The Study on Different Ovulation Induction Protocols used for Intrauterine Insemination and their Pregnancy Rate in Infertile Couples

Infertility affects millions of people of reproductive age worldwide and has an impact on their families and communities. Infertility is a disease of male or female reproductive system defined by failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is treated by different fertility drugs, ovulation induction (OI), intrauterine insemination (IUI) and in-vitro fertilization (IVF). The aim of the study is to find out the significant difference in pregnancy rate with different OI protocols used for IUI. OI is the first line treatment given to infertile women. In OI, medications are given to women for egg development and for release of eggs. OI is monitored by follicular study by ultrasonography. Semen is collected from the male partner and processed with culture media to retrieve high motile sperms, which are injected into the uterus of the female. A prospective randomized study was performed among 1343 IUI cycles. OI is started on Day 2 or Day 3 of the menstrual cycle. OI protocol is grouped according to the fertility drugs used for stimulation. The fertility drugs used for the stimulation are Clomiphene Citrate, Letrozole, Recombinant Gonadotropins, Human menopausal Gonadotropins (HMG), Human chorionic Gonadotropin (HCG). Group A uses Clomiphene citrate and HCG, Group B uses Clome, recombinant Gonadotropins and HCG. Group C uses Clome, Human menopausal Gonadotropin and HCG; Group D uses Letrozole and HCG. Group E uses Letrozole recombinant Gonadotropin and HCG. Group F used Letrozole, Human menopausal Gonadotropin and HCG. Group G used recombinant Gonadotropin and HCG. Group H used Human menopausal Gonadotropin and HCG. Group I uses only HCG. Group J was a natural cycle monitoring without any medication and was used as a control. Pregnancy rates were calculated for different age groups with different protocols. The result shows that Group B had 13% pregnancy, Group C had 9%, Group D had 3%, Group E had 10%, Group G had 11%, Group G had 11%, Group H had 7%, Group I had 4%, and Group J had 8% of pregnancy rate. The statistical analysis shows there is no significant difference with different stimulation protocols used.

Download Full-text

A study for evaluation of two protocols comprising of clomiphene citrate, human menopausal gonadotropin with or without follicle stimulating hormone for ovulation induction in patients with infertility for intrauterine insemination

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20192455 ◽

2019 ◽

Vol 8 (6) ◽

pp. 2487

Author(s):

Ashok Verma ◽

Shivani Sharma ◽

Suresh Verma ◽

Pankaj Sharma ◽

Tenzin Tsamo Tenga ◽

...

Keyword(s):

Menstrual Cycle ◽

Pregnancy Rate ◽

Ovulation Induction ◽

Endometrial Thickness ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Human Menopausal Gonadotropin ◽

Multiple Gestation ◽

Group A ◽

Group B

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility.Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3-7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle. Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards.Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, significant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups.Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.

Download Full-text

STUDY FOR EVALUATION OF COMPRISING OF CLOMIPHENE CITRATE, HUMAN MENOPAUSAL GONADOTROPIN WITH OR WITHOUT FOLLICLE STIMULATING HORMONE FOR OVULATION INDUCTION IN PATIENTS WITH INFERTILITY FOR INTRAUTERINE INSEMINATION AT NMCH, JAMUHAR, SASARAM, BIHAR

10.36106/ijsr/1638275 ◽

2021 ◽

pp. 30-32

Author(s):

Smriti Sinha ◽

Rita Sinha ◽

Debarshi Jana

Keyword(s):

Menstrual Cycle ◽

Pregnancy Rate ◽

Ovulation Induction ◽

Endometrial Thickness ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Human Menopausal Gonadotropin ◽

Multiple Gestation ◽

Group A ◽

Group B

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility. Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3 - 7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle. Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards. Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, signicant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups. Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.

