Letrozole following laparoscopic ovarian drilling in women with clomiphene resistant polycystic ovary syndrome

Abstract EN

Objective: To assess the effect of letrozole use after laparoscopic ovarian drilling (LOD) in patients with clomiphene citrate (CC) resistant polycystic ovary syndrome (PCOS).

Method: This prospective randomized trial was conducted at Al-Azhar University Hospitals in Cairo (Al-Hussein and Sayed Galal Hospitals and Assuit) between October 2013 and March 2016.

The study included 80 women with CC resistant PCOS underwent LOD were randomly allocated to receive letrozole from day 3 to day 7 of menses for 6 consecutive cycles (group I), or not to receive any drug for induction of ovulation after LOD (group II).

Rates of ovulation, pregnancy, miscarriage, endometrial thickness, multiple pregnancy and ovarian hyper stimulation syndrome (OHSS) were evaluated.

Results: Both groups were similar with regard to baseline clinical characteristics and hormonal profiles.

Group I (letrozole group) showed a statistical significant increase of rates of ovulation and clinical pregnancy than those in group II [31 (77.5%) vs 21 (52.5%) and 24 (60%) vs 15 (37.5%) respectively; P < 0.05].

Whereas there were no significant differences between both groups regarding rates of miscarriage, endometrial thickness, multiple pregnancy or OHSS.

Conclusion: Induction of ovulation using letrozole in women suffering CC resistant PCOS after LOD is associated with increased rates of ovulation and clinical pregnancy.

Therefore letrozole is recommended for these women.