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Comparison of Letrozole Combined With Gonadotropins Versus Clomiphene Citrate Combined With Gonadotropins in Infertile Women Presenting With Polycystic Ovary Syndrome (PCOS)

Dr Musharib Butt1, Prof. Dr. Madeeha Rashid1, Prof. Dr. Amna Zia Eusaph1, Dr. Usman Iftikhar1, Dr. Auoon Tariq2, Dr. Saad Zahid3
1Obstetrics and Gynecology, FJMU, Sir Ganga Ram Hospital, Lahore
2Internal Medicine, Hamid Latif Hospital, Lahore
3Gastroenterology, Mayo Hospital, Lahore
DOI: https://doi.org/10.70517/revcc2624154
Published: 13/10/2026
: Dr Musharib Butt, Prof. Dr. Madeeha Rashid, Prof. Dr. Amna Zia Eusaph, Dr. Usman Iftikhar, Dr. Auoon Tariq, Dr. Saad Zahid. Comparison of Letrozole Combined With Gonadotropins Versus Clomiphene Citrate Combined With Gonadotropins in Infertile Women Presenting With Polycystic Ovary Syndrome (PCOS). Revista Cultura Científica, 2026 Issue 24. pg. 1842-1850.

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age and an important cause of anovulatory infertility. Although clomiphene citrate (CC) has traditionally been used for ovulation induction, letrozole is increasingly preferred because of its favorable effects on ovulation and its limited peripheral antiestrogenic activity. This randomized controlled trial compared clinical pregnancy outcomes following letrozole combined with gonadotropins and CC combined with gonadotropins among infertile women with PCOS. The study was conducted in the Department of Obstetrics and Gynecology, Sir Ganga Ram Hospital, Lahore, from November 2025 to April 2026. A total of 110 women aged 20–39 years were randomized into two groups of 55. Group L received letrozole 2.5 mg daily on cycle days 2–6, while Group CC received CC 50 mg daily on the same days. Both groups subsequently received gonadotropins at 75 IU daily from cycle day 7, with treatment offered for up to three consecutive cycles. Ovulation was triggered using 10,000 IU of human chorionic gonadotropin once the dominant follicle reached at least 18 mm. Clinical pregnancy was assessed using serum β-hCG testing and transvaginal ultrasonographic confirmation of an intrauterine gestational sac. Data were analyzed using SPSS version 26. Clinical pregnancy occurred in 17 of 55 women (30.9%) in Group L and 4 of 55 women (7.3%) in Group CC. The between-group difference was statistically significant (two-sided Fisher exact test, p = 0.0029). These findings indicate that, in this single-center sample, the letrozole–gonadotropin regimen was associated with a higher clinical pregnancy rate than the CC–gonadotropin regimen. The study did not provide sufficient adverse-event or live-birth data to establish comparative safety or longer-term reproductive outcomes. Further multicenter trials with transparent allocation procedures, complete safety reporting, and live-birth follow-up are warranted.

Keywords: clomiphene citrate; gonadotropins; infertility; letrozole; ovulation induction; polycystic ovary syndrome; clinical pregnancy

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age and an important cause of anovulatory infertility. Although clomiphene citrate (CC) has traditionally been used for ovulation induction, letrozole is increasingly preferred because of its favorable effects on ovulation and its limited peripheral antiestrogenic activity. This randomized controlled trial compared clinical pregnancy outcomes following letrozole combined with gonadotropins and CC combined with gonadotropins among infertile women with PCOS. The study was conducted in the Department of Obstetrics and Gynecology, Sir Ganga Ram Hospital, Lahore, from November 2025 to April 2026. A total of 110 women aged 20–39 years were randomized into two groups of 55. Group L received letrozole 2.5 mg daily on cycle days 2–6, while Group CC received CC 50 mg daily on the same days. Both groups subsequently received gonadotropins at 75 IU daily from cycle day 7, with treatment offered for up to three consecutive cycles. Ovulation was triggered using 10,000 IU of human chorionic gonadotropin once the dominant follicle reached at least 18 mm. Clinical pregnancy was assessed using serum β-hCG testing and transvaginal ultrasonographic confirmation of an intrauterine gestational sac. Data were analyzed using SPSS version 26. Clinical pregnancy occurred in 17 of 55 women (30.9%) in Group L and 4 of 55 women (7.3%) in Group CC. The between-group difference was statistically significant (two-sided Fisher exact test, p = 0.0029). These findings indicate that, in this single-center sample, the letrozole–gonadotropin regimen was associated with a higher clinical pregnancy rate than the CC–gonadotropin regimen. The study did not provide sufficient adverse-event or live-birth data to establish comparative safety or longer-term reproductive outcomes. Further multicenter trials with transparent allocation procedures, complete safety reporting, and live-birth follow-up are warranted.

Keywords: clomiphene citrate; gonadotropins; infertility; letrozole; ovulation induction; polycystic ovary syndrome; clinical pregnancy

References

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Dr Musharib Butt
Obstetrics and Gynecology, FJMU, Sir Ganga Ram Hospital, Lahore
musharibtariq14@gmail.com
Prof. Dr. Madeeha Rashid
Obstetrics and Gynecology, FJMU, Sir Ganga Ram Hospital, Lahore
Prof. Dr. Amna Zia Eusaph
Obstetrics and Gynecology, FJMU, Sir Ganga Ram Hospital, Lahore
Dr. Usman Iftikhar
Obstetrics and Gynecology, FJMU, Sir Ganga Ram Hospital, Lahore
Dr. Auoon Tariq
Internal Medicine, Hamid Latif Hospital, Lahore
Dr. Saad Zahid
Gastroenterology, Mayo Hospital, Lahore

How to cite:

Dr Musharib Butt, Prof. Dr. Madeeha Rashid, Prof. Dr. Amna Zia Eusaph, Dr. Usman Iftikhar, Dr. Auoon Tariq, Dr. Saad Zahid. Comparison of Letrozole Combined With Gonadotropins Versus Clomiphene Citrate Combined With Gonadotropins in Infertile Women Presenting With Polycystic Ovary Syndrome (PCOS). Revista Cultura Científica, 2026 Issue 24. pg. 1842-1850.

Publication History

  • Received: 09/06/2026
  • Accepted: 01/10/2026
  • Published: 13/10/2026
Copyright © 2026, Dr Musharib Butt, Prof. Dr. Madeeha Rashid, Prof. Dr. Amna Zia Eusaph, Dr. Usman Iftikhar, Dr. Auoon Tariq, Dr. Saad Zahid. Published by Revista Cultura Científica. This article is published as open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (http://creativecommons.org/licenses/by/4.0/).

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