Download Full-text

Comparative Analysis of Effectiveness of Clomiphene Citrate and Letrozole Combined with Low Dose Human Menopausal Gonadotropin for Controlled Ovarian Stimulation in Intrauterine Insemination Cycles

Siriraj Medical Journal ◽

10.33192/smj.2021.26 ◽

2021 ◽

Vol 73 (3) ◽

pp. 198-203

Author(s):

Padmalaya Thakur ◽

Sujata Pradhan

Keyword(s):

Pregnancy Rate ◽

Ovarian Stimulation ◽

Low Dose ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Clinical Pregnancy ◽

Clinical Pregnancy Rate ◽

Controlled Ovarian Stimulation ◽

Human Menopausal Gonadotropin ◽

Group B

Objective: To compare the efficacy of clomiphene citrate and letrozole in combination with low dose human menopausal gonadotropin for controlled ovarian stimulation in intrauterine insemination (IUI) cycles.Methods: During January-2018 to December-2019 for intending 496 IUI cycles, controlled ovarian stimulation was performed with either clomiphene or letrozole combined with human menopausal gonadotropin (hMG), in two arms: subjects in one arm (Group A) were with clomiphene and hMG in 222 cycles; those in the second arm (Group B) were with letrozole and hMG in 274 cycles. Pregnancy rate and clinical pregnancy rate of both groups were considered as the primary outcomes.Results: Patient characteristics like female age, indications for IUI, type of IUI, endometrial thickness and total motile fraction (TMF) of spermatozoa of male partners were seen similar in both groups. The letrozole-hMG group (Group B) had significantly higher numbers of cycles with single dominant follicle (P=0.01) and human chorionic gonadotropin (hCG) was more frequently used as the ovulation trigger (P=0.03). Pregnancy rate (18.5% vs. 15.3%, P=0.35) and clinical pregnancy rate (18.5% vs. 15.3%, P=0.35) were similar in groups A and B, respectively.Conclusion: Clomiphene citrate and letrozole combined with low dose human menopausal gonadotropin were equally effective for controlled ovarian stimulation in IUI cycles.

Download Full-text

Relationship between pregnancy rate and number of intrauterine insemination cycles during the study of comparative efficacy of letrozole and clomiphene citrate adjuvants to gonadotropin stimulation in controlled ovarian stimulation cycles combined with intrauterine insemination therapy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20215084 ◽

2021 ◽

Vol 11 (1) ◽

pp. 106

Author(s):

Pankaj Sharma ◽

Ashok Verma ◽

Kritika Katoch

Keyword(s):

Pregnancy Rate ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Randomized Study ◽

Good Alternative ◽

Human Menopausal Gonadotropin ◽

Male Factor ◽

Medical College ◽

Group A ◽

Group B

Background: Infertility is commonly defined as the failure of conception after at least twelve months of unprotected intercourse. Factors contributing are both male and female in which unexplained etiology accounts for 51%, male factor 28%, endometriosis 17% and ovulatory disorders 4%.Methods: Prospective, randomized study was conducted at DRRPG medical college, Tanda, Kangra, Himachal Pradesh. In our study, patients were randomized into two groups of 30 each. Women in group A received clomiphene citrate 100mg/day and group B received letrozole 2.5 mg/day from day 3-7 of menstrual cycle. All the patients received human menopausal gonadotropin 75 U given every alternate day from day 5 until HCG administration. Ovulation was triggered with recombinant HCG (5000 IUIM) when the dominant follicles reached 18 mm in diameter. A single IUI was performed 36 hours later. A maximum of four cycles were given.Results: In our study, total number of induction cycles given in group A and B were 120 and 114 respectively. Out of these, 112 and 111 IUI cycles were done in group A and B respectively. A pregnancy rate of 1.66% and 7.87% per IUI cycle was observed in group A and B respectively.Thus it is concluded that the pregnancy rates were significantly higher in letrozole group (30%) in comparison to clomiphene citrate group (6.66%).Conclusions: Aromatase inhibitor letrozole appears to constitute a good alternative to clomiphene citrate in patients with unexplained infertility undergoing gonadotropin-stimulated COS cycles combined with IUI therapy.

