Letrozole versus laparoscopic ovarian diathermy for ovulation induction in clomiphene-resistant women with polycystic ovary syndrome: a randomized controlled trial
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To compare the effect of letrozole with laparoscopic ovarian diathermy (LOD) for ovulation induction in clomiphene citrate (CC) resistant women with polycystic ovary syndrome (PCOS).
Two hundred and sixty anovulatory women with CC-resistant PCOS were selected in this randomized controlled trial. Group A (n = 128) received 2.5 mg letrozole daily for 5 days for up to six cycles. Group B (n = 132) underwent LOD with 6 months follow-up. Outcome measures were ovulation rate, midcycle endometrial thickness, pregnancy, miscarriage and live birth rates.
Ovulation occurred in 335/512 cycles (65.4%) in letrozole group and 364/525 cycles (69.3%) in LOD group without significant difference between both groups. Resumption of regular menstruation was similar in both treatment groups. A significant increase in midcycle endometrial thickness was observed in letrozole group (8.8 ± 1.1 mm vs. 7.9 ± 1.2 mm) (P < 0.05). Pregnancy rate was similar in both groups (15.6 vs. 17.5%). There were no statistical significant differences as regards miscarriage and live birth rates between both groups. No multiple pregnancy or ovarian hyperstimulation occurred in either group.
Letrozole and LOD are equally effective for inducing ovulation and achieving pregnancy in CC-resistant PCOS patients.
KeywordsPolycystic ovary syndrome Clomiphene resistance Laparoscopic ovarian diathermy Letrozole Ovulation induction
The authors would like to thank Dr. M. El Rakhawy, senior lecturer and consultant of Diagnostic Radiology, Mansoura University Hospitals, for his invaluable effort doing transvaginal ultrasound assessment and follow-up of patients enabling completion of this trial report.
Conflict of interest statement
We declare that we have no conflict of interest.
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