Subfertility Clinical Trial
Official title:
Effect of High BMI on Ovulation Induction Using Letrozole Versus Clomid
There is an increased prevalence of high Body mass index (BMI) all over the world.High BMI is
shown to have an impact on the female reproductive system.It can contribute to both ovulatory
and anovulatory subfertility.
Clomiphene citrate and Letrozole have been used for treatment of infertility.Both are used
for induction of ovulation.
Clomiphene citrate is an estrogen receptor antagonist .It increases serum FSH and it has its
limitation due to his antiestrogenic effect,it has an ovulation rate 70-80% but pregnancy
rate is only 22% because of its anti-estrogenic effect on endometrium and poor cervical mucus
(Legro RS et al.,2007) Letrozole is an aromatase inhibitor which inhibits the production of
estrogen, which influences the action of the brain's hypothalamus and pituitary on the
functioning of the ovaries by increasing FSH.Due to the antiestrogenic effect of clomiphene
citrate,Letrozole can be used as an alternative.
The investigators are comparing the effect of both medications on the outcome of the
induction of ovulation in women with high BMI.
This is a Randomized controlled trial .The researchers include160 women with BMI more than 30
who were suffering from subfertility for more than 2 years. The investigators will randomise
them into 2 groups. Group A:They were prescribed 100 mg of clomiphene citrate from day 2-5 of
the cycle for 5 days. Group B : They were prescribed 5 mg of Letrozole from day 2-5 of the
cycle.
Vaginal ultrasound was performed on day 11 of the cycle, After at least one follicle reached
15 mm, The patient was encouraged to have sexual intercourse every other day for few days.The
patients will have a midluteal progesterone level to confirm ovulation and will have a
pregnancy test in 2 weeks if missed period. The researchers will compare the number of mature
follicles, endometrial thickness on the day when there are mature follicles, occurrence of
pregnancy, multiple pregnancies, and miscarriages .
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