Letrozole or clomiphene citrate as the first-line treatment of infertile women with unovulatory and unexplained infertility
Svetlana Spremovic-Radjenovic (RS), Ljiljana Stanisic - Peulic (BA), Snezana Vidakovic (RS), Jelena Stojnic (RS), Jovan Bila (RS)
[Spremovic-Radjenovic] Clinic for Gynecol and Obstetr CCS School of Medicine University of Belgrade, [Stanisic - Peulic] University Clinical Center Republic Srpska, Clinic for Gynecology and Obstetrics , [Vidakovic] Clinic for Gynecology and Obstetrics Clinical Center of Serbia, School of Medicine University of Belgrade, [Stojnic] Clinic for Gynecology and Obstetrics Clinical Center of Serbia, School of Medicine University of Belgrade, [Bila] Clinic for Gynecology and Obstetrics Clinical Center of Serbia, School of Medicine University of Belgrade
Context: The safety issues linked to use of letrozole for ovulation stimulation are resolved and new guidelines propose letrozole as the first line of therapy for specific groups of patients. More controversial are publications about efficacy of letrozole compared to the other medication for the ovulation induction+. Objective: To compare the efficacy of letrozole to clomiphene citrate (CC) for ovulation induction and infertility treatment in patients with unovulatory and unexplained infertility. Methods: Prospective controlled observational study started from 2015. in Department for assisted reproductive technologies Clinic for Gynecology and Obstetrics CCS; Patients: The study included 151 patients: 61 in Letrozole and 90 in Clomphen citrate group Main outcome measures: Pregnancy rates and live birth rates in Letrozole and Clomiphen citrate group Interventions: The outcomes for the first cycle of stimulation either in Letrozole (5 mg per day for 5 days starting from day 3) or in Clomiphene group (100 mg per day for 5 days starting from day 2) are analyzed by statistical methods – SPSS, using chi square. Results: There is not statistically significant difference (ƛ2= 0. 12) between pregnancy rate in Letrozole vs Clomiphene citrate group: 13 of 61 (21. 3%) vs 17 of 90 (18. 8%); There is statistically significant difference in live birth rate between Letrozole and Clomiphene citrate group: 9 of 61 (14. 7%) vs 4 of 90 (4. 44%), ƛ2= 4. 87 Conclusion: In women with unovulatory and unexplained infertility, ovarian stimulation with letrozole after first stimulation cycle resulted in a similar pregnancy rate but higher frequency of live birth rate, as compared with clomiphene.