A randomized trial of letrazole versus clomiphene citrate in induction of ovulation in patients with polycystic ovary syndrome (PCOS)

Objective: The aim of this study was to compare the effect of letrazole (2.5mg) and clomiphene citrate (150mg) on ovulation in patients with polycystic ovary syndrome. Design: Prospective randomized trial. Setting: University teaching hospital. Materials and Methods: Sixty four consecutive patients with polycystic ovary syndrome were recruited. Thirty four patients (70 cycles) were given clomiphene citrate and thirty patients (64 cycles) were given letrazole. Both drugs were given orally on days 3-7 of menses. Letrazole, clomiphene citrate, ovulation induction, timed intercourse. Main outcome measures: Number of follicles, endometrial thickness and pregnancy rates. Results: The mean age, body mass index, and duration of infertility in both groups were similar. Ovulation occurred in 78% of the cycles (50 /64) in letrazole treated group and 73% of the cycles (51/70) in clomiphene citrate treaded group. The endometrial thickness was significantly higher in letrazole group, the number of mature follicles was significantly lower in the letrazole group. Pregnancy rate per cycle was 16% in the letrazole group and 13% in the clomiphene citrate group. Conclusion: Aromatase inhibitor letrazole is as effective as clomiphene citrate in induction of ovulation in patients with polycystic ovarian syndrome, and may have a role as first line treatment for anovulatory patients with polycystic ovary syndrome