Evidence mapPaperPMID 41428720Full record

SynthesisJBRA assisted reproduction2026

Comparative Outcomes of Letrozole Versus Clomiphene Citrate for Ovulation Induction in Patients With PCOS: Systematic Review and Meta-Analysis.

Katherine Ann Reimão Miller, Gabriel Monteiro Pinheiro

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in JBRA assisted reproduction, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Katherine Ann Reimão MillerMedical Student, University of Santo Amaro, São Paulo, Brazil.
Gabriel Monteiro PinheiroMD, Department of Obstetrics and Gynecology, University of Santo Amaro, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to synthesize available high-quality randomized controlled trials (RCTs) comparing reproductive outcomes between letrozole (LE) and clomiphene citrate (CC) for ovulation induction in women with PCOS.

methodsFollowing PRISMA guidelines, this review was registered in PROSPERO (CRD420251013416). A comprehensive search was conducted in PubMed, Cochrane Library, Elsevier, the National Library of Medicine, and Google Scholar up to March 2025. A total of 32 RCTs were included. Statistical analysis used a random-effects model to calculate risk ratios (RR) with 95% confidence intervals (CI), as determined using Review Manager. Heterogeneity was assessed with the I2 statistic. The risk of bias was evaluated using the ROB 2 tool. The primary outcome was ovulation rate; secondary outcomes included pregnancy, live birth, miscarriage, and multiple pregnancy rates.

resultsLE showed higher ovulation (RR: 1.18; 95% CI: 1.11-1.25; I2: 57%) and pregnancy rates (RR: 1.57; 95% CI: 1.39-1.76; I2: 21%) compared to CC. LE also had a higher live birth rate (RR: 1.54; 95% CI: 1.24-1.91; I2: 35%). Miscarriage rates were similar between groups (RR: 0.97; 95% CI: 0.73-1.28; I2: 0%). The multiple pregnancy rate was significantly lower in the LE group (RR: 0.42; 95% CI: 0.18-0.98; I2: 0%).

conclusionsLetrozole shows greater effectiveness than clomiphene citrate for ovulation induction in women with PCOS, with a lower risk of multiple pregnancy and similar miscarriage risk. These findings support its use as a first-line treatment in clinical practice.

Indexed as

ClomipheneFertility Agents, FemaleLetrozoleOvulation InductionPolycystic Ovary SyndromeFemaleHumansInfertility, FemalePregnancyPregnancy RateRandomized Controlled Trials as TopicClomipheneFertility Agents, FemaleLetrozoleclomiphene citrateinfertilityletrozoleovulation inductionPCOSpolycystic ovary syndrome

Identifiers

PMID41428720
PMCPMC13055185

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.