Letrozole versus clomiphene citrate in polycystic ovary syndrome: a meta-analysis of randomized controlled trials

@article{Hu2018LetrozoleVC,
  title={Letrozole versus clomiphene citrate in polycystic ovary syndrome: a meta-analysis of randomized controlled trials},
  author={Shifu Hu and Qiong Yu and Yingying Wang and mei Wang and Wei Xia and Changhong Zhu},
  journal={Archives of Gynecology and Obstetrics},
  year={2018},
  volume={297},
  pages={1081-1088}
}
PurposePolycystic ovary syndrome (PCOS) is a common endocrine disturbance affecting women in the reproductive age group. The present study aimed to compare the effects of letrozole (LE) and clomiphene citrate (CC) for ovulation induction in women with PCOS.MethodsThe PUBMED, Web of Science, and EMBASE databases were screened systematically for randomized controlled trials (RCTs) published from database inception to July 2017.ResultsEleven RCTs involving 2255 patients were included, and data… 

Letrozole and Clomiphene citrate versus Letrozole alone in ovulation induction for patients with Polycystic Ovarian Syndrome

TLDR
Although there is absolute difference between the two groups in favor of the combined use of letrozole plus clomiphene citrate, this difference is not statistically significant and these new findings indicate that this combined therapy might be a low-risk, low-cost infertility treatments.

Higher ovulation rate with letrozole as compared with clomiphene citrate in infertile women with polycystic ovary syndrome: a systematic review and meta-analysis

TLDR
A higher probability of ovulation is expected in infertile patients with PCOS treated with letrozole as compared to clomiphene citrate, and the higher ovulation rate might have contributed to the higher clinical pregnancy and live birth rate.

COMPARATIVE STUDY BETWEEN CLOMIPHINE CITRATE AND LETROZOLE FOR OVULATION INDUCTION IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

TLDR
Letrozole is preferable on clomiphene citrate regarding higher pregnancy rate as well as monofollicles that will decrease the risk of multiple pregnancies which is clearly observed with clomine citrate.

Clomiphene citrate plus letrozole versus clomiphene citrate alone for ovulation induction in infertile women with chronic anovulation: A randomized controlled trial

TLDR
There was no significant difference between combination CC plus letrozole and CC alone relative to their ability to induce ovulation in infertile women with chronic anovulation.

ANALYSIS OF COMPARISON OF PREGNANCY OUTCOMES IN INFERTILE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME USING LETROZOLE

TLDR
It was showed that letrozole was superior to clomiphene as a treatment for an ovulatory infertility in women with the polycystic ovary syndrome and was associated with higher live-birth and ovulation rates.

Letrozole for patients with polycystic ovary syndrome

TLDR
It is demonstrated that the efficacy of letrozole is not superior to the clomiphene in patients with PCOS, and no adverse events differ significantly between 2 groups.

Letrozole Versus Clomiphene Citrate and Natural Cycle: Endometrial Receptivity During Implantation Window in Women With Polycystic Ovary Syndrome

TLDR
Endometrial receptivity during the implantation window of LE is superior to CC in PCOS women, which may be related to higher clinical pregnancy and ongoing pregnancy rates.

A Randomized Trial of Combined Letrozole with Metformin Versus Clomiphene Citrate with Metformin in Polycystic Ovary (PCOS) patients

TLDR
Both CC and letrozole are equally effective in treatment of infertility in PCOS patients, when combined with metformin treatment.

Clomiphene-Metformin in Comparison with Letrozole-Metformin in Overweight Infertile Women with PCOS

TLDR
CC and letrozole are similarly viable in the treatment of overweight women with PCOS, when joined with metformin treatment.

Changes in serum markers of patients with PCOS during consecutive clomiphene stimulation cycles: a retrospective study

TLDR
Two cycles of CC-stimulation that did not lead to a pregnancy were accompanied by mean LH, AMH, and LH:FSH ratio declines and an SHBG increase.

References

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Letrozole versus clomiphene citrate in polycystic ovary syndrome: systematic review and meta-analysis

TLDR
This study found that letrozole is superior to CC when considering the live birth and pregnancy rates in patients with PCOS.

A prospective randomized trial comparing the efficacy of Letrozole and Clomiphene citrate in induction of ovulation in polycystic ovarian syndrome

TLDR
The effect of letrozole showed a better endometrial response and pregnancy rate compared with CC, and patients of anovulatory polycystic ovarian syndrome with infertility became pregnant.

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TLDR
In the absence of supportive high-quality evidence, AIs should not be recommended as the first-line pharmacological therapy for infertility in women with PCOS, and further research is needed.

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TLDR
Letrozole has beneficial effect on endometrium, thereby potentially increasing pregnancy rates after successful ovulation induction in women with PCOS.

Efficacy of letrozole in ovulation induction compared to that of clomiphene citrate in patients with polycystic ovarian syndrome.

TLDR
Letrozole might be an acceptable alternative to clomiphene citrate to induce ovulation and pregnancy in PCOS patients, and the number and the size of mature follicles were similar between the 2 groups.

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TLDR
Letrazole may have a role as the first-line treatment for unovulatory patients with polycystic ovary syndrome and primary infertility and there was no significant difference in pregnancy rate between the two groups.

Comparison of the Effects of Letrozole and Clomiphene Citrate on Ovulation and Pregnancy Rate in Patients with Polycystic Ovary Syndrome

TLDR
The aim of this study was to compare the effects of letrozole and clomiphene citrate on ovulation and pregnancy rate in patients with polycystic ovary syndrome.

Comparison of Letrozole and Clomiphene Citrate in Women with Polycystic Ovaries Undergoing Ovarian Stimulation

TLDR
Letrozole is associated with a higher pregnancy rate than CC in PCO patients and may have a role as a first-line treatment for anovulatory patients with PCOs.