Effekten av kombinerad behandling med letrozol och klomifen vid infertilitet hos kvinnor med polycystiskt ovariesyndrom : En Jämförelse med Monoterapi

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that impacts the ovaries of reproductive-age women, disrupting ovulation and fertility, and frequently resulting in infertility. The exact etiology of PCOS remains unclear, but it is believed to stem from a combination of genetic alterations and environmental influences, such as excess body weight and dietary patterns. PCOS manifests with varying symptoms among individuals, but the most prevalent include menstrual irregularities, excessive hair growth, acne, and increased body weight. To diagnose PCOS, patients must meet at least two of the Rotterdam criteria, which encompass irregular ovulation, elevated androgen levels, and the presence of multiple cysts on the ovaries. The course of treatment for PCOS is determined by the patient's age, the symptoms they experience, and the desired outcome. For addressing fertility issues in PCOS patients, ovulation-inducing medications such as clomiphene and letrozole are employed. Letrozole acts locally by inhibiting the ovaries' aromatase enzyme, whereas clomiphene acts centrally by blocking the hypothalamus's estrogen receptors. Purpose: The objective of this literature review was to assess the safety and efficacy of clomiphene and letrozole combination therapy compared to letrozole or clomiphene monotherapy in infertile women with PCOS. Method: PubMed was utilized to conduct a search for clinical studies pertinent to the objective of this research. The search yielded 18 results, from which five studies were selected based on predetermined inclusion and exclusion criteria. Results The five selected studies underwent analysis. The initial three studies demonstrated that utilization of the combination was associated with elevated ovulation rates, while the fourth study indicated no statistically significant difference between combination and monotherapy treatment. The fifth study revealed increased pregnancy rates with combination therapy. Conclusion: The combined use of letrozole and clomiphene proved more effective than single-drug treatments using either antigenic letrozole or clomiphene alone, while maintaining a similar safety profile.