An Evaluation of Letrozole and Clomiphene Citrate Efficacy as Ovulation Induction Medication in Females with Polycystic Ovarian Condition

Authors

  • Keerthi M.S Senior Resident, Department of Obstetrics and Gynaecology, MIMS Mandya, Mysore, Karnataka
  • Sanjay Kumar C.
  • H.C. Savitha
  • Shruthi R.
  • Ankitha C.R.

DOI:

https://doi.org/10.37591/rrjomst.v12i2.3249

Keywords:

Clomifene Citrate, Letrozole, Ovulation Induction, Polycystic Ovary Syndrome, Ovulation-inducing drugs, Endometrial thickness, Pregnancy rate

Abstract

Polycystic ovarian condition is the most common endocrinopathy in anovulatory infertile females. As a long-established conventional treatment for ovulation induction, clomifene citrate (also known as clomiphene) is still recommended to PCOS patients as their first line of treatment. Indian PCOS women are more prone to have high levels of clomiphene resistance due to the high frequency of insulin resistance . While letrozole has a high potential for ovulation induction, it is an orally active aromatase inhibitor Letrozole may therefore become an efficient substitute for ovulation induction in these females. The current study compares letrozole 2.5 mg and clomiphene citrate 50 mg as the first-line ovulation induction medications in infertile women with PCOS in an observational study setting. The study's target population was 100 infertile women with PCOS who matched at least two of Rotterdam's criteria. To induce ovulation, 50 women were divided into the Clomiphene Citrate group and 50 into the Letrozole class, respectively. Age, infertility length, BMI, follicle count, pregnancy rate, and endometrial thickness were among the variables observed and examined. Compared to the clomiphene citrate class, the letrozole level held better rates of ovulation, mono-follicular growth, mean endometrial thickness, and pregnancy. The study concludes; letrozole might substitute clomiphene as the primary therapy for ovulation induction in infertile PCOS womenfolkPolycystic ovarian condition is the most common endocrinopathy in anovulatory infertile females. As a long-established conventional treatment for ovulation induction, clomifene citrate (also known as clomiphene) is still recommended to PCOS patients as their first line of treatment. Indian PCOS women are more prone to have high levels of clomiphene resistance due to the high frequency of insulin resistance . While letrozole has a high potential for ovulation induction, it is an orally active aromatase inhibitor Letrozole may therefore become an efficient substitute for ovulation induction in these females. The current study compares letrozole 2.5 mg and clomiphene citrate 50 mg as the first-line ovulation induction medications in infertile women with PCOS in an observational study setting. The study's target population was 100 infertile women with PCOS who matched at least two of Rotterdam's criteria. To induce ovulation, 50 women were divided into the Clomiphene Citrate group and 50 into the Letrozole class, respectively. Age, infertility length, BMI, follicle count, pregnancy rate, and endometrial thickness were among the variables observed and examined. Compared to the clomiphene citrate class, the letrozole level held better rates of ovulation, mono-follicular growth, mean endometrial thickness, and pregnancy. The study concludes; letrozole might substitute clomiphene as the primary therapy for ovulation induction in infertile PCOS womenfolkPolycystic ovarian condition is the most common endocrinopathy in anovulatory infertile females. As a long-established conventional treatment for ovulation induction, clomifene citrate (also known as clomiphene) is still recommended to PCOS patients as their first line of treatment. Indian PCOS women are more prone to have high levels of clomiphene resistance due to the high frequency of insulin resistance . While letrozole has a high potential for ovulation induction, it is an orally active aromatase inhibitor Letrozole may therefore become an efficient substitute for ovulation induction in these females. The current study compares letrozole 2.5 mg and clomiphene citrate 50 mg as the first-line ovulation induction medications in infertile women with PCOS in an observational study setting. The study's target population was 100 infertile women with PCOS who matched at least two of Rotterdam's criteria. To induce ovulation, 50 women were divided into the Clomiphene Citrate group and 50 into the Letrozole class, respectively. Age, infertility length, BMI, follicle count, pregnancy rate, and endometrial thickness were among the variables observed and examined. Compared to the clomiphene citrate class, the letrozole level held better rates of ovulation, mono-follicular growth, mean endometrial thickness, and pregnancy. The study concludes; letrozole might substitute clomiphene as the primary therapy for ovulation induction in infertile PCOS womenfolkPolycystic ovarian condition is the most common endocrinopathy in anovulatory infertile females. As a long-established conventional treatment for ovulation induction, clomifene citrate (also known as clomiphene) is still recommended to PCOS patients as their first line of treatment. Indian PCOS women are more prone to have high levels of clomiphene resistance due to the high frequency of insulin resistance . While letrozole has a high potential for ovulation induction, it is an orally active aromatase inhibitor Letrozole may therefore become an efficient substitute for ovulation induction in these females. The current study compares letrozole 2.5 mg and clomiphene citrate 50 mg as the first-line ovulation induction medications in infertile women with PCOS in an observational study setting. The study's target population was 100 infertile women with PCOS who matched at least two of Rotterdam's criteria. To induce ovulation, 50 women were divided into the Clomiphene Citrate group and 50 into the Letrozole class, respectively. Age, infertility length, BMI, follicle count, pregnancy rate, and endometrial thickness were among the variables observed and examined. Compared to the clomiphene citrate class, the letrozole level held better rates of ovulation, mono-follicular growth, mean endometrial thickness, and pregnancy. The study concludes; letrozole might substitute clomiphene as the primary therapy for ovulation induction in infertile PCOS womenfolk.

