Induction of Anovulation in Clomiphene Resistant Women with Endocrine Infertility

Abstract

To evaluate the efficacy of letrozole and clomiphene citrate in combination with human menopausal gonadotropin (hMG) in clomiphene citrate-resistant infertile women with PCOS. Research methods: 60 women with resistance to clomiphene citrate, of which: 26 women received letrozole + hMG, 21 women received CC + hMG and 13 women received only hMG. All women were treated according to the same scheme during the cycle. All patients were given 75 IU hMG every other day until the dominant follicle appeared. Results of the study: the incidence of monofollicles was 84.6% in the letrozole + hMG group, 66.7% in the CC + hMG group and 53.8% in the hMG only group (r<0.05 for letrozole + hMG compared with the other two groups). The number of developing follicles (follicles larger than 14 mm) and the frequency of cycle cancellation due to ovarian hyperreactivity were lowest in the letrozole + hMG group. Ovulation and pregnancy rates were similar among the three groups. The mean length of induced days and the dose of hMG IU used were significantly lower in the letrozole + hMG and CC + hMG groups compared to the hMG alone group. Conclusion. Letrozole in combination with hMG is one of the most effective methods in women with clomiphene citrate resistant polycystic ovary syndrome and prevents complications such as ovarian hyperstimulation syndrome and multiple pregnancies.