Efficacy of clomiphene citrate versus letrozole in attaining optimum follicular growth.

Abstract

Department of Obstetrics and Gynecology, Isra University Hospital Sindh Pakistan. Objectives: To compare the efficacy of clomiphene citrate versus letrozole in attaining optimum follicular growth among infertile women of reproductive age group in Isra University Hospital Hyderabad. Study Design: Randomized Controlled trial. Setting: Department of Obstetrics and Gynecology, Isra University Hospital Sindh, Pakistan. Period: May 2016 to November 2016. Material & Methods: A total of 128 women with anovulation due to known endocrine disorders were included in this study. These were randomly allocated in group 1 and 2. Group 1 consisted of 64 women received 50mg of clomiphene citrate and 64 in group 2, treated with letrozole. Proformas were filled and results regarding the drug achieving follicular diameter of >18mm by Trans abdominal Ultrasound in maximum number of women in any of the group was supervised by consultant gynecologist practicing for more than 10 years. Stastical analysis was done using SPSS version 19.The average age of women was 27.21+3.21. Number of patients with primary infertility were 60 (93.8%) and 57 (89.1%) in group 1 and 2 respectively while secondary infertility was observed in 4 (6.3%) and 7(10.9%) in group 1 and 2 respectively. Regarding endocrine disorders, 34 (26.6%) were polycystic ovaries and 35(27.3%) hypothalamic. Results: The average age of women was 27.21±3.21 years. Efficacy was significantly high in clomiphene citrate (group 1) as compared to letrozole (group 2) [92.19% vs 79.69%; p=0.042]. Conclusion: This study demonstrates that clomiphene citrate is superior to letrozole as an inducer of ovulatory cycles. However there is need for larger well designed randomized trials to generate robust data in order to establish the true potential of clomiphene.