Letrezole or clomide for ovulation induction in patients with unexplained infertility

الملخص EN

Background: The aim of our study to compare the efficacy of letrezole to clomiphene citrate in patient with unexplained infertility as empirical treatment.

Methods: 200 patients with unexplained infertility randomly divided into two groups the first group received( 5mg letrezole from the day 3-7 of menstrual cycle), the second group received (100 mg clomiphene citrate from the day 2-5 of menstrual cycle), follicular development followed by serial U/S, when one or more follicles reach > 18mm in diameter ovulation trigger by hCG and timed intercourse was advise later on .

Pregnancy test was performed 5 days after the miss period to confirm the pregnancy, the main outcome was the pregnancy rate and the secondary outcome was follicle development and endometrial thickness.

Result: Both groups were comparable regarding the ovulation rate (62.5% in the group B ( clomid group ) and 75.2% in group A ( letrezole group ) ( P = 0.35 ), the endometrial thickness was statistically significant difference in the letrzole group on day of HCG administration ( 6.6_+1.69 mm in the letrezole group, 5.4_+1.61 mm in the clomide group, P < 0.001).

Serum estradiol was significantly lower in letrezole group ( 456_+150 versus 922_+301 pg/ml, P < 0.001).

While the rate of multiple follicular development was greater in the group B ( clomide 55.15%, letrezole 25.41%, P=0.025), which was statistically significant.

The pregnancy occurred in 36 out 100 (36% ) in letrezole group and 12 out 100 ( 12% ) in clomide group, the difference was highly statistically significant ( P < 0.025 ).

Conclusion: Letrezole had a good efficacy and may be regard as first line treatment in patients with unexplained infertility in comparison with clomiphene citrate.