الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Polycystic ovary syndrome is the most common endocrinological disorder in women of reproductive age. It is commonly associated with an ovulatory subfertility, for which there are a range of treatment options available to help them conceive. These options are given in a step-wise manner with an appropriate selection of patients to maximize success rates with minimal complications.
Clomiphene citrate (CC) continues to be the drug of choice for ovarian stimulation in intrauterine insemination (IUI) cycles. However, 20–25% of the women are resistant to CC and fail to ovulate. In such cases, the traditional option is to administer gonadotropins, though it is associated with an enhanced risk of multiple pregnancies and ovarian hyperstimulation. Several research groups have observed a higher pregnancy rate with gonadotropin therapy as compared to oral ovulation inducing agents in women failing to conceive with CC/IUI. Recently, a consensus has been reached on the use of either exogenous gonadotropins or laparoscopic ovarian surgery in CC-resistant women as a second-line of intervention.
Gonadotropins (FSH/HMG) used in combination with CC decrease the dose required for optimum stimulation and make it more cost-effective in women who fail to respond to CC treatment. Acceptable pregnancy rates with sequential CC and HMG ovulation induction in IUI following previous CC and IUI treatment failure are reported.
The concept of using aromatase inhibitors (AIs) as a new method of ovulation induction had been extensively investigated by several research groups in the past few years. Letrozole, a highly selective AI,