Comparison of anastrozole versus clomiphene citrate in infertile women with anovulatory polycystic ovarian syndrome: A prospective randomised trial

Jagrati Agarwal; Pallavi Verma; Gurpreet Singh

Volume : X, Issue : VII, July - 2020

Comparison of anastrozole versus clomiphene citrate in infertile women with anovulatory polycystic ovarian syndrome: A prospective randomised trial

Jagrati Agarwal, Pallavi Verma, Gurpreet Singh

Abstract :

Objective: To compare the effects of anastrozole and clomiphene citrate (CC) for ovulation induction in infertile women with polycystic ovary syndrome (PCOS). Materials and Methods: This prospective, randomized clinical trial included 80 patients of infertile women with PCOS, comprised of two groups. Group A comprised 40 patients who received anastrozole (oral 1 mg) daily and the group B 40 patients who received (oral 100 mg) CC daily for 5 days starting on day 3 of menses. Both the groups were followed by ultrasound until the dominant follicle reached a diameter ≥18 mm, human chorionic gonadotropin (hCG) 10,000 IU was given, and timed intercourse was advised. The treatment continued for five cycles in both the groups. Results: The mean age, duration of infertility, body mass index, and endocrine status in both the groups were similar at baseline. The mean number of follicles with size >18 mm during stimulation, though statistically not significant, was higher in the anastrozole group (0.95±0.99 vs 0.73±0.85; p=0.277). There was no statistically significant difference in pretreatment endometrial thickness between the two groups, but endometrial thickness at the time of hCG administration was statistically significantly greater in the anastrozole group (10.78±1.09 mm vs. 9.69±1.07 mm; p< 0.001). Ovulation occurred in 12 subjects (30%) in the anastrozole group and 6 (15%) in the CC group. Conception rate was 25% in anastrozole group as compared to 10% in CC group. For both the outcomes, the success rate was higher in anastrozole group; however, difference was not significant statistically (p>0.05). Conclusion: Anastrozole showed superiority over Clomiphene citrate in enhancing the endometrial thickness and consecutively in achieving higher conception rates apart from higher ovulation rates, though they were not significant statistically. Anastrozole may have a role as a first–line treatment for anovulatory patients with PCOS