BACKGROUND & AIM: Ovulation induction is widely practised in conjunction with intrauterine insemination (IUI). The present study is aimed to compare commonly used clomiphene citrate and letrozole for ovulation induction in IUI cycles.

MATERIALS & METHODS: In this observational study 120 infertile couples considered for ovulation induction and IUI were allocated to either clomiphene citrate group or letrozole group. After day2 baseline transvaginal sonography (TVS) tab clomiphene citrate 50mg or tab letrozole 2.5mg administered in respective groups twice daily from day2-6 of period and followed up by TVS adding injection human menopausal gonadotropin (HMG) and tab estradiol valerate accordingly till dominant follicle(s) reached >17mm when trigger for ovulation given and IUI performed 36hours later. Those who conceived were followed till ultrasound confirmation of cardiac activity. Statistical analysis was done using SPS Software 22.

RESULTS: Endometrial thickness on both day9 and the day of ovulation trigger was more favourable in letrozole group (pvalue<0.001). Size of dominant follicle on day9 and day11 were comparable in both the groups, however, on the day of ovulation trigger was statistically more in clomiphene citrate group (pvalue 0.0202). Mean number of dominant follicles was higher in clomiphene citrate group (pvalue<0.0074). Pregnancy up to cardiac activity was similar in both the groups (pvalue 0.836). HMG and estrogen were required more in clomiphene citrate group (pvalue 0.0016).

CONCLUSION: Letrozole can be used as first line treatment for ovulation induction in any infertile women undergoing IUI reducingthe need for gonadotropins and estrogen. 

KEY WORDS:  Letrozole, Clomiphene Citrate, Ovulation Induction, Intrauterine Insemination.

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