TITLE:
Letrozole versus Gonadotropin in Unexplained Infertile Couples Failed to Conceive with Clomiphene Citrate
AUTHORS:
Moustafa Abbas Ibrahaiem, Sherin A. Shazly, Khaled F. Helal, Hala Mowafy, Manal M. El Behery
KEYWORDS:
Letrozole, Gonadotropin, Infertility, Clomiphene Citrate
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.10,
July
28,
2014
ABSTRACT:
Background:Unexplained
infertility represents about 15% - 20% of infertile couples. Usually, these
cases need assistance. Clomiphene citrate is the most used drug for this
problem but sometimes pregnancy failed to achieve it, so other options for
assistance are gonadotrophin or letrezole. The objective of our study was to
compare the pregnancy rate for letrezole and gonadotropin inunexplained infertile
women’s who failed to conceive with clomiphene citrate. Methods: This
prospective quasi-randomized trial was carried out in cytogenetic unite at
obstetrics and gynecology department, Zagazig University Hospital. 140
infertile females were included, induction of ovulation by letrozole for half
of them and by gonadotrophin for the other half. Results: There was
statistically highly significant decrease in duration of stimulation, E2 levels
and endometrial thickness at day of HCG in letrezole group, no significant
difference between two groups as regard number of follicles and pregnancy rate
per cycle, while the cumulative pregnancy rate and the cost of stimulation are
significantly higher in gonadotrophin group. Conclusion: In patient with
unexplained infertility who failed to conceive with clomiphene citrate,
gonadotrophins have a higher pregnancy rate than letrezole. However, pregnancy
rate was high enough with lower cost with letrezole to be acceptable and
justified its use in this group of patients.