Extended Letrozole Versus Recombinant FSH in Ovulation Induction in Cases of Clomiphene Citrate Resistant Polycystic Ovary

Background: Clomiphene citrate (CC) is still the traditional therapy used for inducing ovulation in polycystic ovary syndrome (PCOS). Clomiphene resistance, which refers to persistence of anovulation after standard CC therapy, occurs in 15%–20% of patients. We aimed to compare between extended letrozole versus recombinant FSH in ovulation induction in cases of clomiphene resistant polycystic ovary

Methods: Seventy women with PCOS were included then patients were equally randomized to receive one of the two drugs to be given over the next 3 months. In current study Group A: letrozole group 2.5 mg two tablets once daily for 10 days from day 2 of menses. Group B: Recombinant FSH 75 i.u s.c daily from day 2 for 5 days then monitoring dose according to folliculometry.

Results: There was non-significant difference between two groups as regard FSH and LH but as regard Serum E2 (pg/mL) at day 5 of HCG administration there was significant higher in FSH recombinant group. There was insignificant difference between two groups as regard Ovulating, Number of follicles >18. There was insignificant difference between two groups as regard Size of dominant follicle, endometrial thickness at hCG (mm). OHSS, discontinuation due to OHSS, clinical pregnancy, multiple pregnancy and abortion was higher in FSH recombinant group but differences didn’t reach significance.

Conclusions: There was non-significant difference between two groups in relation to ovulation, Number of follicles, Size of dominant follicle, Endometrial thickness at day of HCG injection however it was reported that OHSS, discontinuation due to OHSS, positive pregnancy test, was higher in FSH recombinant group but differences didn’t reach significance level.