Laparoscopic Ovarian Drilling versus Letrozole in Clomiphene Citrate Resistant Polycystic Ovary: A Randomized Controlled Trial

Abstract

olycystic ovary syndrome (PCOS) is one of the most common endocrine pathologies and is a frequent cause of anovulatory infertility affecting 5 to 8% of reproductive-age women. The main syndromes of PCOS are chronic anovulation, hyperandrogenism, obesity, hypertension, diabetes mellitus type 2, and insulin resistance. Currently, the most frequently administered therapeutic treatments in patients with C/C-resistant PCOS include gonadotropin, laparoscopic ovarian drilling (LOD), and aromatase inhibitors. The main benefits of LOD are the shorter time to pregnancy and less need for ovulation induction drugs. Also, there’re disadvantages of LOD, as it requires hospitalization and general anesthesia and may lead to pelvic adhesions Letrozole (LE), an orally active, reversible, nonsteroidal aromatase inhibitor, has good potential for inducing ovulation in women with PCOS without exerting anti-estrogenic effects on the endometrium. This study aimed to compare the reproductive outcomes of laparoscopic ovarian drilling with LE in women with clomiphene citrate resistant PCOS.