Letrozole versus laparoscopic ovarian drilling in infertile women with PCOS resistant to clomiphene citrate

Abstract

Objective: To compare the efficacy of letrozole and laparoscopic ovarian drilling (LOD) in the induction of ovulation in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). Subjects and methods: A total of 80 women with CC-resistant PCOS were enrolled and randomly allocated into groups A and B. Group A (n = 40) underwent LOD, and group B (n = 40) received 2.5 mg letrozole from days 3 to 7 of menses for up to six cycles. A 6-month follow-up was performed. Results: No statistically significant differences were found in the baseline clinical characteristics and the major serum hormone profiles, women receiving letrozole had a higher rate of ovulation (70 vs. 57.5%) and however, the differences were not statistically significant also there is significant decrease in MAH in group A. The pregnancy rate was 27.5% in group A versus 35% in group B and abortion rate was 18% in group A versus 7% in the other group. Conclusion: Letrozole had superior reproductive outcomes compared with LOD in women with CC-resistant PCOS and seems to be a suitable first-line ovulation induction instead of LOD in those patients.