Clomiphene Citrate versus Letrozole For Induction of Ovulation in Infertile women having Polycystic Ovarian Syndrome (Randomized Controlled Trial)

Abstract

Polycystic ovary syndrome is a disorder but with unclear etiology that its diagnosis depends on exclusion of other etiologies with ovulatory disorders and androgen excess as congenital adrenal hyperplasia, 21-hydroxylase deficient non classic congenital adrenal hyperplasia (NCAH), adrenal or ovarian androgen-secreting tumors, disorders of adrenocortical dysfunction as Cushing’s disease, and abuse of androgenic or anabolic drugs. Polycystic ovary syndrome affects approximately 6-15% of women in reproductive age and constitutes 50% of the causes of infertility in women. The diagnostic criterion of polycystic ovary syndrome depend on the Rotterdam criteria, as diagnosis needs two of three characteristics: oligomenorrhea and/or anovulation, clinical and/or biochemical signs of hyperandrogenism and polycystic ovaries according to pelvic ultrasound. In addition to that, obesity is linked with polycystic ovary syndrome and accompanied by other by other polycystic ovary syndrome metabolic abnormalities as insulin resistance. Polycystic ovary syndrome has additional derangements like impaired glucose tolerance, insulin resistance and dyslipidemia. So, women with this syndrome have risks of type2 diabetes mellitus, cardiovascular disease, hypertension, metabolic syndrome, non-alcoholic fatty liver diseas and endometrial carcinoma. Therefore, polycystic ovary syndrome is known as metabolic disorder not only as a gynecological endocrinopathy disease.