Letrozole versus clomiphene and tamoxifen in ovulation induction in clomiphene-resistant polycystic ovary syndrome cases

• Published in: Menoufia Medical Journal Vol. 34; no. 2; pp. 719 - 723
• Main Authors: Dawood, Ragab, Rezk, Mohammed, Maged, Heba, Abdel-Latif, Omayma
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer India Pvt. Ltd 01.04.2021
• Subjects: letrozole; clomiphene citrate; ovulation induction; tamoxifen; polycystic ovary syndrome
• ISSN: 1110-2098; 2314-6788

Objective The aim of this study was to make a comparison between the effects of letrozole and a combination of clomiphene citrate and tamoxifen in ovulation induction in clomiphene citrate-resistant women with polycystic ovary syndrome (PCOS). Background PCOS is the most common endocrine disorder affecting ~ 6-15% of women of reproductive age causing several medical problems mainly infertility. Ovulation induction can be achieved by administration of an oral drug or a combination of drugs such as clomiphene citrate, tamoxifen, and letrozole, which are considered the first-line treatment for anovulatory PCOS. Patients and methods This prospective comparative study has been performed at the outpatient clinic of Obstetrics and Gynecology of both Menoufia University Hospital and Quesna Central Hospital during the period from December 2018 to March 2020. A total of 100 patients with PCOS (resistant to clomiphene citrate) were selected according to 'Rotterdam criteria,' including biochemical hyperandrogenism. Results There were no statistically significant differences between group A (40 cases) and group B (39 cases) regarding age, BMI, and duration of infertility. The results of both groups regarding ovulation rate were comparable, with no significant difference between the two groups. Conclusion The results of the present study are comparable to previous reported studies, revealing that clomiphene citrate, tamoxifen, and letrozole are effective in the treatment of infertility in patients with PCOS. Addition of tamoxifen to clomiphene citrate enhances its effect and gives better results.