Dados do Trabalho

Title

LETROZOLE X CLOMIPHENE FOR OVULATION INDUCTION IN WOMEN WITH POLYCYSTIC OVARY SYNDROME : A SYSTEMATIZED REVIEW

Objective

To systematically evaluate in the literature the differences between letrozole and clomiphene for ovulation induction in women with Polycystic Ovary Syndrome (PCOS).

Methods

For the study, the VHL and PUBMED databases were consulted. In the selection of articles, the keywords “letrozole”, “clomiphene”, “ovulation” and “PCOS” were used, articulated with the Boolean operator “AND”. The filter “the last 10 years” was used. In VHL, 107 articles were found and in PUBMED, 107 were found. 5 articles from PUBMED and 3 from VHL were read according to the greatest alignment with the research proposal. The conduct used for data extraction was the analysis of the results of the searches carried out in the databases, this analysis was made from the reading of the articles.

Results

It was noticed that comparing the use of letrozole with clomiphene citrate in the treatment of infertile women with PCOS there is a higher probability of ovulation with letrozole. In studies to determine the efficacy and safety of letrozole compared to clomiphene citrate, pregnancy occurred in 29 of 50 patients in the letrozole group (58%) and in 24 of 51 patients in the clomiphene group (47%). Among women with PCOS in another data analysis, the probability of pregnancy was 43% for letrozole and 37% for clomiphene. Moreover, if we consider variables such as the probability of live birth, it is 32% for letrozole and 29% clomiphene, risk of multiple pregnancy was 19% letrozole for 9% clomiphene, risk of prematurity was 20% to 15%, the risk of small for gestational age 5% to 3%, the risk of hospitalization in the neonatal intensive care unit was 22% to 16% and the risk of congenital malformation from 8% to 2% among those with live birth. Therefore, when analyzing these data, it is notorious that the use of letrozole for women with PCOS, is more effective, it should be considered as a first-line pharmacological treatment for women with anovulation, because pregnancy rates are higher, the time of pregnancy and the chances of multiple pregnancy are lower. However, after analyzing the neonatal outcomes, the two treatments presented similar static data, requiring the individual analysis of each patient, since the hypothesis of higher risks in the use of clomiphene in relation to letrozole was not proven.

Conclusion

Studies have suggested a greater effectiveness of letrozole compared to clomiphene citrate, due to better ovulation induction in anovulatory women with PCOS, having increased pregnancy rates and a shorter time to achieve it.

Keywords

Letrozole; Clomiphene; Ovulation; PCOS.