الفهرس 
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Abstract
COMPARISON BETWEEN LETROZOLE AND CLOMIPHENE CITRATE IN OVULATION INDUCTION IN WOMEN HAVING POLYCYSTIC OVARY DISEASE
Ola Ahmed Abd El-Maksoud
ABSTRACT
The aim of this study was to compare between the effect of Clomiphene citrate and letrozole as regard:
- Number and diameter of follicles equal or more than 18 mm.
- Endometrial thickness on day of hCG injection.
- Ovulation rate.
- Pregnancy rate.
The study included sixty infertile women who were diagnosed as having PCOS. Women were subdivided into two groups.
Group (I) include sixty infertile women who were given Letrozole (Femara, Novartis) orally in a dose of 2.5 mg two times daily starting cycle day 3 to 7 of menstrual cycle.
Group (II) includes thirty women who were given CC orally in a dose of 50 mg two times daily starting cycle day 3 to 7 of menstrual cycle.
Women participating in this study were submitted for:
1. Full history taking.
2. General examination.
3. Abdominal examination.
4. Local examination.
5. Base line ultrasound.
6. Hormonal profile. (FSH, LH, TSH, Prolactin)
7. Regular follow up of ovulation with folliculometry by transvaginal ultrasound starting from cycle day 10 for growing of follicle to reach 18 mm or more, occurrence of ovulation as evidenced by rupture of mature follicle & presence of corpus luteum, or presence of fluid in Douglas pouch
8. hCG (10000 IU) was given when at least one follicle reached 18mm or more.
9. Women advised to have intercourse 24 – 36 hours after hCG.
10. Serum hCG was measured after 2 weeks to diagnose pregnancy.
The results of this study can be summarized in the following:
There were no statistical significant differences as regard age, duration of infertility, BMI, and the relative incidence of clinical signs of PCOS among women included in the study.
There was statistically significant difference between the two groups as regard the number of stimulated mature follicles where letrozole tends to stimulate less number than Clomiphene
There was no statistically significant difference as regard follicular diameter of 18mm,but there was significant difference as regard follicular diameter >18mm between both groups.
There was a highly statistical significant difference in endometrial thickness as measured by transvaginal ultrasound among women of group (I) as compared to women of group (II), at time of hCG administration.
There was a highly statistical significant difference as regard the number of women showing evidence of ovulation between both groups.
Follicular maturity was achieved in a relatively shorter period among women in group I than those of group II.
As regard the comparison of the side effects of letrozole and CC, both drugs were generally tolerated with no significant differences in relative incidence of side effects.
There was a significant difference as regard percentage of pregnancy in women included in this study.