SynthesisReproductive sciences (Thousand Oaks, Calif.)2025
Combined Letrozole and Clomiphene Citrate Versus Letrozole Alone in Ovulation Induction for Polycystic Ovarian Syndrome Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Synthesis in Reproductive sciences (Thousand Oaks, Calif.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Letrozole yields superior pregnancy outcomes and safety profile compared with clomiphene citrate in intrauterine insemination cycles: a propensity score matching analysis.American journal of translational research · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Polycystic ovarian syndrome (PCOS) is a leading cause of infertility due to chronic anovulation. Letrozole is the first-line treatment for ovulation induction, but combination therapy with clomiphene citrate (CC) may enhance outcomes. We conducted a systematic search of three databases until October 2024, including randomized controlled trials (RCTs). Bias was assessed using the Revised Cochrane risk of bias tool (RoB 2). Six RCTs with 619 PCOS patients were included. The combination of Letrozole and CC resulted in a higher, though non-significant, ovulation rate (53.74%) vs. Letrozole alone (40.08%) (OR 1.22, 95% CI [0.88, 1.69], P = 0.23). Lower-dose combination therapy (50 mg CC + 2.5 mg Letrozole) significantly improved ovulation (OR 4.45, 95% CI [2.19, 9.08], P < 0.001), whereas higher-dose therapy (100 mg CC + 5 mg Letrozole) had no effect. Pregnancy rates were higher with combination therapy (26.25% vs. 22.18%) but not significant (OR 1.26, 95% CI [0.84-1.88], P = 0.26). Miscarriage rates were lower (OR 0.32, 95% CI [0.12-0.88], P = 0.03). Lower-dose combination therapy also increased the proportion of follicles > 15 mm (OR 4.09, 95% CI [1.94, 8.60], P < 0.001), with no significant differences in endometrial thickness, follicular size, or progesterone levels. Side effects were similar, though hot flushes were more common with combination therapy (OR 2.99, 95% CI [1.23, 7.23], P = 0.02). Our results support lower-dose combination therapy for improved ovulation, follicle count, and pregnancy outcomes while reducing miscarriage risk.
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Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.