ArticleClinical and experimental reproductive medicine2026
Comparative study of two ovulation induction therapies and laparoscopic ovarian drilling on clinical outcomes in women with clomiphene citrate-resistant polycystic ovary syndrome.
Article in Clinical and experimental reproductive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06486870 (Comparative Study Between Two Ovulation Induction Therapies and Laparoscopic Ovarian Drilling on Clinical Outcomes in Clomiphene Citrate-Resistant PCOS Women), which is not on this map. Not yet cited in PubMed.
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Comparative Study Between Two Ovulation Induction Therapies and Laparoscopic Ovarian Drilling on Clinical Outcomes in Clomiphene Citrate-Resistant PCOS Women
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5 authors.
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Abstract
objectiveClomiphene citrate (CC) is the first-line treatment for ovulation induction in women with polycystic ovary syndrome (PCOS), yet a substantial proportion exhibit CC resistance. This study compares clinical outcomes following treatment with gonadotropins, letrozole, or unilateral laparoscopic ovarian drilling (LOD) in women with CC-resistant PCOS.
methodsIn this prospective, randomized clinical trial conducted at the infertility clinic of the Maternity Hospital from May 2021 to May 2024 (Clinical Trial No. NCT06486870), 183 middle-aged, anovulatory infertile women with CC-resistant PCOS, diagnosed using the Rotterdam criteria, were included. Participants were randomly assigned to one of three groups: letrozole (n=61), gonadotropins (n=61), or unilateral LOD (n=61). The primary outcome was the cumulative pregnancy rate over 6 months. Statistical analyses were performed using IBM SPSS Statistics ver. 24.
resultsBaseline demographics were comparable across groups. The gonadotropin-treated cohort achieved the highest cumulative pregnancy rate (41%), followed by letrozole (32.8%) and LOD (18%). Gonadotropin therapy also yielded the highest ovulation rate and the lowest incidence of oligo/amenorrhea. In contrast, LOD produced greater reductions in luteinizing hormone, anti-Müllerian hormone, and antral follicle count, and more patients attained menstrual regularity. Although LOD was associated with a lower pregnancy rate, it conferred a reduced risk of multiple gestations and ovarian hyperstimulation syndrome (OHSS).
conclusionGonadotropins and letrozole are more effective than unilateral LOD for inducing ovulation and achieving pregnancy in women with CC-resistant PCOS. Nevertheless, LOD remains a viable alternative, offering the advantage of lower rates of multiple pregnancy and OHSS.
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