Download Full-text

Letrozole Versus Clomiphene Citrate for Superovulation in Intrauterine Insemination Cycles - Retrospective Comparative Study Conducted in the Department of Reproductive Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/408 ◽

2021 ◽

Vol 10 (27) ◽

pp. 1991-1995

Author(s):

Jawahira Chishti ◽

Jai Chowdhary ◽

Archana Paliwal ◽

Chetan Kumar Sharma ◽

Manisha Choudhary

Keyword(s):

Pregnancy Rate ◽

Ovulation Induction ◽

Endometrial Thickness ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Peripheral Tissues ◽

Sperm Density ◽

Estrogen Production ◽

Oral Agents ◽

Significant Difference

BACKGROUND Superovulation with intrauterine insemination (IUI) increases the probability of pregnancy by increasing number of oocytes and sperm density. The main oral agents used for superovulation are clomiphene citrate and letrozole. Clomiphene citrate a selective estrogen receptor modulator with predominant antiestrogenic action has adverse effects on endometrium and cervical mucous. Letrozole an aromatase inhibitor acts by reducing estrogen production by blocking androgen conversion to estrogen in ovary and peripheral tissues without affecting endometrium and cervical mucous. We wanted to compare the efficacy of letrozole v/s clomiphene citrate as first line ovulation induction drug in infertile patients undergoing IUI. METHODS Based on the inclusion and exclusion criteria, we included 160 patients in our study. They were divided into two groups of 80 each based on the drug given for ovulation induction. The drug was given for 5 days from D3 to D7 of menstrual cycle. IUI was done 38 - 40 hours after trigger and after confirmation of ovulation by sonography. RESULTS The mean age, body mass index (BMI), duration of infertility, type and cause of infertility in both groups were similar. Ovulation rate was 85 % in letrozole group and 71.25 % in clomiphene citrate group, which was statistically significant (P0.035). There was no statistically significant difference between endometrial thickness and total days till ovulation between two groups. Monofolliculogenesis and clinical pregnancy rate were statistically significantly higher in letrozole group. CONCLUSIONS Our study shows that letrozole has better pregnancy rate in comparison to clomiphene citrate (C. C.) in IUI cycles with less risk of anovulation, thin endometrium and multi follicular growth. KEY WORDS Clomiphene Citrate (C.C.), Letrozole (LTZ), Ovulation Induction (OI), Intrauterine Insemination (IUI)

Download Full-text

The effects of adding Gonadotropin-releasing Hormone antagonist on cycle characteristics and pregnancy rate in stimulated Intrauterine Insemination (IUI) cycle

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2407 ◽

2020 ◽

Vol 11 (3) ◽

pp. 3053-3060

Author(s):

Rawaa saad Hassan Abunaila ◽

Lubna Amer Al-anbari ◽

Muayad Sraibet Abbood

Keyword(s):

Pregnancy Rate ◽

Assisted Reproductive Technologies ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Study Groups ◽

Reproductive Technologies ◽

Control Group ◽

Human Menopausal Gonadotropin ◽

Study Group ◽

Significant Difference

A prospective randomised (comparative) study was conducted in the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in AL-Nahrain University, Baghdad – Iraq, from the 1st of October 2018 till 1st of September 2019 involving seventy women of infertile couples with the same inclusion and exclusion criteria. They were randomly allocated into two groupsreceiving minimal ovarian stimulation protocol (Clomiphene Citrate and Human Menopausal Gonadotropin) with IUI adding flexible GnRH antagonist protocol (Cetrorelix) to the study group. IUI was done 40-44 hours after ovulation trigger. There were no significant statistical variances among control and study groups in demographic characteristics concerning: age, BMI, type, duration and cause of infertility. There was no important variance in a mean day of trigger among control and study groups, 12.43 ±1.56 versus 13.11 ±1.49, at the same order (p = 0.064). The Mean number of dominant follicles was considerably greater in study groups than that of the group control, 2.40±1.03 versus 1.89±0.83, respectively (p = 0.025).Mean serum Estradiol of the study group was significantly higher than that of the control group, 478.68 ±423.61 versus 273.12 ±254.57, respectively (p = 0.016). The proportion of women with LH> 10 were significantly less frequent in the study group in comparison with the control group, 22.9 % versus 68.6 %, at the same order (p < 0.001). There was no important variance in mean serum Progesterone among control and study groups. There was no significant difference in the characteristic of the dominant follicle, ruptured versus not ruptured, (p = 0.124) on the day of IUI. The pregnancy rate was higher in the study group when compared with the control group; however, the difference in pregnancy rate doesn’t reach statistical import (p = 0.145)

