Letrozole vs clomiphene citrate in Sudanese patients with infertility secondary to polycystic ovary syndrome

PCOS is a cluster of metabolic, hormonal, and environmental factors coupled with infertility in patients within reproductive age. This cross-sectional study compared letrozole (LTZ) vs Clomiphene citrate (CC) as ovulation inducers in infertile Sudanese patients with PCOS. Follicles >18 mm and pregnancy tests were used for comparison. SPSS version 23 was used for analysis. Significance was calculated with Chi-square, t-test, and logistic regression. P < 0.05 was considered significant. Our results showed 49% of the patients were 20-30 years old, 60% had secondary infertility 98.4% were secondary to PCOS and 64% had a family history of infertility. Comparable results on positive pregnancy tests of 26% (P < 0.017) and 17% (P < 0.027) were observed for LTZ vs CC respectively. Similar strengths (P < 0.000) in compacting the ovarian cysts were recorded. LTZ showed less activity (P < 0.013) on follicles size maturation compared to (P < 0.000) with CC. The endometrial thickness was increased with LTZ (51.87%) but reduced with CC (25.54%). The positive pregnancy test was associated with age and BMI. Conclusion: Letrozole 20 mg single dose showed comparable results on positive pregnancy tests but less significance on follicle maturation compared to CC100mg. Both drugs compacted the ovarian cysts' sizes. letrozole significantly increased the endometrial lining thickness.

Automated summary

PCOS is a complex condition characterized by metabolic, hormonal, and environmental factors, along with infertility in women of reproductive age. This study compared letrozole and clomiphene citrate as ovulation inducers in infertile Sudanese patients with PCOS. The results showed comparable rates of positive pregnancy tests and similar effects on compacting ovarian cysts between letrozole and clomiphene citrate. However, letrozole had a lesser impact on follicle maturation and resulted in increased endometrial thickness compared to clomiphene citrate.