{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:41:22Z","timestamp":1787845282924,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T00:00:00Z","timestamp":1626048000000},"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":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We sought to compare the efficacy of the letrozole (LTZ) stair\u2010step protocol with clomiphene citrate (CC) stair\u2010step protocol in the management of 150\u2009mg dose of CC\u2010resistant polycystic ovary syndrome (PCOS) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively compared a total of 61 patients diagnosed as being resistant to the traditional CC protocol who were subsequently managed using the LTZ stair\u2010step protocol with CC\u2010resistant 56 patients who were treated with CC stair\u2010step protocol. The number of follicles \u226518\u2009mm, endometrial thickness, time to ovulation, clinical pregnancy rates, multiple pregnancy rates, spontaneous abortion rates, live birth rates, and systemic side effects in patients were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean time to ovulation was significantly shorter in the LTZ stair\u2010step group than the CC stair\u2010step group (17.3\u2009\u00b1\u20097.7 and 22.4\u2009\u00b1\u20098.1\u2009days, respectively, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The ovulation rate was significantly higher in patients treated with LTZ stair\u2010step protocol than those treated with the CC stair\u2010step protocol (83.6% and 64.2%, respectively, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.007). The clinical pregnancy rate was higher in the LTZ stair\u2010step than the CC stair\u2010step group (32.7% and 17.8%, respectively, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.015). LTZ stair\u2010step group had a significantly higher live birth rate than that of the CC stair\u2010step group (27.8% and 14.2%, respectively, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The LTZ stair\u2010step protocol revealed higher ovulation, clinical pregnancy, and live birth rates with a shorter time to achieve ovulation than the CC stair\u2010step protocol. Increment of the dose in the same cycle in both protocols did not cause any additional severe side effects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14936","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T01:00:53Z","timestamp":1626138053000},"page":"3875-3882","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparison of the efficacy of letrozole stair\u2010step protocol with clomiphene citrate stair\u2010step protocol in the management of clomiphene citrate\u2010resistant polycystic ovary syndrome patients"],"prefix":"10.1111","volume":"47","author":[{"given":"Mehmet Nafi","family":"Sakar","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Memorial Hospital  Diyarbak\u0131r Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7634-3008","authenticated-orcid":false,"given":"S\u00fcleyman Cemil","family":"O\u011flak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Health Sciences University, Gazi Ya\u015fargil Training and Research Hospital  Diyarbak\u0131r Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2014.5000"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-1208.97789"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2016.03.009"},{"key":"e_1_2_7_5_1","first-page":"385","article-title":"Clomiphene citrate impairs the endometrial CD98 expression in ovariectomized and non\u2010ovariectomized rats: role of HCG","volume":"17","author":"Yousefi B","year":"2019","journal-title":"Int J Reprod 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