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Do Aromatase Inhibitors Offer Better Choice Than Selective Estrogen Receptor Modulators For Management Of Polycystic Ovarian Syndrome?

Amit Kant Singh, Shalini Tomar, and Narsingh Verma

Polycystic ovarian syndrome (PCOS) is responsible for 55% -70% of infertility cases caused by chronic anovulation. Clomiphene Citrate (CC) is considered as first line drug for induction of ovulation in these patients. Aromatase inhibitor has been used as new drug for ovulation induction for last decade. There are many studies related to comparative use of CC and Letrozole but results are not consistent. To review the literature related to use of Letrozole and CC in infertile patient with PCOS to conclude, which is better ovulatory agent for the management of anovulation?. A search of English language literature was conducted using PubMed, Google Scholar, Cochrane database of systemic review and EMBASE databases. Old to most recent publications regarding Letrozole and Clomiphene for ovulation induction were reviewed. Evidences suggest that Letrozole (AI) may replace CC as a first line ovulation inducing agent in infertile patients with PCOS in the future. Many studies showed increased rates of ovulation and pregnancy with fewer side effects by Letrozole as compare to CC. But definitive studies in the form of randomized controlled trials comparing CC with AIs are needed