COMPARING THE CLINICAL EFFECTS OF LETROZOL V.S. CLOMIFENE IN INFERTILE OVULATOR WOMEN (BORDERLINE MALE FACTOR INFERTILITY, AND UNEXPLAINED INFERTILITY) UNDERGOING INTRAUTERINE IN SEMINATION.

Infertility affects approximately 10-15% of couples. The major causes of infertility include ovulatory dysfunction, tubal and peritoneal pathology, uterine pathology and male factors. Unexplained infertility is 10-15% of cases of infertility. Ovarian stimulation combined with IUI is treatment of couples with male factor infertility and unexplained infertility. Once limited to just clomiphene citrate for ovulation induction but now includes a wide variety of agents. Although its use is still extremely limited, the aromatase inhibitor letrozol may be another potential option for ovulation induction an ovulatory women. The aim of this study is to compare the effectiveness of letrozol and clomiphene for ovulation induction in patients with unexplained and borderline male factor infertility.

Materials & Methods : In this study 206 patients with unexplained infertility and borderline male factor infertility were recruited.The patients were randomized into two groups, being treated with clomiphen and another groups treated with letrozol. HMG injected due to growth follicle. HCG was used to trigger ovulation. IUI was performed in patients, 36-40 hours after administration of HCG.

Transvaginal sonography determined endometrial thickness and number of mature follicle on the day of use HCG. Pregnancy Rate, multiple pregnancy and rate abortion were detrmined in both groups.

Results: The mean number of gonadotropin ampules used in both groups were: c.c groups 2.18±1.86 vs. letrozol group 2.94±3.3, p<0.05. Different endometrial thickness was found between the two groups (c.c groups 8.23±1.08 mm, letrozol group 7.86±1.03mm, p<0.05.

Total number of mature follicles during stimulating were: 2.10±1.04 in C.C group v.s 1.86±1.03 in letrozol group, p>0.05. Pregnancy rate per cycle was 37 (36.3%) in the letrozol group and 20 (19.2%) in the clomiphene group, p< 0. 05. Multiple pregnancy occurred in the letrozol group 3 (8.1%) and in the clomiphene group 3(15%), p>0/05. Abortion rate per cycle was 11(29/73%) in the letrozol and 5 (25%) in the clomiphene group, P<0/05.

Conclusion : Superovulation with letrozol in patients with unexplained infertility and borderline male factor infertility was associated with a significantly higher Pregnancy rate is encouraging for the development of these agents as first-line ovulation induction agents.