Letrozole vs clomiphene citrate in Sudanese patients with infertility secondary to polycystic ovary syndrome

Warda Salah Elkhalifa; Hayat Mohamed Suliman; Iman H Abdoon; Walaa Mohamed; Bashier Osman

doi:10.1016/j.heliyon.2023.e18107

Letrozole vs clomiphene citrate in Sudanese patients with infertility secondary to polycystic ovary syndrome

Heliyon. 2023 Jul 10;9(7):e18107. doi: 10.1016/j.heliyon.2023.e18107. eCollection 2023 Jul.

Authors

Warda Salah Elkhalifa¹, Hayat Mohamed Suliman², Iman H Abdoon², Walaa Mohamed³, Bashier Osman²

Affiliations

¹ Clinical Pharmacy, Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Sudan.
² Pharmacology, Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Sudan.
³ Khartoum North Teaching Hospital, Sudan.

Abstract

PCOS is a cluster of metabolic, hormonal, and environmental factors coupled with infertility in patients within reproductive age. This cross-sectional study compared letrozole (LTZ) vs Clomiphene citrate (CC) as ovulation inducers in infertile Sudanese patients with PCOS. Follicles ≥18 mm and pregnancy tests were used for comparison. SPSS version 23 was used for analysis. Significance was calculated with Chi-square, t-test, and logistic regression. P ≤ 0.05 was considered significant.Our results showed 49% of the patients were 20-30 years old, 60% had secondary infertility 98.4% were secondary to PCOS and 64% had a family history of infertility. Comparable results on positive pregnancy tests of 26% (P ≤ 0.017) and 17% (P ≤ 0.027) were observed for LTZ vs CC respectively. Similar strengths (P ≤ 0.000) in compacting the ovarian cysts were recorded. LTZ showed less activity (P ≤ 0.013) on follicles size maturation compared to (P ≤ 0.000) with CC. The endometrial thickness was increased with LTZ (51.87%) but reduced with CC (25.54%). The positive pregnancy test was associated with age and BMI.

Conclusion: Letrozole 20 mg single dose showed comparable results on positive pregnancy tests but less significance on follicle maturation compared to CC100mg. Both drugs compacted the ovarian cysts' sizes. letrozole significantly increased the endometrial lining thickness.

Keywords: Clomiphene citrate; Infertility; Letrozole; Polycystic ovary syndrome; Pregnancy inducers; Sudanese patients.