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Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial

  • GENERAL INFERTILITY
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Abstract

Purpose

Letrozole, though reported to be an effective ovulation inducing agent, warrants larger randomized trials. The purpose of this study is to compare the efficacy of letrozole with that of rFSH and clomiphene citrate(CC)/rFSH for ovarian stimulation in IUI cycles.

Methods

Randomized, prospective, single-blinded clinical trial. 1387 PCOS women after CC failure were randomized into three groups: Group A received letrozole, Group B received CC with two doses rFSH and Group C received continuous rFSH day 2 onwards until hCG injection.

Results

Group A, B and C had an ovulation rate of 79.30%, 56.95% and 89.89% and cycle cancellation rate of 20.70%, 43.05% and 10.11%, respectively. Pregnancy rates in Group A, B and C were 23.39%, 14.35% and 17.92%, while the miscarriage rates were 13.80%, 16.67% and 14.52%, respectively.

Conclusion

Letrozole appears to be a suitable ovulation inducing agent in PCOS women with CC failure and is found to be most effective when baseline estradiol level >60 pg/ml.

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Acknowledgements

One of the authors, Dr. Ashalatha Ganesh sincerely acknowledges the Council of Scientific and Industrial Research (CSIR) for providing financial support. All authors thank Dr Himadri S. Sarkar, PhD., Institute of Reproductive Medicine, Salt Lake, Kolkata, India for measuring various hormone levels in the laboratory. Mr. Soumen Das, a graduate student, is acknowledged for helping with the statistical analysis.

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Authors and Affiliations

  1. School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, 721302, India

    Ashalatha Ganesh & Koel Chaudhury

  2. Institute of Reproductive Medicine, Salt Lake, Kolkata, 700106, India

    Sourendra Kant Goswami, Ratna Chattopadhyay & Baidyanath Chakravarty

Authors
  1. Ashalatha Ganesh
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  2. Sourendra Kant Goswami
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  3. Ratna Chattopadhyay
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  4. Koel Chaudhury
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  5. Baidyanath Chakravarty
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Corresponding author

Correspondence to Koel Chaudhury.

Additional information

Capsule Letrozole appears to be an effective ovulation inducing agent as compared to clomiphene-rFSH and continuous rFSH protocols in PCOS women after clomiphene citrate failure.

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Ganesh, A., Goswami, S.K., Chattopadhyay, R. et al. Comparison of letrozole with continuous gonadotropins and clomiphene-gonadotropin combination for ovulation induction in 1387 PCOS women after clomiphene citrate failure: a randomized prospective clinical trial. J Assist Reprod Genet 26, 19–24 (2009). https://doi.org/10.1007/s10815-008-9284-4

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  • DOI: https://doi.org/10.1007/s10815-008-9284-4

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