PREGNANCY ACHIEVEMENT USING LETROZOLE VERSUS CLOMIPHENE CTTRATE IN ANOVULATORY WOMEN WITH POLYCYSTTC OVARIAN SYNDROME

Background: The most prevalent type of anovulatory infertility that occurs in women of reproductive age is polycystic ovarian syndrome (PCOS). Clomiphene citrate has been used in ovulation induction for a long time, but the anti-estrogenic effects can impair pregnancy outcomes. Aromatase inhibitor, letrozole, has been introduced as a viable alternative to improve the ovulation and pregnancy ratio. Objective: To compare the rate of pregnancy achievement between letrozole and clomiphene citrate in anovulatory women with polycystic ovarian syndrome. Materials and Methods: The study was a randomised controlled trial, which was carried out in the Allama Iqbal Teaching Hospital, Dera Ghazi Khan, from 1st December, 2023 to 30th May, 2024. One hundred and six non-probability consecutive sampling women with anovulatory PCOS were enrolled and randomized into two equal groups. Group A was given letrozole 5mg/kg/day, and Group B was given clomiphene citrate 100mg/kg/day during days 5 to 9 of the menstrual cycle. The results of ovulation and pregnancy were measured within 12 weeks. The analysis of data was done with SPSS version 25. Results: There was a similarity in the mean baseline characteristics in both groups. The ovulation rate among women in the letrozole group (92.5%) was higher than the rate among women in the clomiphene group (83.0%) (p=0.04). The achievement of pregnancy was much higher in the letrozole group (42.2%) compared to the clomiphene citrate group (20.8%) (p=0.01). Letrozole demonstrated better pregnancy outcomes in both the obese and non-obese groups. Conclusion: Letrozole has been proven to be more effective than clomiphene citrate in the achievement of pregnancy in anovulatory women with PCOS. It is to be viewed as the preferred initial ovulation induction agent, especially in resource-constrained environments.