Publication:

A comparative study of the efficacy of letrozole versus clomiphene citrate for ovulation induction in anovulatory cycle in subfertile women

Background Anovulation is a leading cause of female infertility, with clomiphene citrate (CC) and letrozole (LTZ) being commonly used agents for ovulation induction. While CC has been the first-line therapy, its anti-estrogenic effects may impair endometrial receptivity. LTZ, an aromatase inhibitor, offers a potentially superior alternative by enhancing follicular sensitivity without adverse endometrial effects.

Methods This randomized controlled trial was conducted at the department of obstetrics and gynecology, Government Medical College and Hospital, Akola, Maharashtra, involving subfertile women with anovulatory cycles. Participants were allocated to receive either CC or LTZ. Outcomes assessed included ovulation rate, pregnancy rate, cycles to conception, single follicle formation, and endometrial thickness. Data were analyzed using appropriate statistical methods.

Results Letrozole demonstrated higher ovulation and pregnancy rates compared to clomiphene citrate. LTZ was associated with improved endometrial thickness and a greater proportion of monofollicular development. Fewer side effects and complications were observed in the LTZ group. The number of cycles required for conception was lower with LTZ.

Conclusions Letrozole is more efficacious than clomiphene citrate for ovulation induction in anovulatory subfertile women. It offers better endometrial receptivity, higher pregnancy rates, and fewer adverse effects, making it a preferable first-line agent in selected cases.