Letrozole Low Dose versus High Dose for Ovulation Induction with Timed versus Spontanous Intercourse in PCO

Abstract Objective to compare the effect of low dose and high dose of letrozole in ovulation induction in PCOS. Effect of (HCG) administration in ovulation rate and pregnancy rate. Effect of timed Versus spontaneous intercourse in pregnancy rate. Study Setting This study was carried out at. Ain Shams Maternity Hospital Infertility Clinic and Qena General Hospital Infertility Clinic. Study Design Four arm clinical randomized trial. Study Time Start from 4-October 2021 ended 10- Jan. 2023. Results The objective of this study was to investigate the effect of low dose and high dose of letrozole on ovulation induction and effect of spontaneous & timed intercourse with (HCG) on pregnancy rate in one treatment cycle. This four arm clinical randomized trial study was carried out at Ain Shams Maternity Hospital Infertility Clinic and Qena General Hospital Infertility Clinic. The current study was conducted on 136 women. They were divided into 4 equal groups: A = letrozole 2.5 mg (Femra 2.5 mg NOVARTIS) (one tablet) without HCG. B = letrozole 2.5 mg+ HCG 10.000 IU. C = letrozole 10 mg (Femra 2.5 mg NOVARTIS) (four tablets) without HCG. D = lertozole 10 mg + HCG 10.000 IU. The study started 4-October 2021.ended 10-Jan 2023. Conclusion Conclusion, the present study revealed that, applying low dose or high dose of letrozole on ovulation induction and effect of spontaneous & timed intercourse with (HCG) had similar follicular response and pregnancy rates. Recommendations Good selection of PCO patients acording to Rotirdam critaria. Start mangement of PCO patients by wieght reduction for obes patients. Start induction ovulation by letrozole as first choice. Start by smallest dose of letrozole 2.5mg & can be titrated dose for not responding patient to high dose.