Meta-Analysis Of Letrozole For Ovulation Induction In Polycystic Ovary Syndrome

OBJECTIVE: To systematically access the clinical efficacy and safety of letrozole used for ovulation induction in women with polycystic ovary syndrome (PCOS).METHODS: The Cochrane Central Register of Controlled Trials(CENTRAL/CCTR),PubMed,EMbase,CBMdisc,CNKI were screened for randomized controlled trials (RCTs) of letrozole used for ovulation induction in PCOS patients to June 2010. Two reviewers independently extracted information and evaluated methodological quality according to the Cochrane Handbook 5.0. The meta-analysis was performed with RevMan 5.0(Computer program).RESULTS: Ten eligible RCTs involving 1854 patients were included. The Meta-analysis showed that :â‘ Letrozole was associated with a higher ovulation rate per cycle , a thinner endometrial thickness at HCG, and a lower mature follicles per cycle compared with clomiphene citrate . Pregnancy rate and abortion rate was no significant difference between the two groups.â‘¡Considerable ovulation rate per cycle (>60%)and pregnancy rate (>30%) was obtained when letrozole used in PCOS patients with clomiphene resistance.â‘¢ When compared with gonadotropin, there was a lower ovulation rate per cycle in letrozole group, a similar pregnancy rate, endometrial thickness at HCG, and abortion rate. Ovarian hyperstimulation syndrome and multiple pregnancy rate was less in letrozole group than in gonadotropin group.CONCLUSION: Not enough evidence to prove for letrozole was superior to CC at the present time. But letrozole can obtain effective ovulation rate and pregnancy rate for PCOS patients with CC-resistance. And may prevent ovarian hyperstimulation syndrome and multiple pregnancy in patients who was highly sensitive to sex hormone.