DefinePK hosts the largest index of Pakistani journals, research articles, news headlines, and videos. It also offers chapter-level book search.
Title: Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.
Authors: Nadia Sharif, Uzma Manzoor, Saadia Bano, Uzma Shahzaad
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2023
Volume: 30
Issue: 1
Language: English
DOI: 10.29309/TPMJ/2023.30.01.7397
Keywords: LetrozoleEndometrial thicknessClomiphene citrateOvulation induction
Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.
To compare the efficacy of Letrozole and clomiphene citrate in patients with anovulatory polycystic ovarian syndrome and infertility, specifically in terms of ovulation induction and pregnancy rate.
Randomized Controlled Trial involving 100 patients with anovulatory polycystic ovarian syndrome and infertility, divided into two groups of 50. Group A received letrozole (2.5-5mg daily from day 3-7), and Group B received clomiphene citrate (50-100mg incremental dose from day 3-7). Both drugs were administered for 3-6 cycles. Main outcome measures included optimal follicle size (>18mm), endometrial thickness, and pregnancy rate. Statistical analysis was performed using SPSS version 13 with the Chi-square test, considering p-value <0.05 as significant.
graph TD
A["Patient Recruitment Anovulatory PCOS with Infertility"] --> B["Randomization"];
B --> C["Group A: Letrozole Treatment"];
B --> D["Group B: Clomiphene Citrate Treatment"];
C --> E["Ovulation Monitoring & Follicle Tracking"];
D --> E;
E --> F["Endometrial Thickness Measurement"];
F --> G["Pregnancy Testing"];
G --> H["Data Recording & Statistical Analysis"];
H --> I["Conclusion"];
The study suggests that letrozole is more effective than clomiphene citrate for ovulation induction and achieving pregnancy in patients with anovulatory polycystic ovarian syndrome. Letrozole's favorable effect on endometrial thickness and its mechanism of action, which mimics central reduction of negative feedback without the anti-estrogenic effects on cervical mucus and endometrium seen with clomiphene citrate, contribute to its higher efficacy.
- Letrozole group showed a mono-ovulation rate of 88.9% compared to 60.0% in the clomiphene citrate group.
- The mean endometrial thickness was significantly higher in the letrozole group (9.6mm ± 1.6mm) compared to the clomiphene citrate group (6.9mm ± 1.2mm) (p < 0.001).
- The pregnancy rate was 18% in the letrozole group and 1.1% in the clomiphene citrate group. (Note: The abstract states 18% and 1.1%, while the results section states 43% conceived in Group A and 36% in Group B. The abstract's figures are used here as they are presented as a direct result).
Letrozole demonstrated significantly higher efficacy compared to clomiphene citrate in terms of ovulation induction, endometrial thickness, and pregnancy rate in patients with anovulatory infertility due to PCOS. Letrozole should be considered a first-line drug for ovulation induction in such patients.
- The study period was from September 30, 2019, to June 29, 2020.
- The mean age of patients in the study was 28.03 ± 3.02 years.
- The mean endometrial thickness in the letrozole group was 9.6mm ± 1.6mm.
Loading PDF...
Loading Statistics...