{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:00:19Z","timestamp":1780401619152,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>One in seven couples is infertile and ovulatory dysfunction accounts for 25% of the cases. Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy associated with ovulatory dysfunction. Traditionally, clomiphene is considered the first\u2010line drug for infertile PCOS women. Recently, letrozole was found to be an effective alternative ovulogen. The recent Cochrane review concluded that although live birth was higher with letrozole in unselected PCOS population, evidence was insufficient regarding effect of letrozole in treatment\u2010na\u00efve women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We conducted a cohort study that included treatment\u2010na\u00efve infertile PCOS women at a tertiary level infertility center in South India. Participants in the prospective arm were given letrozole 2.5\u2009mg daily for 5\u2009days and the retrospective arm included women who had undergone ovulation induction with clomiphene (100\u2009mg) for up to five treatment cycles. The primary outcome was ovulation rate. Secondary outcomes were clinical pregnancy, live birth, multiple pregnancy, and miscarriage rate. The trial was registered under the Clinical Trials Registry, India (CTRI\/2018\/07\/014704).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 135 women in the letrozole group and 127 women in the clomiphene group underwent treatment. The ovulation rate per woman was similar in both groups (84.4% vs. 77.2%;<jats:italic>p<\/jats:italic>\u00a0=\u00a00.13). Letrozole was associated with significantly higher clinical pregnancy (38.5% vs. 22.0%;<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004) and live birth rate per woman (30.3% vs. 18.9%;<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The current study found letrozole to be a superior ovulation induction agent as compared to clomiphene in treatment\u2010na\u00efve infertile women with PCOS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14926","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:40:16Z","timestamp":1628210416000},"page":"3583-3589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Letrozole as first\u2010line drug for ovulation induction in treatment\u2010na\u00efve infertile polycystic ovarian syndrome women"],"prefix":"10.1111","volume":"47","author":[{"given":"Batiston Decruse","family":"Waanbah","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine Christian Medical College Vellore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Treasa","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine Christian Medical College Vellore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Rebekah","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Christian Medical College Vellore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6506-0133","authenticated-orcid":false,"given":"Aleyamma Thayparmbil","family":"Kunjummen","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine Christian Medical College Vellore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohan Shashikant","family":"Kamath","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine Christian Medical College Vellore India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"National Institute for Health and Care Excellence2007.Fertility problems: Assessment and treatment Clinical guideline; 2013.www.nice.org.uk\/guidance\/cg156."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ics.2004.12.028"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.03.094"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313517"},{"issue":"5","key":"e_1_2_9_6_1","first-page":"CD010287","article-title":"Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome","volume":"5","author":"Franik S","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_7_1","first-page":"71","article-title":"Ethnic specific PCOS","volume":"8","author":"Wijeyeratne CNU","year":"2013","journal-title":"Expert Rev Endocrinol Metab"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2003.10.004"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmp048"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.06.005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dms003"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j138"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dex227"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.4103\/2277-9175.175237","article-title":"Letrozole as the first\u2010line treatment of infertile women with poly cystic ovarian syndrome (PCOS) compared with clomiphene citrate: a clinical trial","volume":"5","author":"Ghahiri A","year":"2016","journal-title":"Adv Biomed Res"},{"key":"e_1_2_9_15_1","first-page":"23","article-title":"Comparison of the effects of letrozole and clomiphene citrate on ovulation and pregnancy rate in patients with polycystic ovary syndrome","volume":"34","author":"Dehbashi S","year":"2009","journal-title":"Iran J Med Sci"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.07.313"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.04.026"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja18.00635"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.14926","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.14926","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.14926","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:06:38Z","timestamp":1699315598000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.14926"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,5]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1111\/jog.14926"],"URL":"https:\/\/doi.org\/10.1111\/jog.14926","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,5]]},"assertion":[{"value":"2020-12-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}