A PROSPECTIVE COMPARATIVE STUDY OF LETROZOLE AND CLOMIPHENE CITRATE IN OVULATION INDUCTION IN WOMEN HAVING PCOS

Introduction: Clomiphene citrate (CC) is the primary drug of choice for ovulation induction in PCOS but resistance to ovarian stimulation is frequent observation with CC. Letrozole (Let), an Aromatase Inhibitor (AI) induces folliculogenesis by releasing hypothalamo-pituitary axis from tonic inhibitory effect of estrogen. Aim: To compare the rate of folliculogenesis, number of follicle count, ovulation rate, conception rate and pregnancy outcome. Materials & Methods: This prospective comparative study was conducted in RGKMCH & NKIIC, Kolkata from July 2018 to June 2019.  In this study 200 anovulatory PCO matched women of 20-40 years were divided into two groups, Group A-100 patients receiving CC 100 mg daily and  Group B-100 patients  receiving Letrozole 5 mg daily from Day 2 for 5 days. Follicular study started from D₉ of cycle and ovulation triggering by using Injection hCG was done as per standard protocol. Patients were evaluated in respect of terminal endocrinological profile, number of follicles, ovulation rate, pregnancy rate & outcome. Results: In Gr A & Gr B, mean  no of follicles and terminal E₂ were 2.9 ±0.9 vs 1.8 ± 0.6 (p< 0.001) and 486 ± 54 vs 266 ±46 pg (p< 0.0001) respectively. Ovulation and pregnancy rate in both groups were 84.6% Vs 90.2% (p = 0.157) and 18.5% vs 24.3% (p<0.005) in Gr A and Gr B respectively. Conclusion: Though the ovulation rate is comparable in both the groups, Letrozole group achieved more pregnancy than CC group.