Letrozole combined with HMG for inducing ovulation in women with polycystic ovarian syndrome

Objective To explore the suitable ovarian stimulation protocol by comparing the efficacy of letrozole(LE) with human menopausal gonadotropin(HMG) or HMG in treatment of polycystic ovarian syndrome(PCOS).Methods 112 PCOS women were randomized into two groups received either HMG(126 cycles) or LE-HMG(86 cycles).HMG group: HMG dose of 75 IU/ml administered every day starting at third day until hCG day.LE-HMG group: Letrozole dose of 5 mg/d was given on day 3-7 of the menstrual cycles and combined with HMG dose of 75 IU/ml administered every day starting at 7th day.Main outcome measures included dose of HMG used per cycle,the number of mature follicles,endometrial thickness,serum E2 on hCG day,Clinical pregnancy rate and OHSS rate.Results The total doses,the number of mature follicles,serum E2 and the rate of OHSS in HMG group were higher than those in LE-HMG group.There were no differences in the duration of ovarian stimulation,endometrial thickness and clinical pregnancy rate between two groups.Conclusion LE-HMG seems to be safer,more cost-effective ovulation stimulation protocol in PCOS women.