Objective: To compare the clinical, metabolic, and hormonal characteristics of patients with and without selected dominant follicles in infertile women with PCOS who used letrozole for ovulation induction.
Study design: A descriptive cohort study.
Place and duration of study: Department of Obstetrics and Gynaecology of Bagcilar Research and Training Hospital, Istanbul, Turkey, from October 2019 to November 2021.
Methodology: Eighty-eight female patients with PCOS, who underwent ovulation induction by giving 5 mg/day letrozole, were screened for demographic characteristics, laboratory values, and dominant follicle development. Those who were given letrozole as the first treatment agent, those who took clomiphene citrate (CC) and started letrozole the following month, and those who were treated with letrozole and given letrozole again were recorded separately. Seventy-five patients responded to letrozole and developed a dominant follicle; 13 patients did not develop a dominant follicle. Threshold values were determined for statistically significant parameters between patients with and without dominant follicles.
Results: Follicle development occurred in 85.2% of the women. A statistically significant variable in clinical and metabolic values, between ovulating and non-ovulating groups could not be found. There was a significant difference between the two groups for the serum AMH value, total testosterone value, and FSH level. The authors found that follicle response was higher in those with AMH values less than 11.89 ng/mL, FSH levels higher than 6.25 Iu/L, and total testosterone less than 0.96 ng/mL. In this study, the pregnancy rate was found to be lower than in the literature (11%).
Conclusion: Among the women with PCOS who had ovulation induction with letrozole, follicle development was higher in women with lower FSH, androgen and AMH values.
Key words: Letrozole, Aromatase inhibitor, Androgens, Ovulation induction, AMH.