European Journal of Molecular & Clinical Medicine

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.

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.