Letrozole versus clomiphene citrate in polycystic ovary syndrome: a meta-analysis of randomized controlled trials
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Polycystic ovary syndrome (PCOS) is a common endocrine disturbance affecting women in the reproductive age group. The present study aimed to compare the effects of letrozole (LE) and clomiphene citrate (CC) for ovulation induction in women with PCOS.
The PUBMED, Web of Science, and EMBASE databases were screened systematically for randomized controlled trials (RCTs) published from database inception to July 2017.
Eleven RCTs involving 2255 patients were included, and data were independently extracted and analyzed using 95% risk ratios (RRs) and confidence intervals (CIs) based on a random- or fixed-effect model (as appropriate). Meta-analyses of nine RCTs comparing LE and CC ovulation induction, followed by timed intercourse, indicated that the former significantly increased the ovulation rate (RR = 1.18; 95% CI 1.03–1.36, P = 0.01), pregnancy rate (RR = 1.34; 95% CI 1.09–1.64, P = 0.006), and live birth rate (RR = 1.55; 95% CI 1.28–1.88, P < 0.00001). However, LE and CC did not differ significantly in terms of the multiple pregnancy and abortion rates. Furthermore, LE for ovulation induction significantly improved the pregnancy rate after IUI.
LE is superior to CC for ovulation induction in patients with PCOS.
KeywordsLetrozole Clomiphene citrate Polycystic ovary syndrome Randomized controlled trials Meta-analysis
This work was supported by the National Natural Science Foundation of China (Grant no. 81671507), Fundamental Research Funds for the Central Universities (HUST; Grant no. 2015ZDTD050), and National Key Research and Development Program (Grant no. 2016YFC1000903).
SH, first author: project development, data collection, data analysis, and manuscript writing. QY, co-first author: project development, data collection, statistical analysis. YW and MW: data collection. WX, corresponding author: manuscript editing. CZ, co-corresponding author: manuscript editing.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest.
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