Efficacy of Cabergoline Combined with Letrozole Versus Letrozole Alone in Anovulatory Pco Women with Europrolactinaemia, Randomized Controlled Trial

Objective: To evaluate the therapeutic effect of adding cabergolinewith letrozole in infertile women having (PCOS) with normal prolactin level.Study design: A randomized controlled study.Patients & methods: Infertile PCOS women with normal prolactin levelattending out patient clinic of obstetric &gynaecology department ofzagazig university & private clinic . Those included( 200 ) patients randomly divided into two groups, each group(100) patientsgroup A,received letrozole plus cabergoline and group B recievedletrozole.Study design: for all patients , ultrasound on 2 nd day ofcycle then folliculometry after treatment detecting number,size of follicles ≥17mm with endometrial thickness ,patients followed for one cycle.The primary outcome was ovulation rate. The secondaryoutcomes, clinical pregnancy r, miscarriage , multiple pregnancyand ovarian hyperstimulation rate.Results: 200 patients divided ( 100 in each group ). No statisticaldifference between both groups in basal criteria. Theovulation rate (group1) was 75% versus 60% (group 2) p-value 0.023* ,,Number ofdominant follicle ≥17mm significantly more in the same groupthan in other ( p value 0.00**).Stimulation days are less in group 1 than letrozole only group but no significance.Patients in letrozole cabergoline group had a higher clinical pregnancyrate reaching 27.0% versus 15.0 % in patients of the letrozole group (p-value 0.037*)No difference between both groups in miscarriage ,,multiplegestation , ovarian hyperstimulation rate .Conclusions: higher ovulation & clinical pregnancy rate with theadding cabergoline with letrozole during ovulation induction ineuprolactinemic infertile pcos than use letrozole alone.