested.
Results: There was a 91.0 percent prevalence of vitamin D insufficiency (

Aim: To investigate the relation of vitamin D concentration and parathyroid hormone with
insulin resistance in PCOS women.
Methods: In the department of Obstetrics and Gynecology at Dr. Baba Saheb Ambedkar
Medical College & Hospital, Rohini, Delhi, a one-year observational study was conducted.
The levels of 25, hydroxyvitamin D and PTH, as well as the levels of fasting sugar and
insulin in the blood, were tested.
Results: There was a 91.0 percent prevalence of vitamin D insufficiency (<20 ng/ml) in the
study, whereas 67.9 percent of participants had an elevated parathyroid hormone level.
According to the study, vitamin D insufficiency (r=-0.64, p=0.01) had a significant negative
connection with the HOMA-IR. Increased PTH levels were shown to have a positive
correlation with HOMA-IR.
Conclusion: Women with PCOS who have high parathyroid hormone levels or vitamin D
insufficiency have a higher incidence of glucose intolerance.
If vitamin D insufficiency and insulin resistance are strongly linked, it may be possible to
treat insulin resistance by raising vitamin D levels.

Background: PCOS is the most common endocrinological disorder affecting 6 -14% amongst reproductive age group. The pathophysiology of PCOS is complex and it is still not well understood. Many markers have been studied to correlate between homocysteine level and other clinical, metabolic and hormonal profile. Preliminary investigations indicate that in women with PCOS, serum biomarkers of cardiovascular disorders such as homocysteine are abnormal. Furthermore the interactions between homocysteine and PCOS, biochemical features such as obesity, insulin resistance and higher levels of androgen, have been researched and the potential determinant of this finding is still being explored.
Aim and Objectives: We aim to determine association between hyperhomocysteinemia and PCOS. The objectives of this study is to evaluate and compare clinical, metabolic and 
hormonal profile in women of PCOS with normal homocysteine level with that of increased homocysteine level.
Materials and Methods: This is a prospective observational study which will be performed in the department of obstetrics and gynaecology, AVBRH, DMIMS (Deemed to be University, Wardha), a tertiary care teaching hospital situated in the rural area of Wardha district in over 140 patients for period between 2020-22. This study will include PCOS patients based on Rotterdam diagnostic criteria and will exclude patients with known metabolic, cardiovascular and endocrine disorders. Metabolic and hormonal profile will be evaluated with BMI, Lipid profile, Insulin resistance, serum levels of LH, FSH, DHEA and Testosterone in all patients. Serum homocysteine levels will be measured using ELISA.
Expected Results: We expect that there will be significant difference in clinical, metabolic and hormonal profile of PCOS women having hyperhomocysteinemia than women having normal homocysteine level.

Objective: To compare the effects of clomiphene citrate and anastrozole on follicular diameter and endometrial thickness in women with polycystic ovary syndrome (PCOS).
Methods: This prospective study was conducted at the private-practice setting. The study group consisted of 14 patients who received clomiphene citrate 50 mg and 14 patients received anastrozole 1 mg on day 3 of menstruation for 5 days. Follicular diameter and endometrial thickness were measured with transvaginal ultrasound on day 12 of menstruation.
Results: The mean diameter of follicles in the clomiphene citrate group was not significantly differ compared with anastrozole group (13.35±4.72 mm vs 10.92±4.29 mm; p>.05, respectively). A similar effect also observed in endometrial thickness for both study groups (8.51±1.88 mm in anastrozole vs 7.49±2.09 mm in clomiphene citrate; p>.05).
Conclusion: Clomiphene citrate and anastrozole were not significantly improved follicular diameter dan endometrial thickness in polycystic ovary syndrome.