Wasim Tayyiba, Nasrin Tahira, Zunair Javeria, Irshad Sonia
Tayyiba Wasim, FCPS, Department of Obstetrics and Gynaecology, Services Hospital Lahore, Lahore, Pakistan.
Tahira Nasrin, FCPS, Department of Obstetrics and Gynaecology, Services Hospital Lahore, Lahore, Pakistan.
Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):78-83. doi: 10.12669/pjms.40.1.7971.
To compare the efficacy of letrozole vs Clomiphene citrate for ovulation induction in PCOS women.
This double blind randomized controlled trial was conducted at Services Hospital, Lahore, from January 2016 to December 2020. Total 220 patients, diagnosed with PCOS according to Rotterdam criteria were randomly assigned into two groups after taking informed consent. The women were followed for ovulation, pregnancy and live birth rates in the next five consecutive menstrual cycles with either clomiphene citrate or letrozole.
Letrozole had significantly better pregnancy rate (29.0% vs 15.4% p-value 0.015), monofollicular development (77.2% vs 52.7% p-value 0.000) and live birth rate (25.4% vs 10.9% p-value 0.005) as compared to clomiphene citrate. There was no difference between the two groups in ovulation rate (68.1% vs 63.6%, p-value 0.477), early pregnancy loss (3.6% vs 4.5% p-value 0.734), and twin pregnancy (0.0% vs 1.81% p-value 0.155). There was no ectopic pregnancy and no congenital anomalies in both groups. Hot flushes were higher in clomiphene group (31.8% vs 12.7% p-value 0.001) while fatigue (30.9% vs 8.1% p-value 0.000) and dizziness (21.8% vs 10.0% p-value 0.029) was higher with letrozole but these were well tolerated.
Letrozole is better treatment choice than clomiphene citrate in PCOS women with infertility in terms of pregnancy and live birth rate. NCT05702957.
比较来曲唑与枸橼酸氯米芬对多囊卵巢综合征（PCOS）女性促排卵的疗效。
本双盲随机对照试验于2016年1月至2020年12月在拉合尔服务医院进行。根据鹿特丹标准诊断为PCOS的220例患者在获得知情同意后被随机分为两组。这些女性在接下来连续五个月经周期中接受枸橼酸氯米芬或来曲唑治疗，并随访排卵、妊娠和活产率。
与枸橼酸氯米芬相比，来曲唑的妊娠率（29.0%对15.4%，p值0.015）、单卵泡发育率（77.2%对52.7%，p值0.000）和活产率（25.4%对10.9%，p值0.005）显著更高。两组的排卵率（68.1%对63.6%，p值0.477）、早期妊娠丢失率（3.6%对4.5%，p值0.734）和双胎妊娠率（0.0%对1.81%，p值0.155）无差异。两组均无宫外孕和先天性异常。枸橼酸氯米芬组潮热发生率更高（31.8%对12.7%，p值0.001），而来曲唑组疲劳（30.9%对8.1%，p值0.000）和头晕（21.8%对10.0%，p值0.029）发生率更高，但这些症状耐受性良好。
就妊娠率和活产率而言，来曲唑是治疗PCOS不孕女性比枸橼酸氯米芬更好的选择。NCT05702957。