References

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. Fertile Steril. 2010;94:1405-9.

Azziz R, Carmina E, Chen Z et al (2016) Polycystic ovary syndrome. Nat rev Dis Prim 2:16057. https://doi.org/10.1038/nrdp.2016.57

Badawy A, Mosbah A, Shady M. Anastrozole or letrozole for ovulatin induction in clomiphene-resistant women with polycystic ovarian syndrome: a prospective randomize trial. Fertil Steril. 2008;89:1209-12.

Biljan MM, Mahutte NG, Tulandi T, Tan SL. Prospective randomized double-blind trial of the correlation between time of administration and antiestrogenic effects of clomiphene citrate on reproductive end organs. Fertil Steril. 2009;71(4):633-8.

Jia G, Tao H, Xue Y et al (2018) Analysis of secreted peptidome from omental adipose tissue in polycystic ovarian syndrome patients. J Cell Physiol 233:5885–5894

Kar S. Clomiphene citrate or letrozole as first-line ovulation induction drug in infertile PCOS women: a prospective randomized trial. J Hum Reprod Sci. 2012;5(3):262-5.

Mitwally MFM, Casper RF. Aromatase Inhibitors: a novel method of ovulation induction in women with polycystic ovarian syndrome. Reprod Technol. 2010;10:244-7.

Sioufi A, Gauducheau N, Pineau V, Marfil F, Jaouen A, Cardot JM, et al. Absolute bioavailability of letrozole in healthy postmenopausal women. Biopharmac Drug Dispos. 2017;18(9):779-89.

Bharathi R.V, Swetha S, Neerajaa J et al (2017) An epidemiological survey: effect of predisposing factors for PCOS in Indian urban and rural population. Middle East Fertil Soc J 22:313–316. https://doi.org/10.1016/j.mefs.2017.05.007

Shakil M, Ashraf F, Wajid A. Sexual functioning as predictor of depressive symptoms and life satisfaction in females with Polycystic Ovary Syndrome (PCOS) Pak J Med Sci. 2020;36(7):1500–1504. doi:10.12669/pjms.36.7.2562.

Jones GL, Palep-Singh M, Ledger WL, Balen AH, Jenkinson C, Campbell MF, et al. Do South Asian women with PCOS have poorer health-related quality of life than Caucasian women with PCOS?A comparative cross-sectional study. Health Qual Life Outcomes. 2010;8:149. doi:10.1186/1477-7525-8-149.

Sadia S, Waqar F, Akhtar T, Sultana S. Characteristics of infertile patients with ovulatory dysfunction and their relation to body mass index. J Ayub Med Coll Abbottabad. 2009;21(3):12–16

Rehman S, Salahuddin, Obaid-Ur-Rehman M. Polycystic ovary syndrome treatment of subfertilitywith insulin lowering medications. Pak J Pharmacol. 2005;22(1):35–39.

Khan A, Karim N, Ainuddin JA, Fahim MF. Polycystic Ovarian Syndrome:Correlationet between clinical hyperandrogenism, anthropometric, metabolic and endocrine parameters. Pak J Med Sci. 2019;35(5):1227–1232. doi:10.12669/pjms.35.5.742.

Witchel SF, Oberfield SE, Pena AS. Polycystic Ovary Syndrome:Pathophysiology, presentation, and treatment with emphasis on adolescent girls. J Endocr Soc. 2019;3(8):1545–1573. doi:10.1210/js.2019-00078.

Downloads

Published

2023-08-30

Issue

Vol. 12 No. 2 (2023)

Section

Research Article

License

Declaration and Copyright Transfer Form

(to be completed by authors)

I/ We, the undersigned author(s) of the submitted manuscript, hereby declare, that the above manuscript which is submitted for publication in the STM Journals(s), is not published already in part or whole (except in the form of abstract) in any journal or magazine for private or public circulation, and, is not under consideration of publication elsewhere.

  • I/We will not withdraw the manuscript after 1 week of submission as I have read the Author Guidelines and will adhere to the guidelines.
  • I/We Author(s ) have niether given nor will give this manuscript elsewhere for publishing after submitting in STM Journal(s).
  • I/ We have read the original version of the manuscript and am/ are responsible for the thought contents embodied in it. The work dealt in the manuscript is my/ our own, and my/ our individual contribution to this work is significant enough to qualify for authorship.
  •  I/We also agree to the authorship of the article in the following order:

Author’s name                                    

 

1. ________________

2. ________________

3. ________________

4. ________________

 

We  Author(s) tick this box and would request you to consider it as our signature as we agree to the terms of this Copyright Notice, which will apply to this submission if and when it is published by this journal.