LETROZOLE FOLLOWING LAPAROSCOPIC OVARIAN DRILLING IN CLOMIPHENE RESISTANT POLYCYSTIC OVARY SYNDROME WOMEN

Abstract

Polycystic ovary syndrome (POOS) is the most common endocrine disorder in reproductive age, and it is the commonest cause of anovulatory infertility. Purpose: to evaluate letrozole for ovulation induction (OI) after laparoscopic ovarian drilling (LOD) in (clomiphene citrate) CC-resistant polycystic ovary syndrome (PCOS) women. Methods: Two hundred and forty (240) CC-resistant PCOS women were included in this study after LOD and randomized into two groups; 120 CC-resistant PCOS women received letrozole after LOD (letrozole group), and controls (120 women).Women in letrozole group received 2.5 mg of letrozole twice daily for 5 days between 2-5th days of menses for 6 consecutive cycles after LOD, while controls did not receive any OI medications after LOD for 6 months. The ovarian response, and endometrial thickness were monitored in both studied groups using trans-vaginal sonography (TVS). Pregnancy was confirmed by serum β-hCG or visualization of gestational sac after missed period. The collected data were compared in both studied groups to evaluate letrozole for OI after LOD in CC-resistant PCOS women. Results: The endometrial thickness at the time of human chorionic gonadotropins (hCG) injection was significantly higher in letrozole group compared to controls (7.5 ± 1.7 versus 6.2 ± 1.4 mm), (P=0.01, 95%CI; 0.90, 1.3, 1.69). The ovulation, and clinical pregnancy rates were significantly higher in letrozole group compared to controls (77.5% (93/120), and 60% (72/120) versus 46.7% (56/120) and 35.8% (43/120); respectively), (P=0.01, and 0.02; respectively). While, the miscarriage, multiple pregnancy, and ovarian hyperstimulation syndrome (OHSS) rates were similar with no significant difference between the two studied groups. Conclusions: The use of letrozole for OI after LOD in CC-resistant PCOS women was associated with significantly higher ovulation, and clinical pregnancy rates