Combination Letrozole and Clomiphene Citrate Versus Letrozole Alone

Summary

Clomiphene citrate is a non-steroidal triphenylethylene derivative distantly related to diethylstilbestrol. It acts as a selective estrogen receptor modulator (SERM), similar to tamoxifen and raloxifene. All three drugs are competitive inhibitors of estrogen binding to estrogen receptors (ERs) and have mixed agonist and antagonist activity, depending upon the target tissue. Letrozole is a potent, nonsteroidal, aromatase inhibitor, originally used for postmenopausal breast cancer therapy.

Eligibility

Inclusion Criteria:

* Diagnosis of infertility, defined as the inability of couple to achieve a pregnancy after 12 months of regular timed unprotected intercourse in women \<35 years of age or after 6 months in women \>35 years of age.
* Diagnosis of PCOS based on the Rotterdam criteria, including two of the following three findings: oligomenorrhea or chronic anovulation, hyperandrogenism (clinical or laboratory), and polycystic ovary(ies) on ultrasound .
* Normal HSG
* Normal semen analysis.
* Has capacity to participate in the study.

Exclusion Criteria:

* Unexplained infertility.
* Other conditions that can cause chronic anovulation and androgen excess such as hyperthyroidism by thyroid profile.
* congenital adrenal hyperplasia
* Cushing
* Untreated hyperprolactinemia.
* Medical conditions not well controlled or contraindicated to get pregnant with it like (uncontrolled diabetes mellitus, hypertension) .
* endometrial hyperplasia/cancer
* Allergy or contraindications to letrozole or CC. (by history)

Conditions2

Interventions1

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