Letrozole or Combined Metformin Clomiphene Citrate (CC) for Women With CC Resistant Polycystic Ovary Syndrome

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The purpose of this study is to compare and determine the efficacy of letrozole administration to that of combined metformin and Clomiphene in infertile women with polycystic ovary syndrome (PCOS) not responding to treatment with Clomiphene alone...

Brief Summary

Official Title: “Letrozole Versus Combined Metformin and Clomiphene Citrate for Ovulation Induction in Clomiphene-Resistant Women With Polycystic Ovary Syndrome”

The purpose of this study is to compare and determine the efficacy of letrozole administration to that of combined metformin and Clomiphene in infertile women with polycystic ovary syndrome (PCOS) not responding to treatment with Clomiphene alone.

  • Study Type: Interventional
  • Study Design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
  • Study Primary Completion Date: January 2009

Detailed Clinical Trial Description

Withdrawal bleeding was achieved using 10 mg of dydrogesterone tablets for 10 days before stimulation. In the letrozole group, 2.5 mg of letrozole oral tablets (Femara; Novartis Pharma Services, Switzerland) daily from day 3 of the menses for 5 days, whereas all patients in the combined metformin-CC group) received metformin HCl [Cidophage®; Chemical Industries Development(CID), Cairo, Egypt], 500 mg three times daily for 6-8 weeks. Then after the end of this period, they received 150 mg CC (Clomid®; Global Napi Pharmaceuticals, Cairo, Egypt) for 5 days starting from day 3 of menstruation. Patients continued treatment for three successive cycles using the same protocol. Metformin was stopped only when pregnancy was documented.

Intervention(s) in this Clinical Trial

  • Drug: Letrozole tablets (Femara; Novartis Pharma, Switzerland)
    • 2.5 mg letrozole daily from day 3 of the menses for 5 days
  • Drug: metformin HCl (Cidophage®; CID,Cairo, Egypt)
    • metformin HCl 1500 daily for 6-8 weeks
  • Drug: CC (Clomid®; Global Napi Pharmaceuticals, Cairo, Egypt)
    • 150 mg CC for 5 days starting from day 3 of menstruation

Arms, Groups and Cohorts in this Clinical Trial

  • Experimental: Letrozole
  • Active Comparator: Metformin-CC

Outcome Measures for this Clinical Trial

Primary Measures

  • Principally the ovulation rate as well as the number of growing and mature follicles, serum E2 (pg/ml), serum P (ng/mL), and endometrial thickness (mm).
    • Safety Issue?: No

Secondary Measures

  • The occurrence of pregnancy and miscarriage.
    • Safety Issue?: No

Criteria for Participation in this Clinical Trial

Inclusion Criteria:

  • CC resistant PCOS

Exclusion Criteria:

  • Congenital adrenal hyperplasia
  • Cushing syndrome
  • Androgen secreting tumors

Gender Eligibility for this Clinical Trial: Female

Minimum Age for this Clinical Trial: 20 Years

Maximum Age for this Clinical Trial: 36 Years

Are Healthy Volunteers Accepted for this Clinical Trial?: No

Clinical Trial Investigator Information

Lead Investigator: Mansoura University Other

Overall Clinical Trial Officials and Contacts

Hatem Abu Hashim, MD. MRCOG Principal Investigator Mansoura University Hospitals  

Related Publications

References

Holzer H, Casper R, Tulandi T. A new era in ovulation induction. Fertil Steril. 2006 Feb;85(2):277-84. Review.

Siebert TI, Kruger TF, Steyn DW, Nosarka S. Is the addition of metformin efficacious in the treatment of clomiphene citrate-resistant patients with polycystic ovary syndrome? A structured literature review. Fertil Steril. 2006 Nov;86(5):1432-7. Epub 2006 Sep 27. Review.

Additional Information

Information obtained from ClinicalTrials.gov on February 12, 2012

Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00911313

Study ID Number: MU- 059

ClinicalTrials.gov Identifier: NCT00911313

Health Authority: Egypt: Institutional Review Board

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http://clinicaltrialsfeeds.org/clinical-trials/show/NCT00911313