A COMPARATIVE STUDY OF LETROZOLE AND CLOMIPHENE CITRATE FOR OVULATION INDUCTION IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Abstract

Background: Clomiphene citrate has usually been the first choice for ovulation stimulation. But the growing evidence indicates that letrozole may be more effective and better for the endometrium. There is limited comparative data on treatment efficacy across different demographic and socioeconomic groups, particularly in South Asian populations.

Objective:  To compare the outcome of letrozole versus clomiphene citrate (CC) on ovulation induction in females presenting with polycystic ovary syndrome (PCOS) having subfertility.

Methods: The was a quasi-experimental study conducted in Department of Obstetrics and Gynecology, Khawaja Muhammad Safder Medical College Hospital, Sialkot, Pakistan from July 2024 to February 2025. Total of 100 patients, were divided into two groups, CC (group 1, n= 50) and Letrozole (group 2, n=50) from treatment initiation to outcome evaluation. Women aged 20–40 years, diagnosis of PCOS and both (primary and secondary) subfertility and Male with normal semen parameters were included in this study. The main outcome was success of ovulation induction.

Results Baseline demographic and clinical characteristics were similar between the two groups. Ovulation occurred in 84% of women taking letrozole compared to 76% of those taking clomiphene citrate. This difference is statistically significant (p = 0.04). The pregnancy rate was higher in the letrozole group at 16% versus 10.5% (p = 0.00).

Conclusion: Letrozole showed significantly better ovulation induction effectiveness compared to clomiphene citrate in women with PCOs.