Download Full-text

Therapeutic Effect of Vitamin D3 Supplementation to Clomiphene Citrate Resistant PCOS Women: A Randomized Controlled Trial

QJM ◽

10.1093/qjmed/hcab115.033 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Mohamed Nour El-Din Hashaad ◽

Reda Mokhtar Kamal Ghanem ◽

Sara Abouelfath Abouelasrar Gad Dawoud

Keyword(s):

Vitamin D ◽

Pregnancy Rate ◽

Ovulation Induction ◽

Clomiphene Citrate ◽

Reproductive Age ◽

Secondary Outcome ◽

Group V ◽

Cumulative Pregnancy Rate ◽

Study Results ◽

Significant Difference

Abstract Background Polycystic ovary syndrome (PCOS) is considered one of the most common endocrine disorders affecting females in their reproductive age. In PCOS, an imbalance between androgens, anti-Müllerian hormone (AMH) and follicle stimulating hormone (FSH), cause a halt of follicular growth. Insulin resistance (IR) is another important component of PCOS. There is increasing evidence that vitamin D affects insulin and glucose metabolism, Vitamin D plays a vital role in the regulation of glucose-insulin homeostasis. Objectives to assess the efficacy of vitamin D supplementation in improving ovulation induction in PCOS women (1ry outcome) and increasing pregnancy rate (secondary outcome). Patients and Methods 120 women diagnosed PCOS according to Rotterdam criteria and were resistant to CC treatment were randomly allocated into equal two groups: Group V: number of 60 patients received cholecalciferol + Metformin for 2 months. Group C: 60 patients received Metformin 2 months. After two months from the start:Both study groups started induction with Clomiphene Citrate added every month starting from the 3rd month to the 5th month (3 cycles of ovulation induction) in addition to previous drugs mentioned. Results In our study results, regulation of menstrual cycle occured in 63.6% of women who recieved vitamin D + metformin (group V) and ovulation was confirmed in 34.5% of the total number (55 women). Later, 18% of them got pregnant after 3 months of treatment. Added to that 16 women out of 39 (41%) got pregnant by the end of the follow up period with cumulative pregnancy rate (53%). On the other hand menstrual regularity in (group C: metformin) recorded 61% with ovulation percentage of 26.9% (n = 54). Followed by 14.8% pregnancy rate at the 3rd month., which increased to 27.5% by the end of the study out of 47.5% ovulated women (n = 40). Cumulative pregnancy rate 40%. Conclusion From the current study we can conclude that there is no significant difference of adding vitamin D to CC resistant PCOS regarding ovulation and pregnancy rates. However, it can augment metformin action and improves its outcome.

Download Full-text

Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.05.6497 ◽

2021 ◽

Vol 28 (05) ◽

pp. 749-754

Author(s):

Nadia Sharif ◽

Uzma Manzoor ◽

Saadia Bano ◽

Uzma Shahzaad

Keyword(s):

Pregnancy Rate ◽

Ovulation Induction ◽

Endometrial Thickness ◽

Controlled Trial ◽

Clomiphene Citrate ◽

Epidemiological Data ◽

P Value ◽

Group A ◽

The Mean ◽

Group B

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.

