Purpose: To compare the effects of letrozole, clomiphene citrate and metformin plus letrozole on ovulation induction in infertile women with polycystic ovarian syndrome.

Study design: Prospective, randomized clinical study

Material and method: This study was conducted on 15 patients with polycystic ovarian syndrome, who admitted to infertility clinic of Erciyes University, Faculty of Medicine between March 2004 and November 2005. Patients were randomized into three treatment groups. In group 1, continuous metformin was used at the dose of 850mg/tid/day for six months; afterwards, daily 2.5mg letrozole between 3 and 7 days of the menstrual cycle was added to the metformin therapy. Group 2 patients received only daily 2.5mg letrozole between days 3 and 7 of the menstrual cycle and group 3 patients received daily 100mg clomiphene citrate only between days 3 and 7 of the menstrual cycle. The patients were treated until either a pregnancy occurred, or six cycles were reached without pregnancy.

Results: There were five patients in group 1, five women in group 2 and five women in group 3. Endometrial thickness of patients treated with clomiphene citrate (6.8±0.5) was only significantly thinner when compared to those with the letrozole only (10.4±1.4) and letrozole plus metformin groups (9.6±1.3). Serum estradiol on the day of hCG administration was significantly higher in the clomiphene citrate group.

Conclusion: Letrozole may have a beneficial effect on ovulation induction in patients with polycystic ovarian syndrome.

Amaç: Polikistik over sendromlu infertil kadınlarda ovulasyon indüksiyonunda metformin ile letrozol kombinasyonu, yalnız letrozol ve yalnız klomifen sitrat kullanımının karşılaştırılması.

Materyal ve metod: Mart 2004 - Kasım 2005 tarihleri arasında Kadın Hastalıkları ve Doğum polikliniğine infertilite şikayeti ile başvuran polikistik over sendromlu 15 gönüllü hasta üzerinde yapıldı. Hastalar 3 gruba randomize edildi. Grup I' deki hastalara altı ay metformin tedavisinin ardından metformine ek olarak 3-7. günlerde 2,5 mg letrozol, grup II' deki hastalara siklusun 3-7. günlerinde 2,5 mg/gün letrozol, grup III' teki hastalara siklusun 3-7. günlerinde 100 mg/gün klomifen sitrat ile altı ay ovulasyon indüksiyonu uygulandı.

Bulgular: Endometriyal kalınlık klomifen sitrat grubunda letrozol+metformin ve letrozol grubuna göre anlamlı şekilde ince bulundu. hCG günü serum E2 değeri klomifen sitrat grubunda yüksek bulunurken ovulasyon ve gebelik oranları her üç grupta benzerdi. Letrozol+metformin grubuyla letrozol grubunun tüm sonuçları benzerdi.

Sonuç: Polikistik over sendromlu infertil hastalardaki ovulasyon indüksiyonunda letrozol faydalı olabilir.