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Reproductive outcome after letrozole versus laparoscopic ovarian drilling for clomiphene‐resistant polycystic ovary syndrome
Author(s) -
Abdellah Mohamad S.
Publication year - 2011
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2010.11.026
Subject(s) - letrozole , polycystic ovary , ovulation , medicine , gynecology , pregnancy rate , ovulation induction , human chorionic gonadotropin , pregnancy , randomized controlled trial , urology , obstetrics , hormone , biology , insulin , insulin resistance , tamoxifen , cancer , breast cancer , genetics
Objective To compare the clinical outcomes of letrozole and laparoscopic ovarian drilling (LOD) in patients with clomiphene‐citrate‐resistant polycystic ovary syndrome (PCOS). Methods In the present prospective randomized trial, 140 women with clomiphene‐citrate‐resistant PCOS were randomly allocated to receive 5 mg letrozole from day 3 to day 7 of menses for 6 consecutive cycles, or to undergo LOD. When a leading follicle of at least 18 mm was present, ovulation was triggered with human chorionic gonadotropin (hCG). The 6‐month rates of ovulation, pregnancy, abortion, and live births were evaluated. Results The groups were similar with regard to baseline clinical characteristics and hormonal profiles. The ovulation rate was significantly higher in the letrozole group than in the LOD group (59.0% versus 47.5%). On the days of the hCG injection, women in the letrozole group had a significantly thicker endometrium than those in the LOD group ( P < 0.0001). Women receiving letrozole had a higher pregnancy rate (35.7% versus 28.6%) and a lower rate of spontaneous abortion (8.0% versus 20.0%, respectively), but these differences were not statistically significant. Conclusion Letrozole seems to be a suitable second‐line ovulation‐inducing alternative to LOD in women with PCOS who do not conceive with clomiphene citrate.