Ayesha Nasir, Saira Nazeer, Haleema Yasmin, Razia Korejo.
Letrazole for Ovulation Induction in Clomiphene Resistant Women with Polycystic Ovarian Syndrome.
J Surg Pak Jan ;20(1):28-31.

Objective: To determine the frequency of successful ovulation induction with letrozole in infertile women with polycystic ovarian (PCO) syndrome who were resistant to clomiphene citrate. Study design: Descriptive case series. Place & Duration of study: Department of Gynaecology and Obstetrics ward-8, Jinnah Postgraduate Medical Center Karachi, from September 2009 to March, 2010. Methodology: Women between 20-40 year of age with history of PCO and primary infertility of at least one year duration who failed induction on clomiphene citrate for at least 2 months, were included in the study. After taking informed consent and counseling letrozole was given in a dose of 2.5 mg daily from day 3-7 of menstrual period. Patients were monitored by transvaginal ultrasound scan (TVS). The mean follicular diameter was noted on day 10, 12, 14, and 16. This was followed by HCG injection 10000 IU and serial monitoring of the follicles till 18mm size reached. Results: Sixty seven patients were selected. Mean age was 27.6 ± 3.3 year and mean duration of infertility was 4.3 ± 1.6 year. Fifteen (22.4%) of patients had infertility for 4 years, 13 (19.4%) had for 5 years and 12 (17.9%) for 6 years. Ovulation was successfully induced in 33 (49.3%) women. Conclusion: Letrozole can be used as a second line agent when there is resistance to clomiphene citrate, a first-line treatment, for induction of ovulation in women with polycystic ovarian syndrome.

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