Comparison of Ovulation Induction with Letrozole with Metformin Versus Letrozole Alone in Females Presenting with Polycystic Ovarian Syndrome

Objective: To compare the frequency of Ovulation Induction after administration of Letrozole with metformin versus Letrozole alone in females presenting with Polycystic Ovarian Syndrome Methods: This Randomized Controlled Trial was done in unit 5 of Lady Aitchison Hospital Lahore for 6 months. Total 200 females fulfilling the inclusion criteria were recruited from OPD. Lottery method was used for randomization of study subjects. Females in group A were given Letrozole 2.5mg once a day for five days (from third to seventh day)of the cycle for three consecutive months and metformin 1500mg (500mg 3 times a day) daily for three months, while females in group B were given Letrozole 2.5mg once a day for five days (from third to seventh day) le for three consecutive months. Then they were followed up in OPD for 3 cycles. In all 3 cycles TVS was done on day 12 to access the number of follicles and to measure the size of largest follicle, and on day 21 of cycle progesterone level will be assessed for confirmation of ovulation induction. The data was entered and analyzed through SPSS version 20. Mean and standard deviation was calculated for age and BMI. Frequency and percentage was calculated for Ovulation induction. Both groups were compared by using chi-square test taking p-value<0.05 as significant. Data was stratified for BMI (Normal, overweight and Obese).After stratification chi-square test was applied keeping a p value < 0.05 as significant. Results: In Group-A mean age of women was 28.18±6.58 years. In Group-B mean age of women was 27.08±5.15 years. In Group-A ovulation induction rate was much higher as compared to that of Group-B women. i.e. (89% vs. 60%). p-value=0.000. Ovulation induction rate was significantly higher with Letrozole+ Metformin in women who were having normal BMI, overweight & obese as compared to that of Letrozole alone. Conclusion: Letrozole with metformin is more effective for the ovulation Induction females presenting with polycystic ovarian Syndrome as compared to letrozole alone.()