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Letrozole versus combined metformin and clomiphene citrate for ovulation induction in clomiphene-resistant women with polycystic ovary syndrome: a randomized controlled trial.
Fertil Steril. 2010 Sep; 94(4):1405-9.FS

Abstract

OBJECTIVE

To compare the effect of letrozole with combined metformin and clomiphene citrate (CC) for ovulation induction in CC-resistant women with polycystic ovary syndrome (PCOS).

DESIGN

A randomized controlled trial.

SETTING

University teaching hospital and a private practice setting.

PATIENT(S)

Two hundred fifty anovulatory women (582 cycles) with CC-resistant PCOS.

INTERVENTION(S)

Patients received 2.5 mg of letrozole daily (123 patients, 285 cycles) or combined metformin-CC (127 patients, 297 cycles) for three treatment cycles.

MAIN OUTCOME MEASURE(S)

Ovulation rate, number of follicles, serum E(2), serum P, endometrial thickness, pregnancy, and miscarriage rates.

RESULT(S)

Ovulation occurred in 185/285 cycles (64.9%) in the letrozole group versus 207/297 cycles (69.6%) in the combined metformin-CC group, without statistically significant difference. The total number of follicles was significantly more in the combined metformin-CC group (4.4+/-0.4 vs. 6.8+/-0.3). A nonsignificant increase in endometrial thickness on the day of hCG administration was observed in the letrozole group (9.5+/-0.2 mm vs. 9.1+/-0.1 mm). No statistically significant difference regarding the pregnancy rate (PR) was observed between both groups (14.7% vs. 14.4%).

CONCLUSION(S)

Letrozole and combined metformin-CC are equally effective for inducing ovulation and achieving pregnancy in patients with CC-resistant PCOS.

Authors+Show Affiliations

Department of Obstetrics, Mansoura University, Mansoura, Egypt. hatem_ah@hotmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

19732888

Citation

Abu Hashim, Hatem, et al. "Letrozole Versus Combined Metformin and Clomiphene Citrate for Ovulation Induction in Clomiphene-resistant Women With Polycystic Ovary Syndrome: a Randomized Controlled Trial." Fertility and Sterility, vol. 94, no. 4, 2010, pp. 1405-9.
Abu Hashim H, Shokeir T, Badawy A. Letrozole versus combined metformin and clomiphene citrate for ovulation induction in clomiphene-resistant women with polycystic ovary syndrome: a randomized controlled trial. Fertil Steril. 2010;94(4):1405-9.
Abu Hashim, H., Shokeir, T., & Badawy, A. (2010). Letrozole versus combined metformin and clomiphene citrate for ovulation induction in clomiphene-resistant women with polycystic ovary syndrome: a randomized controlled trial. Fertility and Sterility, 94(4), 1405-9. https://doi.org/10.1016/j.fertnstert.2009.07.985
Abu Hashim H, Shokeir T, Badawy A. Letrozole Versus Combined Metformin and Clomiphene Citrate for Ovulation Induction in Clomiphene-resistant Women With Polycystic Ovary Syndrome: a Randomized Controlled Trial. Fertil Steril. 2010;94(4):1405-9. PubMed PMID: 19732888.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Letrozole versus combined metformin and clomiphene citrate for ovulation induction in clomiphene-resistant women with polycystic ovary syndrome: a randomized controlled trial. AU - Abu Hashim,Hatem, AU - Shokeir,Tarek, AU - Badawy,Ahmed, Y1 - 2009/09/03/ PY - 2009/05/23/received PY - 2009/07/11/revised PY - 2009/07/14/accepted PY - 2009/9/8/entrez PY - 2009/9/8/pubmed PY - 2010/9/21/medline SP - 1405 EP - 9 JF - Fertility and sterility JO - Fertil. Steril. VL - 94 IS - 4 N2 - OBJECTIVE: To compare the effect of letrozole with combined metformin and clomiphene citrate (CC) for ovulation induction in CC-resistant women with polycystic ovary syndrome (PCOS). DESIGN: A randomized controlled trial. SETTING: University teaching hospital and a private practice setting. PATIENT(S): Two hundred fifty anovulatory women (582 cycles) with CC-resistant PCOS. INTERVENTION(S): Patients received 2.5 mg of letrozole daily (123 patients, 285 cycles) or combined metformin-CC (127 patients, 297 cycles) for three treatment cycles. MAIN OUTCOME MEASURE(S): Ovulation rate, number of follicles, serum E(2), serum P, endometrial thickness, pregnancy, and miscarriage rates. RESULT(S): Ovulation occurred in 185/285 cycles (64.9%) in the letrozole group versus 207/297 cycles (69.6%) in the combined metformin-CC group, without statistically significant difference. The total number of follicles was significantly more in the combined metformin-CC group (4.4+/-0.4 vs. 6.8+/-0.3). A nonsignificant increase in endometrial thickness on the day of hCG administration was observed in the letrozole group (9.5+/-0.2 mm vs. 9.1+/-0.1 mm). No statistically significant difference regarding the pregnancy rate (PR) was observed between both groups (14.7% vs. 14.4%). CONCLUSION(S): Letrozole and combined metformin-CC are equally effective for inducing ovulation and achieving pregnancy in patients with CC-resistant PCOS. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/19732888/Letrozole_versus_combined_metformin_and_clomiphene_citrate_for_ovulation_induction_in_clomiphene_resistant_women_with_polycystic_ovary_syndrome:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(09)02481-9 DB - PRIME DP - Unbound Medicine ER -