Publication:

Clomiphene citrate versus letrozole with gonadotropins in intrauterine insemination cycle

Background This study aimed to evaluate and compare the efficacy of clomiphene citrate (CC) and letrozole, both alone and in combination with gonadotropins, for ovulation induction in infertile women.

Methods A total of 200 participants were divided into four groups: CC alone, letrozole alone, CC plus gonadotropins, and letrozole plus gonadotropins. Ovulation was monitored via transvaginal ultrasonography, with human chorionic gonadotropin (HCG) administered to trigger ovulation when follicles reached ≥18 mm. Intrauterine insemination (IUI) was performed 24-36 hours post-HCG administration.

Results The letrozole plus gonadotropins group exhibited the highest ovulation rate (86%), followed by CC plus gonadotropins (84%), letrozole alone (72%), and CC alone (70%). Endometrial thickness was significantly greater in the letrozole group (8.53±1.40 mm) compared to the CC group (7.47±0.89 mm; p=0.000), and the size of the dominant follicle was also larger with letrozole (19.20±4.87 mm) than with CC (17.54±5.44 mm; p=0.02).

Conclusions Letrozole, particularly when combined with gonadotropins, may be more effective than CC in inducing ovulation and enhancing endometrial receptivity, thereby potentially improving pregnancy outcomes in infertile women.