Letrozole versus laparoscopic ovarian drilling in infertile women with PCOS resistant to clomiphene citrate

Objective To compare the efficacy of letrozole and laparoscopic ovarian drilling (LOD) in the induction of ovulation in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). Subjects and methods A total of 80 women with CC-resistant PCOS were enrolled and randomly allocated into groups A and B. Group A (n = 40) underwent LOD, and group B (n = 40) received 2.5 mg letrozole from days 3 to 7 of menses for up to six cycles. A 6-month follow-up was performed. Results No statistically significant differences were found in the baseline clinical characteristics and the major serum hormone profiles, women receiving letrozole had a higher rate of ovulation (70 vs. 57.5%) and however, the differences were not statistically significant also there is significant decrease in MAH in group A. The pregnancy rate was 27.5% in group A versus 35% in group B and abortion rate was 18% in group A versus 7% in the other group. Conclusion Letrozole had superior reproductive outcomes compared with LOD in women with CC-resistant PCOS and seems to be a suitable first-line ovulation induction instead of LOD in those patients.