Efficacy of combined letrozole-metformin in comparison with letrozole only in clomiphene resistant infertile women with polycystic ovarian syndrome: a randomized controlled trial

Abstract

The aim of the work is to compare and determine the efficacy of combined metformin-letrozole administration in comparison with letrozole only in ovulation induction and the reproductive outcome in clomiphene – resistant infertile women with PCOS.The sample was 80 Women with PCOS and clomiphene citrate resistance. This study sample was allocated into two groups group (1) that received letrozole plus metformin, and group (2) that received letrozole only. All participants were followed up for 6 cycles and during this period monitoring through transvaginal ultrasonography was done every other day from day 12 of the cycle to assess follicular growth,number of follicles and endometrial thickness until at least one follicle reach 18 mm or more or reaching day 18.HCG was administered to those in whom at least one ovarian follicle reached 18 mm or more in size. The study revealed that Ovulation was 43.68 % in group (1) and 31.69 % in group (2) but without significant differences between both groups. pregnancy occurred in 8 women in group (1) and in 5 women in group (2) (20 % vs. 12.5 %) with no statistically significant differences between the two groups.