Download Full-text

Effects of Letrozole in Prevention of Premature Luteinizing Hormone (LH) Surge in Infertile Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome (PCOS) Undergoing Intrauterine Insemination

Galen Medical Journal ◽

10.31661/gmj.v4i3.232 ◽

2015 ◽

Vol 4 (3) ◽

pp. 104-11

Author(s):

Afsoon Zarei ◽

Tahere Bahrami Shabahrami ◽

Nasrin Dadras

Keyword(s):

Luteinizing Hormone ◽

Pregnancy Rate ◽

Polycystic Ovary ◽

Endometrial Thickness ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Control Group ◽

Lh Surge ◽

Significant Difference ◽

Premature Lh Surge

Background: Polycystic ovarian syndrome (PCOS) is among the important causes of infertility in young women. Premature luteinizing hormone (LH) surge (PLS) is one of its complications. PLS can reduce the quality of oocytes and therefore decrease the success of intrauterine insemination (IUI). Letrozole, a non-steroidal aromatase inhibitor, prevents LH surge. In this study, we aim to evaluate the effects of letrozole on preventing premature LH surge in clomiphene-resistant patients with PCOS undergoing IUI. Materials and Methods: In this randomized clinical trial, 131 patients who were developed with PCOS were selected for IUI cycle, divided into two groups randomly: control group (n=67) and letrozole group (n=64). Incidence of premature LH surge, pregnancy, abortion and ongoing pregnancy rate, endometrial thickness and number of follicles were measured in both groups. Results: No significant difference was seen between mean ages in the two groups; 11.9% of the control group and 21.9% of the letrozole group became pregnant (P =0.005); furthermore, premature LH surge was seen in 4.7% of the letrozole group and 8.9% of the control group (P =0.003). E2 and Endometrial thickness was higher in letrozole group; however, LH was significantly higher in the control group (P =0.026). Conclusion: Administration of letrozole in clomiphene-resistant patients with PCO undergoing IUI cycle can decrease the incidence of PLS. In addition, it can increase pregnancy rate significantly. Therefore, using letrozole is more reasonable in patients who have not responded to clomiphene or are hypersensitive. [GMJ.2015;4(3):104-11]

Download Full-text

Comparison of the efficiency of clomiphene citrate and letrozole in combination with metformin in moderately obese clomiphene citrate - resistant polycystic ovarian syndrome patients

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1604146b ◽

2016 ◽

Vol 144 (3-4) ◽

pp. 146-150 ◽

Cited By ~ 3

Author(s):

Artur Bjelica ◽

Aleksandra Trninic-Pjevic ◽

Ljiljana Mladenovic-Segedi ◽

Nenad Cetkovic ◽

Djordje Petrovic

Keyword(s):

Retrospective Study ◽

Polycystic Ovary Syndrome ◽

Pregnancy Rate ◽

Polycystic Ovary ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Obese Patients ◽

Ovary Syndrome ◽

Metformin Therapy ◽

Significant Difference

Introduction. Polycystic ovary syndrome is the most common endocrinopathy in women of reproductiveage. Therapy for those who want to get pregnant involves ovulation induction using clomiphene citrate, metformin, letrozole and gonadotropins. Objective. The aim of the study was to compare the efficacy of combinations of clomiphene citrate-metformin and letrozole-metformin in obese patients who are resistant to clomiphene citrate alone. Methods. The investigation was conducted as a retrospective study involving 60 moderately obese patients with polycystic ovary syndrome. Thirty-one of them received the clomiphene citrate-metformin, and 29 letrozole-metformin therapy. Stimulation was carried out for the procedures of intrauterine insemination (IUI). Results. The age of patients, duration of infertility, and body mass index in both groups were similar. There was statistically significant difference in the thickness of the endometrium in favor of the group having the letrozole-metformin therapy (8.9 ? 1.7 mm) compared with the group receiving the clomiphene citrate-metformin treatment (6.3 ? 1.3 mm). The number of follicles was not statistically significantly different. Pregnancy rate in the first cycle of IUI in the clomiphene citrate group was 6.4%, and 17.2% in the letrozole group, which also was not statistically different. After the third IUI cycle, the pregnancy rate was significantly higher in the letrozole group (20.6%), while in the clomiphene citrate group it was (9.6%). Conclusion. This retrospective study demonstrated the advantages of the use of letrozole over clomiphene citrate in combination with metformin in moderately obese patients with polycystic ovary syndrome who are resistant to stimulation with clomiphene citrate alone.

Download Full-text