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Archives of Gynecology and Obstetrics

, Volume 297, Issue 5, pp 1081–1088 | Cite as

Letrozole versus clomiphene citrate in polycystic ovary syndrome: a meta-analysis of randomized controlled trials

  • Shifu Hu
  • Qiong Yu
  • Yingying Wang
  • Mei Wang
  • Wei Xia
  • Changhong Zhu
Review

Abstract

Purpose

Polycystic ovary syndrome (PCOS) is a common endocrine disturbance affecting women in the reproductive age group. The present study aimed to compare the effects of letrozole (LE) and clomiphene citrate (CC) for ovulation induction in women with PCOS.

Methods

The PUBMED, Web of Science, and EMBASE databases were screened systematically for randomized controlled trials (RCTs) published from database inception to July 2017.

Results

Eleven RCTs involving 2255 patients were included, and data were independently extracted and analyzed using 95% risk ratios (RRs) and confidence intervals (CIs) based on a random- or fixed-effect model (as appropriate). Meta-analyses of nine RCTs comparing LE and CC ovulation induction, followed by timed intercourse, indicated that the former significantly increased the ovulation rate (RR = 1.18; 95% CI 1.03–1.36, P = 0.01), pregnancy rate (RR = 1.34; 95% CI 1.09–1.64, P = 0.006), and live birth rate (RR = 1.55; 95% CI 1.28–1.88, P < 0.00001). However, LE and CC did not differ significantly in terms of the multiple pregnancy and abortion rates. Furthermore, LE for ovulation induction significantly improved the pregnancy rate after IUI.

Conclusion

LE is superior to CC for ovulation induction in patients with PCOS.

Keywords

Letrozole Clomiphene citrate Polycystic ovary syndrome Randomized controlled trials Meta-analysis 

Notes

Acknowledgements

This work was supported by the National Natural Science Foundation of China (Grant no. 81671507), Fundamental Research Funds for the Central Universities (HUST; Grant no. 2015ZDTD050), and National Key Research and Development Program (Grant no. 2016YFC1000903).

Author contributions

SH, first author: project development, data collection, data analysis, and manuscript writing. QY, co-first author: project development, data collection, statistical analysis. YW and MW: data collection. WX, corresponding author: manuscript editing. CZ, co-corresponding author: manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Family Planning Research Institute, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Reproductive Medicine Center, Tongji Medical College, Tongji HospitalHuazhong University of Science and TechnologyWuhanChina
  3. 3.Reproductive Medicine Center, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

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