Letrozole Step up Protocol for Ovulation Induction in Infertile Women With Polycystic Ovary Syndrome

NCT ID: NCT07143682

Last Updated: 2025-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-08

Study Completion Date

2024-06-30

Brief Summary

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The goal of this clinical trial is to learn if drug letrozole in step up dose works better to treat anovulation in infertile women with polycystic ovary syndrome. It will also learn about the safety of drug letrozole in step up dose. The main Questions it aims to answer are:

* Does drug letrozole in step up dose result in better ovarian response?
* What medical problems do participants have when taking drug letrozole in step up dose? Researchers will compare drug letrozole step up dose to a standard low dose to see if the step up dose works to achieve better ovarian response.

Participants will:

* Take drug letrozole step up or standard low dose from day 2 of menstruation for 3 cycles
* Visit the clinic on day 12-16 of menstural cycle for checkups and tests
* Keep a diary of any untoward symptoms

Detailed Description

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Background: Polycystic ovary syndrome (PCOS) is the largest single cause of anovulatory infertility. Letrozole, an aromatase inhibitor, has been regarded as the first-line drug for ovulation induction in PCOS patients. The conventional protocol of letrozole includes the administration of a fixed dose of letrozole (2.5 -7.5 mg) for 5 days. Few recent studies have shown that the step-up letrozole protocol causes more follicles to grow, induces more ovulation, and increases the pregnancy rate. This study aimed to compare the effect of the letrozole step-up and conventional fixed-dose protocol for ovulation induction in infertile women with PCOS.

Methods: This open-label randomized controlled study was conducted on a total of 70 infertile PCOS women eligible for ovulation induction. Treatment with letrozole started from day 2-3 of menstruation or withdrawal bleeding. They were randomly allocated into two groups. The experimental group (n=35) was given step-up letrozole, one (2.5 mg), two (5 mg), three (7.5 mg), and four (10 mg) tablets, single dose sequentially for 4 days. The comparator group (n=35) received conventional fixed-dose letrozole, two (5mg) tablets daily for 5 days. The outcome variables were the number of participants having a mature follicle by day 12-16 of the cycle and the number of mature follicles on the day of trigger.

Conditions

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Polycystic Ovarian Syndrome (PCOS) Infertility

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Letrozole step up

Tab letrozole 2.5mg one, two, three, and four tablets once daily from 2nd/3rd day of the menstrual cycle for 4 days

Group Type EXPERIMENTAL

Letrozol step up dose

Intervention Type DRUG

Tablet letrozole 2.5mg one, two, three, and four tablets once daily from 2nd/3rd day of the menstrual cycle for 4 days

Conventional fixed dose letrozole

Tab letrozole 5mg once daily for 5 days started from the 2nd/3rd day of the menstrual cycle

Group Type ACTIVE_COMPARATOR

Conventional fixed dose letrozole

Intervention Type DRUG

Tab letrozole 5mg once daily for 5 days started from the 2nd/3rd day of the menstrual cycle

Interventions

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Letrozol step up dose

Tablet letrozole 2.5mg one, two, three, and four tablets once daily from 2nd/3rd day of the menstrual cycle for 4 days

Intervention Type DRUG

Conventional fixed dose letrozole

Tab letrozole 5mg once daily for 5 days started from the 2nd/3rd day of the menstrual cycle

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* PCOS women with subfertility
* Selected for ovulation induction

Exclusion Criteria

* Body mass index (BMI) ˂18 and ≥30 kg/m2,
* Women with other infertility factors (endometriosis, suspected tubal factor, and uterine causes of infertility)
* Male factor infertility
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

OTHER

Sponsor Role lead

Responsible Party

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Shakeela Ishrat

Professor Shakeela Ishrat

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Bangabandhu Sheikh Mujib Medical University

Dhaka, , Bangladesh

Site Status

Countries

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Bangladesh

References

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Kaur J, Suri V, Gainder S, Arora A. Prospective randomized trial comparing efficacy of letrozole step-up protocol with letrozole plus gonadotropins for controlled ovarian stimulation and intrauterine insemination in patients with unexplained infertility. Arch Gynecol Obstet. 2019 Dec;300(6):1767-1771. doi: 10.1007/s00404-019-05326-2. Epub 2019 Oct 20.

Reference Type BACKGROUND
PMID: 31631248 (View on PubMed)

Other Identifiers

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4286

Identifier Type: -

Identifier Source: org_study_id