• Jinee Baruah, K K Roy, S M Rahman, Sunesh Kumar, J B Sharma, and Debjyoti Karmakar.
• Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Room No. 3085, 3rd Floor, Teaching Block, New Delhi, India.
• Arch. Gynecol. Obstet. 2009 Mar 1; 279 (3): 311-4.

ObjectivesTo compare the effects of letrozole and clomiphene citrate (CC) on endometrial response in PCOS using subendometrial spiral artery Doppler.MethodsFifty consecutive patients of anovulatory PCOS were recruited. Twenty-five patients (58 cycles) received 2.5-5 mg of letrozole; 25 patients (56 cycles) received 50-100 mg of CC (both orally on days 5-9 of menses).Main Outcome Measuresnumber of dominant follicles, endometrial thickness (ET), spiral artery resistance index (RI) and pulsatility index (PI) and pregnancy rate.ResultsThe mean number of dominant follicles in letrozole group and CC groups was 1.63+/-1.02 and 1.62+/-0.96, respectively (P>0.05). The mean mid cycle ET was 6.9+/-0.74 mm in letrozole group and 5.9+/-0.53 mm in CC group (P<0.05). In letrozole and CC groups, the mean RI of spiral artery were 0.63+/-0.05 and 0.79+/-0.09, respectively, and the mean PI of spiral artery were 1.19+/-0.06 and 1.55+/-0.13, respectively. Both RI and PI in the letrozole group showed significant lower impedance compared to CC group (P<0.05). Pregnancy rate per cycle was 19% (11/58) in the letrozole group and 12.5% (7/56) in the CC group (P>0.05).ConclusionThe effect of letrozole showed a significantly better endometrial response compared to CC.

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