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ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 159-165

A randomized controlled trial of combination of letrozole and clomiphene citrate or letrozole alone for induction of ovulation in women with clomiphene citrate-resistant polycystic ovary syndrome attending infertility centre


Infertility Centre, Bijuli Bazar, Kathmandu, Nepal

Correspondence Address:
Dr. Uma Shrivastava
Uma Shrivastava, Infertility Centre, Bijuli Bazar, Kathmandu 12521
Nepal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/fsr.fsr_34_21

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Objectives: To measure the efficacy of combined clomiphene citrate (CC) and letrozole versus letrozole alone in the induction of ovulation in CC-resistant polycystic ovary syndrome (PCOS) cases. Design: Outcome assessor-blinded randomized controlled trial. Setting: Infertility Centre, Kathmandu, Nepal. Participants: One hundred and ninety-eight CC-resistant PCOS cases (99 in each group). Intervention: Treatment group received CC 100 mg once a day starting day 3 or 5 of menstrual cycle alternately for 3 days and letrozole 5 mg once a day starting day 4 or 6 of menstrual cycle alternately for 3 days. The comparison group received letrozole 5 mg once a day starting day 3 or 5 of menstrual cycle for 5 days. Main outcome measures: Number of mature follicles (18–22 mm), and increase in endometrial thickness. Results: Among total participants, 159 (81 in treatment and 78 in comparison group) were analyzed. Number of matured follicles was higher in the treatment group (1.59 ± 0.16) when compared with the comparison group (1.21 ± 0.56) which was statistically significant (P = 0.03) at 95% confidence interval. There was significant difference in the mean endometrial thickness (P = 0.01) in the treatment group (9.04 ± 0.15) when compared with the comparison group (8.51 ± 0.12). The conception rate was 35.80% in treatment group and 32.05% in the comparison group which was not significant in the Chi-squared test (P = 0.62). Conclusion: The combined CC and letrozole treatment is better than letrozole alone for ovulation induction in CC-resistant PCOS cases. Trial registration: Clinical Trials Registry-India CTRI/2019/01/017311


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