Comparing Letrozole versus Clomiphene for PCOS-Related Infertility — A Single-Center Study

Abstract

Introduction: Polycystic Ovary Syndrome (PCOS), a common endocrine disorder affecting women of reproductive age, is characterized by hyperandrogenism, anovulation, and polycystic ovaries. Infertility is a frequent consequence of PCOS, primarily due to anovulation. Letrozole and Clomiphene Citrate, two widely used medications for treating PCOS-related infertility. Objective: Purpose of this study to compare the efficacy and safety of Letrozole vs. Clomiphene Citrate for PCOS-related infertility. Methods and Materials: A single-center RCT was conducted in OPD of Dhaka National Medical College in Bangladesh from 1^st January 2022 to 31^st December 2022. Total 160 patients diagnosed with PCOS with infertility according to Rotterdam criteria were recruited and randomly assigned into two groups after taking written informed consent. The women were followed by Ultrasound to monitor follicular development, endometrial thickness, ovulation, and pregnancy outcomes. Results: While both groups had similar distributions of infertility types and endometrial thickness, a significant difference was observed in follicular development (p = 0.002). Group A had a higher rate of mono-follicular development, while Group B showed more multi-follicular development. No significant difference was found in ovulation rates (p = 0.796), but Group A had a significantly higher pregnancy rate than Group B (p = 0.000961).  Conclusion: letrozole is better than clomiphene citrate in patients with PCOS with subfertility where letrozole users demonstrated significantly higher pregnancy rates than clomiphene citrate users. So letrozole should be considered as first line treatment option for ovulation induction in patients with PCOS with subfertility.