The effects of Letrozole, Tamoxifen and Clomiphene on Endometrial Pattern, Vascularity and Receptivity

Background: The endometrium's characteristics are influential in the implantation process. A reduced endometrium thickness of under neath seven mm indicates an inadequate potential for successful implantation.Aim and objectives: In order to conduct a comparative analysis of the impacts of clomiphene, tamoxifen, & letrozole on endometrial thickness, sub-endometrial blood flow, & endometrial receptivity relative to ovulation induction agents.Patients and methods: Participants in this prospective observational research comprised ninety individuals were selected from attendee of outpatient at Obstetrics and Gynecology clinics at Al-Hussien University Hospitals, from 1/6/2023 to 15/1/2024.Results: The groups 1 & 3 exhibited notably diminished endometrial thickness & volume (P<0.001). However, there was no substantial variance amongst collections 2 & 3 regarding endometrial thickness and volume p>0.05. A significant negative association was observed among endometrial thickness. Meanwhile, there is a substantial positive association between endometrial thickness with FI, VI, and VFI p<0.001. There was no substantial difference amongst the three collections regarding clinical pregnancy rate p=.187. However, the positive pregnancy rate was lower among group 1 compared to the other two groups.Conclusion: A significant increase in endometrial thickness and volume was observed in the tamoxifen group, followed by letrozole and clomiphene. However, Sub-endometrial blood flow was the highest in the clomiphene group, followed by tamoxifen and letrozole groups. PDA indexes were the highest in the tamoxifen group, followed by letrozole and clomiphene. Our study showed an increase in pregnancy rate; however, it was insignificant in the letrozole group, followed by tamoxifen, and lastly, the clomiphene group.