Treating Infertility: Is taking letrozole alone, or in combination with clomiphene more effective in women with polycystic ovary syndrome?

This study examined if ovulation rates are higher in women with polycystic ovary syndrome (PCOS) when taking letrozole (Femara) alone, or combined with clomiphene citrate (Clomid).

This study concluded that ovulation rates are higher with the combination treatment in these women.

PCOS is a common cause of female infertility which can be difficult to treat. It is caused by cysts on the ovaries. Ovarian cysts can lead to an overproduction of male hormones (androgens). It can also cause irregular or reduced periods (oligomenorrhea). This leads to a lower rate of ovulation (the release of eggs to be fertilized).

Letrozole (LTZ) and clomiphene citrate (CC) are drugs used to stimulate ovulation in women with PCOS. They are usually given as monotherapy (single drug treatment). It is unclear if taking LTZ alone, or in combination with CC is more likely to increase ovulation rates in women with PCOS.

This study included 70 patients with PCOS. LTZ alone was taken by 35 patients, and 35 patients received both LTZ and CC (combination group). Both groups received the drugs on days 3-7 of one menstrual cycle.

Women who received both LTZ and CC had higher ovulation rates when compared with those who took LTZ alone (77% vs. 43%). 

There were no serious side effects reported. The number of minor side effects was similar in both groups. These included headaches (41% – LTZ vs. 28% – combination) and stomach pain/cramps (19% in each group).  

This study concluded that ovulation rates are higher when LTZ is taken in combination with CC, in women with PCOS.

The number of patients in this study was low. Larger studies are needed to confirm these findings. This study only included patients who took the drugs for one cycle.

If you have any concerns regarding fertility treatment, please consult with your physician.