{Reference Type}: Journal Article
{Title}: Effects of letrozole alone or in combination with gonadotropins on ovulation induction and clinical pregnancy in women with polycystic ovarian syndrome: a systematic review and meta-analysis of randomized controlled trials.
{Author}: Baradwan S;Al-Shalhoub F;Alshahrani MS;Himayda S;AlSghan R;Sabban H;Ahmad IH;Sayed MFME;Mohamad EO;AlAmodi AA;Abdelhakim AM;Shaheen K;
{Journal}: Hormones (Athens)
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jan 27
{Factor}: 3.419
{DOI}: 10.1007/s42000-024-00531-4
{Abstract}: <B>OBJECTIVE: </B>To compare letrozole in combination with gonadotropins versus letrozole monotherapy in ovulation induction and clinical pregnancy among infertile women with polycystic ovarian syndrome (PCOS).<BR><B>METHODS: </B>Several databases were searched for available clinical trials from inception until March 2023. We selected randomized controlled trials (RCTs) that compared sequential letrozole/gonadotropin versus letrozole alone among infertile women who met the Rotterdam criteria for PCOS. RevMan software was used to perform our meta-analysis. Our primary outcomes were ovulation and clinical pregnancy rates. Our secondary outcomes were endometrial thickness, number of mature follicles (diameter ≥ 18 mm), and incidence of miscarriage and ovarian hyperstimulation syndrome (OHSS).<BR><B>RESULTS: </B>Six RCTs were retrieved with a total number of 723 patients. The ovulation and clinical pregnancy rates were significantly higher among the letrozole/gonadotropin group versus the letrozole monotherapy group (p < 0.001). In addition, there were significant improvements in endometrial thickness and number of mature follicles in the letrozole/gonadotropin group. There were no significant differences between the two groups regarding incidence of miscarriage and ovarian hyperstimulation syndrome.<BR><B>CONCLUSIONS: </B>Letrozole in combination with gonadotropin is superior to letrozole alone in improving ovulation induction and clinical pregnancy among PCOS patients. More trials are required to confirm our findings.