Title: To Study the Efficacy on Fertility Outcome by short term Letrozole versus Extended Letrozole Regimen in Clomiphene Citrate Resistant PCOS Women
Authors: Dr Poonam Yadav, Dr Mohita Agarwal, Dr Vishy Agarwal, Dr Urvashi Verma, Dr Rachana Agarwal
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.57
Abstract
Introduction: Polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4– 6% reproductive age group, letrozole has been used successfully for ovulation induction in patients with PCOD and unexplained infertility.
Aim: The aim was to study the efficacy on fertility outcome by short term letrozole versus extended letrozole regimen in clomiphene citrate resistant PCOS women.
Material & Method: It was a prospective study in which 105 women with clomiphene resistant PCOS were randomly allocated in two groups. Group 1 having 55 patients receives letrozole in a dose of 2.5 mg for 5 days while the group 2 having 50 patients receives letrozole in a dose of 2.5 mg for 10 days.
Result: The ovulation rate, total number of follicles in the short term letrozole was 60.4% and 3.5±0.5 in the short term letrozole group while it was 67.3% and 6.8 ± 0.3 in the long letrozole group respectively. In our study the the endometrial thickness and serum estradiol level on day 10 was 10.2±0.2 and 240±46 in the short letrozole group while it was 11.4±0.6 and 338±70.4 in the long letrozole group respectively .The results of our study shows that the in the short letrozole group the pregnancy rate was 12.5% and miscarriage rate was 16.7% while it was 18.3% and 11.1% in the long letrozole group respectively.
Conclusion: The results of this study suggests that by extending the duration of letrozole therapy in midfollicular phase the FSH levels were maintained above the threshold allowing multifollicles to develop and leads to better ovulation and pregnancy rate.
Keywords: PCOS, Clomiphene citrate resistant PCOS, letrozole, extended letrozole therapy.
